BACKSLIDING ON CHILDHOOD IMMUNIZATIONS DUE TO ONGOING COVID-19 PANDEMIC: A RETROSPECTIVE STUDY IN BANADIR REGION, SOMALIA.

Background: SARS-CoV-2 has resulted in a global public health crisis. During the pandemic, considerable delay was observed making it impossible for some children to receive their due vaccines on time. Like most resource-poor countries, COVID-19 pandemic is thought to have a negative impact on Somalia's immunization coverage. Materials and methods: This study aimed to assess the impact of the COVID-19 pandemic on routine childhood immunization coverage in Somalia. A retrospective comparative cross-sectional approach was employed to investigate the number of under-5-year children who got their immunization from the two major mother and child hospital, (Banadir and SOS hospitals) in Mogadishu, Somalia from October 2019 to December 2020. To do this, a total of 112, 060 data relating to the routine childhood immunization (measles, polio, whooping cough, hepatitis B, pneumonia, and tuberculosis) were collected from the monthly immunization report-data from the two hospitals. Results: The results showed that all the vaccines except birth vaccines have remarkably dropped with Penta-3 (27%), Penta-2 (11%), measles (10%) and Penta-1 (8%) respectively. However, the birth vaccines (BCG and Polio 0) were not affected as observed in this study. The reduction in children immunization rate in Somalia may be a combination of many other factors, we however recognize that the COVID-19 pandemic may have contributed significantly to this outcome . Conclusion: The government needed to take proactive measures to encourage parents to present their children for immunizations, including increasing community awareness concerning the importance of these routine childhood immunizations despite the ongoing COVID-19 pandemics.

Fatal subacute sclerosing panencephalitis in an 8-year-old male: a case report.

Subacute sclerosing panencephalitis (SSPE) is a chronic slow progressive neurodegenerative disease that is often associated with measles complications. The disease is characterized by seizures, behavioral changes, motor deficit and eventually death. In this case report we discuss the case of an 8-year-old male who developed SSPE and was presented to our hospital with a history of generalized tonic colonic convulsion followed by gait abnormality, episodes, abnormal behaviors, and cognitive regression. On clinical exploration, the child had a history of measles at 8 months of age and meningitis at 18 months. The electroencephalogram (EEG) investigation showed high amplitude spikes, with focal seizure and slowing, while the magnetic resonance imaging reveal signals synonymous with high fluid-attenuated inversion recovery (FLAIR), both of which are consistent with probable SSPE. The case was managed symptomatically; until his parents decided to take him back home, after which his condition deteriorated, and he sadly died. To the best of our knowledge, this is the first recorded case of SSPE in Mogadishu, Somalia. Hence, the need to further investigation to better understand the incidence of the disease in the population and propose better ways of managing the condition.

Investigation of severe acute respiratory syndrome coronavirus 2 antibodies among the paediatric population in Mogadishu, Somalia.

BACKGROUND: We undertook this cross-sectional study to determine the level of circulating anti-severe acute respiratory syndrome coronavirus 2 immunoglobulins (IgM and IgG) in children, as well as to evaluate other potential risk factors. METHODS: Children attending the outpatient department of the SOS and Benadir Hospitals in Mogadishu from 26 July to 8 August 2021 were selected following parental consent. The children (aged <18 y) were screened using the coronavirus disease 2019 (COVID-19) rapid test lateral flow immune-assay kit. RESULTS: Of the 500 children screened for COVID-19, 32 (6.4%) tested positive, out of which 26 (5.2%) had IgG antibodies, while five (1%) had IgM, with the other child (0.2%) having both circulating IgG and IgM antibodies. Also, 46.9% of the COVID-19-positive children were asymptomatic without any clinical signs of the disease. Children aged >6 y and those attending school were the most affected (p=0.002). The most common clinical features among positive children were fever (22.6%), cough (22.2%), shortness of breath (5.8%) and loss of smell (2.6%) and taste (2.2%). Similarly, not wearing a facemask as a preventive measure was found to be a significant risk factor (p=0.007). CONCLUSIONS: This study shows that children are at risk of contracting COVID-19 infection. Our study also shows evidence of a high rate of IgG antibodies in school-aged children having close contact with infected adults, in those not wearing facemasks, as well as in those with a family history of comorbidities.

Early perinatal outcomes of babies born to adolescent mothers at two maternity hospitals in Mogadishu, Somalia.

Background: Adolescent motherhood remains a major problem in developing countries. We set out to describe the perinatal outcomes of infants born to adolescent mothers and to determine factors associated with birth asphyxia among these infants in Mogadishu, Somalia. Methods: This cross-sectional study involved adolescent mothers who presented in labor. Sociodemographic and medical data was collected and mother-infant pairs were followed up at 24hrs. Poor perinatal outcomes were: low birth weight, birth asphyxia, death or hospitalization after 24 hours. Data was entered into Epi data 3.1 and analysed using STATA version 12.0. Results: Of the 270 adolescents, mean age was 17.7 years (±1.19), 89% were married, 94% were unemployed and 54% had not received formal education. Of the 270 babies born, 70 (25.9%) had poor perinatal outcomes which included; 35 (12.9%) died; of whom 30 (11.1%) were stillbirths. Thirty-two infants (13.3%) had birth asphyxia and 18 (6.7%) had low birth weight. Prolonged labor (p-value=<0.001) and preterm birth (p-value=0.023) were significantly associated with birth asphyxia while living in Mogadishu was protective (p- value=0.018). Conclusions: About one in four adolescent mother's babies had poor perinatal outcomes. Prolonged labor and preterm delivery and were associated with birth asphyxia while residing closer to the facilities was protective.