Tertiary Hospital In North-Western Nigeria Research Articles

Molecular characterization of antimicrobial resistance and virulence factors in coagulase – negative staphylococci nasal isolates among adult patients in a tertiary hospital in North-Western Nigeria

Coagulase-negative staphylococci are harmless microorganisms that can become pathogenic when the host resistance is impaired. Their ability to exhibit multidrug-resistance and form biofilm limit treatment options and contributes to the health and financial burden on health care systems worldwide. This study aimed to provide data on the acquisition and expression of genetic elements associated with resistance and virulence in the organisms from nasal colonization of adults admitted to a University Teaching Hospital in Nigeria. One hundred and twenty-three presumptive staphylococci isolates were obtained from the medical microbiology laboratory of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. The isolates were characterized, and the antibiotics susceptibility pattern assessed. Biofilm formation was evaluated by the micro-titre plate method, and polymerase chain reaction was used to detect resistance genes (mecA and ermB), virulence gene (psm-mec) and adhesin genes, (icaAB, icaC and icaD) in the isolates. Out of the 60 coagulase-negative staphylococci isolates, 50 (83.3%) were strong biofilm formers, 5 (8.3%) were moderate biofilm formers and 5 (8.3%) were weak biofilm formers. For the 14 isolates that were characterized by PCR, mecA and ermB resistance genes were detected in 78% and 71% of the isolates respectively. Twenty-one percent had psm-mec virulence gene while biofilm adhesin genes, icaAB and icaD were detected in 36% and 57% respectively, icaC gene was not detected. This study confirmed formation of biofilm, carriage of resistance and virulence genes which have been shown to play a role in pathogenesis. This study shows the necessity of the periodical monitoring of the drug resistance pattern and virulence factors of coagulase-negative staphylococci.

A survey of knowledge, attitude, and practice of oral hygiene amongst healthcare workers at a tertiary hospital in Northwestern Nigeria

The overall well-being of an individual cannot be complete without adequate oral health since the oral cavity is the gateway to the whole body and an integral part of the Gastrointestinal Tract (GIT). Many systemic illnesses manifest in the oral cavity and can be diagnosed easily by its simple clinical examination. The involvement of other healthcare workers in the hospital, such as medical doctors, nurses, and laboratory scientists, for effective and efficient dissemination of oral health education to the general populace, is of paramount importance by virtue of the large number of patients they come in contact with in their daily practice. However, this could not be arbitrarily assumed without calibrating their knowledge, perception, and practice of oral health to ascertain if they can truly impart positively to the patients. This study determined the knowledge, attitude, and practice of oral hygiene amongst healthcare workers at the Federal Medical Centre Gusau, northwestern Nigeria. A descriptive cross-sectional study was conducted amongst healthcare workers in Federal Medical Centre Gusau, Zamfara State, Nigeria. A total of 200 self-administered questionnaires were distributed using a convenient sampling technique. Data collected was analyzed using the Statistical Package for Social Sciences (SPSS; IBM Corp., Armonk, NY, USA) software for Windows version 25.0. Of the 200 questionnaires distributed, 193 (96.5%) were retrieved. The mean age of the participants was 37.1±8.53 years, with a range of 21 to 60 years. Study participants comprised of 114 (59.1%) males and 79 (40.1%) females. The majority (79.3%) were Muslims, while about one-fifth (20.7%) were Christians. About half (48.2%) of the participants were nurses, followed by laboratory scientists (31.1%), while medical doctors were 40 (20.7%) of the population. Slightly above half (50.8%) obtained their oral health information from oral health workers, while 58 (30.1%), 24 (12.4%), and 13 (6.7%) obtained their information from leaflets, family and friends, and newspapers, respectively. The average knowledge, attitude, and practice score amongst all the participants was good, as about 75%, 69%, and 63% answered correctly in the knowledge, attitude, and practice domains, respectively. There was a statistically significant difference between the different cadres of health workers in the attitude and practice domains tested (p<0.05). The oral health knowledge attitude and practice in the studied health workers is satisfactory. However, there are other aspects of the attitude and practice that need to be modified through continuous medical and dental education to be anchored by the Preventive Dentistry Department in conjunction with the Public Health Department of the state Ministry of Health.

Evaluation of Radiation Dose to the Thyroid Gland on Infant Patients Undergoing Anteroposterior Chest X-Ray at a Tertiary Hospital in North-Western Nigeria

The study aims at measuring the entrance surface dose (ESD) of the thyroid gland of infant patients undergoing anterior-posterior (AP) chest x-ray in Usmanu Danfodiyo University Teaching Hospital Sokoto (UDUTHS). The study further determines the effective dose to the thyroid on infant patients undergoing AP chest x-ray. Also, compare the entrance surface dose of infant patients obtained from the study with other similar studies and diagnostic reference levels (DRLs) recommended by the International Commission on Radiological Protection ICRP. This is a prospective cross-sectional study and the primary source of data was obtained. Pediatric patients used for the study who are referred to the radiology department for an anteroposterior chest x-ray, UDUTH, Sokoto state, Nigeria. A non-probability sampling technique was adopted for the patient who came in for a chest x-ray (AP) and as recommended by ICRP that a minimum of 10 patients should be used to determine the ESD for each projection, therefore 15 patients were adopted for this study. The result of the ESD obtained for the thyroid on infant patients undergoing chest x-ray (AP) was averaged and the mean of the ESD was 1.38 mGy. This result was compared to similar studies done within the country and outside the country and with the European Commission on radiological protection as seen in Table 6 and Figure 3. The ESD obtained in this study is much higher than those obtained in similar studies as well as the recommended Diagnostic Reference Levels (DRLs). The method adopted in the study was recommended by the international commission on radiological protection, as a result of this, comparisons were reliably made with the reference values and similar studies. The result has shown that entrance surface doses and radiation doses to the thyroid exceed the permissible value in Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto.

Colorectal carcinoma in a tertiary hospital in North-western Nigeria: a histopathologic retrospective review

Colorectal Carcinoma (CRC) accounts for about 3.9% of all malignant lesions in human beings with several studies identifying it as the most common gastrointestinal malignancy. It was previously considered to be more common in developed nations of the world but recent studies have reported increasing trends in developing nations. The study was done on all cases of colorectal carcinomas diagnosed between 1st January 2001 and 31st December 2010 in the Department of Histopathology of a tertiary institution. The laboratory request forms and the duplicate copies of histology reports were retrieved for extraction of relevant clinical information like age, sex, anatomical sites of the lesions and clinical presentations. Histological diagnoses and grading were also extracted. Corresponding haematoxylin and eosin-stained slides were retrieved and evaluated. Special stains were carried out where necessary. The lesions were classified according to the World Health Organization (WHO) histological variants and tables and figures were used to illustrate the results. A total of 186 cases of colorectal carcinoma were diagnosed during the period, representing 3.9% of the total malignant tumors and 50.4% of the gastro-intestinal malignancies. One hundred and ten cases (59.1%) and 76 cases (40.9%) were in males and females respectively with a male:female ratio of 1.46:1. The age range was from 17-87 years with a mean of 42.8 years and peaked at 61-70 years. Site distribution showed rectosigmoid lesions accounted for 64.5%, caecum, ascending colon, transverse and descending colons accounted for 9.1%, 3.8% and 2.2% each respectively. Most of the cases were adenocarcinoma (71.0%), followed by mucinous carcinoma (23.7%) and signetring cell carcinoma (3.8%). Colorectal carcinoma is prevalent in our environment and is the commonest malignant gastro-intestinal tumors. There is a slight male preponderance with adenocarcinoma the commonest lesion and rectosigmoid as the most common site.

A Two-Phase Survey of Psychiatric Morbidity among Females with Infertility in a Tertiary Hospital in North-Western Nigeria

ABSTRACT Background: The inability of couples to conceive or infertility has been identified as a major source of psychiatric morbidity. In several studies in sub-Saharan Africa, the psychological burden, often higher among females, is mostly assessed through screening measures and hardly by diagnostic instruments. This study evaluated the prevalence and clinical pattern of psychiatric morbidity among adult female patients attending Aminu Kano Teaching Hospital (AKTH) infertility clinic using the two-phase survey method. Methods: In the first phase, 281 respondents were assessed using sociodemographic, clinical, and the 12-item General Health Questionnaire (GHQ-12). The second phase was by using the World Health Organization Schedule for Clinical Assessment in Neuropsychiatry (SCAN) to interview all probable cases on the GHI-12 with a score of 3 or more, and 10% of non-cases. Psychiatric diagnosis was made in accordance with the diagnostic criteria of the 10th edition of the International Classification of Diseases (ICD-10). Results: The point prevalence of psychiatric morbidity in this study was 29.2% with a weighted prevalence rate of 64.8% projected onto the infertile population seeking medical help within the 3-month study period. Depression (21%) was the most occurring diagnosis. Generalized Anxiety Disorder and Somatisation were diagnosed in 6% and 2% respectively. There was a significant relationship between psychiatric morbidity and age, educational status, religion, and the duration of marriage (p<0.05). Conclusion: About one-third of infertile women in this study had psychiatric morbidity with depression being the most prevalent diagnosis. Psychiatric morbidity was significantly associated with increasing age, high educational attainment, religion and longer duration of marriage. The study demonstrated the need to include Consultation-Liaison Mental Health Practitioners in the management of women with infertility in order to meet their unmet mental health needs.

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Challenges of contact tracing during COVID-19 pandemic response in a tertiary hospital in Northwestern Nigeria

Abstract Background: Contact tracing is a traditional pillar of infectious disease control, especially for illnesses involving direct transmission from person to person, such as COVID-19. Several challenges have arisen from COVID-19 contact tracing activities, particularly in low-resource settings. These include refusal of positive clients to disclose their close contacts, difficulties in conducting risk assessment for contacts traced, among others. Objectives: To explore the activities and identify challenges of contact tracing during COVID -19 pandemic response in a tertiary hospital in Northwestern Nigeria from May, 2020 to March, 2021. Methodology: A mixed method approach was done with quantitative secondary data analysis of COVID-19 contacts traced, and qualitative assessment through Key Informant Interviews (KII) of Ahmadu Bello University Teaching Hospital staff involved in COVID-19 outbreak response during the period. Results: A total of 2,249 clients were tested for COVID-19, of which 925 (41.1%) were healthcare workers. The identified challenges included problems with contact identification, delay in notification of results, refusal to disclose contacts by cases, contacts refusing to allow risk assessment, and health workers being overwhelmed by the task of contact tracing. Conclusion: Challenges identified include refusal of cases to disclose their contacts, overwhelming number of contacts, and delay in notification of results. There is need to institute contact tracing protocols to mandate cases to disclose their contacts, train more manpower to reduce the burden of contact tracing, and improve the notification of results.

Development and reliability testing of a cervical cancer patients knowledge and practice of self-care management of treatment-related adverse events questionnaire.

Cervical cancer (CC) treatment-related adverse events (AEs) were found to be among the major reasons for treatments delays and medication non-adherence. Knowledge and practice of self-care management of these AEs are therefore needed to complement the pharmacotherapeutic interventions. Instruments for assessing CC patients' knowledge and practice of self-care management of treatment-related Adverse Events (AEs) are lacking. Hence, the rational for this study. A prospective, cross-sectional study was conducted on CC patients receiving chemotherapy, radiotherapy or both, with or without surgery in Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, a tertiary hospital in North-Western Nigeria. A panel of 14 experts judged the content validity of the items initially selected. Purposive sampling technique was used, 31 CC patients were recruited and interviewed for the questionnaire pre-testing. Descriptive statistics and psychometric analysis were conducted using SPSS Version 20.0 for Windows. A Cronbach's alpha coefficient ≥0.70 was considered acceptable. A 12-domain questionnaire instrument was developed. Eight (57.1%) of the expert panelists rated the questions' items as "Very good for the study" and none of them rated any of the content "not relevant for the study". The reliability studies showed that the overall knowledge and practice questions response rates were 71.0% and 77.4% and Cronbach's alpha (α) values were 0.956 and 0.913, respectively. A reliable, 12-domain cervical cancer patients' knowledge and practice of self-care management of treatment-related adverse events questionnaire was developed. Further research on the psychometric qualities of the instrument is needed.

Correlates of Depression among Elderly Patients Attending the General Out-Patient Department of a Tertiary Hospital in Northwestern Nigeria

Background: Depression is a common mental health problem in the geriatric population associated with significant morbidity (including decreased physical, cognitive and social functioning) and mortality. Although patients differ in their presentations, certain social and demographic characteristics are common to the elderly population with depression. It is hoped that identifying these patients based on their sociodemographic characteristics will help reduce the difficulties in diagnosis.
 Objective: The objective of this study is to determine the risk factors for depressive illness among elderly patients attending the GOPD of AKTH.
 Methods: This cross-sectional questionnaire-based study involved 392 elderly patients systematically selected from Family Medicine Clinic attendees in Kano, Nigeria. Data collected included sociodemographic and clinical characteristics. Geriatric Depression Scale was used to screen for depression. Chi-square test and logistic regression analysis were used to determine the association between categorical variables and predictors of depression among participants, respectively.
 Results: The prevalence of depression prevalence was 22.4%. Most participants were females aged 60-69 years (62.5%), Hausas (77.6%) and living with their spouses and children (77.3%). Gender, marital status, marital setting, socio-economic class, osteoarthritis and body-mass index were associated with depression. The predictors of depression were female gender (p=0.014, OR=1.401, CI=1.757- 2.591), widows/widowers (p=0.030, OR=4.533, CI= 1.186-17.317) and obesity (p=0.001, OR=5.644, CI=2.759-11.544).
 Conclusion: The high prevalence of depression among this population highlights the need for screening. Females, widows/ widowers and obese geriatric patients are more likely to be depressed and should be targeted for screening in our busy outpatient setting.
 Author
 F Damagum 1, B A Grema 1, G C Michael 1

Prescription patterns of evidence-based heart failure medications in a Tertiary Hospital in North-Western Nigeria—A retrospective study

Context: Several large clinical trials on the use of medical therapy in the management of heart failure have shown angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), beta blockers (BBs), and mineralocorticoid receptor antagonists (MRAs) to be of proven benefit and are recommended by guidelines. Aim: The aim of this study is to describe the trend of prescription and dosing of evidence-based medications used for chronic heart failure (CHF) in our population. Settings and Design: This is a retrospective study on the pattern of prescription of evidence-based heart failure medications on 200 consecutive patients with CHF who attended the cardiology clinic or were admitted into the Medical wards from January 2020 to December 2020 at Murtala Muhammed Specialist Hospital, Kano, North-Western Nigeria. The data was obtained from patients' records. Statistical Analytics Used: Data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 23 software. (SPSS Inc. Illinois, USA). Results: ACE inhibitors or ARBs were prescribed in 89 (44.5%), BBs in 76 (38%), and MRAs, in 192 (96%). None of the patients were prescribed angiotensin receptor-neprilysin inhibitors (ARNi) or sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors). Conclusion: Evidence-based heart failure medications are underutilized in patients with CHF in our population. Improved uptake and up-titration are needed for better patients' outcomes.

Spectrum and Management of Urological Emergencies at Tertiary Hospital in Northwestern Nigeria

Spectrum and Management of Urological Emergencies at Tertiary Hospital in Northwestern Nigeria

P–683 Correlation of vitamin D deficiency with anti-Mullerian hormone (AMH) among infertile women in comparison to fertile women in a tertiary health facility in North-Western Nigeria

Abstract Study question is there correlation between Vitamin D Deficiency and AMH levels in infertile and fertile women? Summary answer there is no significant correlation between Vitamin D deficiency and AMH levels in both infertile and fertile women What is known already Vitamin D deficiency and insufficiency is a global health problem affecting over a billion people with higher prevalence among reproductive-age women, and blacks. Vitamin D is well known to play significant role in calcium-phosphate homeostasis and bone metabolism, however, recent studies have demonstrated diverse expression of vitamin D receptors in reproductive organs. This suggest the probable role of vitamin D in reproductive physiology and fertility. The pathogenesis of vitamin D in infertility is poorly understood, but thought to involve hypothalamo-pituitary axis, ovarian folliculogenesis and uterine implantation. Most studies are done in Assisted Reproduction Technology and in developed countries Study design, size, duration A case-control study that involved 128 consecutively consenting women within the reproductive age group; 64 infertile women as the cases and 64 age and body mass index (BMI) matched fertile women as the controls. The study was conducted over a period of six (6) months Participants/materials, setting, methods The study was conducted in Obstetrics and Gynaecology and Chemical pathology departments of Ahmadu Bello University Teaching Hospital Zaria, a tertiary hospital in North-Western Nigeria. It involved all cases of female-factor infertility as cases, while the controls were fertile women from 6 weeks postpartum to 1 year. Venous blood samples were assayed for serum 25(-hydroxy) vitamin D and AMH levels using Enzyme-Linked Immunosorbent Assay (ELISA) and data analysed with level of significance set as < 0.05 Main results and the role of chance The mean ± standard deviation (SD) of serum Vitamin D levels in the infertile women and fertile women were 17.01 ± 7.61ng/ml and 11.34 ± 6.12ng/ml respectively, significantly higher in the infertile women (p-value <0.000). The prevalence of Vitamin D deficiency (<20ng/ml) was found to be significantly higher in the fertile women compared to infertile women (89.1% versus 68.8%; p-value 0.007). Vitamin D levels were found to be positively correlated with age (r 0.374; p-value 0.002) and parity (r 0.338; p-value 0.006). There was no association between vitamin D with type of, and causes of infertility. Vitamin D deficient women were found to be 6.5 times less likely to be infertile than non-deficient women (aOR 95% confidence interval 1.96–21.55; p-value 0.002). There was no significant correlation between vitamin D and AMH levels in vitamin D deficient women of both study groups (rs 0.180; p-value 0.242 and rs 0.088; p-value 0.521). Interestingly, there was significant relationship between AMH levels and causes of infertility (p-value 0.001), with higher levels of AMH found in infertile women with polycystic ovarian syndrome Limitations, reasons for caution There is no consensus on the cut-off values for vitamin D levels as it relates to fertility, and no reference values for vitamin D deficiency and AMH levels in study area. The sample size was limited by cost, and the study was conducted in a single study area Wider implications of the findings: The vitamin D levels in women with infertility was low but yet not significantly correlated with AMH. Overall, prevalence of vitamin D deficiency among reproductive-age women was found high. There is need for life-style and dietary modifications. Further researches are needed to ascertain the effect of vitamin D on fertility. Trial registration number Not applicable

Management of peno-scrotal wound defects in a tertiary hospital in North-Western Nigeria: a 20-year retrospective review

BackgroundFournier’s gangrene and trauma to the external genitalia are the commonest causes of peno-scrotal wound defects in our environment. The management of these patients includes initial resuscitation and subsequent wound care with or without wound cover. The aim of this study is to document our experience in the management of peno-scrotal defects in a tertiary hospital of North-Western Nigeria.MethodsThis is a 20-year retrospective study of patients managed for peno-scrotal wound defects by the Urology Unit in the Department of Surgery of our hospital from January 2001 to December 2019. Data were collected from the patients’ case notes and entered into a proforma. Data were analysed using SPSS version 25.0.ResultsA total number of 54 patients with peno-scrotal wound defects were managed within the study period with the mean age of 46.27 ± 22.09 years and a range of six weeks to 107 years. The wound defects were sequelae of Fournier’s gangrene in 42 patients (77.8%) and traumatic in 12 patients (22.2%). Healing by secondary intention was achieved in 20 patients (37.0%). Direct closure was done in 17 patients (31.5%), skin graft in nine patients (16.7%), and advancement flap in eight patients (14.8%) depending on the location and size of the defects. Fourteen patients (26.0%) developed surgical site infection ± wound dehiscence and partial graft loss. The complication rate was higher in post-Fournier’s gangrene wound defects, but without statistical significance (p = 0.018).ConclusionFournier’s gangrene and trauma to the external genitalia are the commonest causes of peno-scrotal wound defects in our environment. Smaller wound defects were healed by secondary intention, while larger defects required either direct closure or the use of advancement flap or skin grafting depending on the location and size of the wound. The study reported a higher post-repair complication in patients that had Fournier’s gangrene.

Disclosure of human immune deficiency virus status to infected children at a tertiary hospital in North-western Nigeria

Background: With the advent of highly active anti-retroviral therapy, human immunodeficiency virus (HIV)-infected children are surviving into adolescence and adulthood. Disclosure of HIV-positive status is important for the life-long management of HIV. However, disclosing HIV-positive status is a challenging task due to the associated blame, shame, and potential stigma. Aim: The aim of this study is to assess the prevalence of disclosure to HIV-infected children and associated factors in a tertiary hospital in North-west Nigeria. Materials and Methods: A descriptive, cross-sectional study was carried out. Fifty-two parents/caregivers were interviewed using a pretested interviewer-administered questionnaire. The questionnaire had three sections: sociodemographic characteristics of caregivers, child's profile, and determinants of disclosure of HIV status. Data were collected and analyzed using the Statistical Package for the Social Sciences (SPSS) software version 21, and results were presented using the tables. The Chi-square test was used to test for the association. Fisher's exact test was used where conditions for the Chi-square test were not met. P < 0.05 was statistically significant. Results: The prevalence of disclosure of HIV-positive status to HIV-infected children was 32.7%. Children's age (P = 0.003) and their level of education (P = <0.001) had significant associations with the disclosure. The most common (9, 52.9%) reason given for disclosure was persistent questioning of caregivers about reasons for taking medication despite not being ill. Conclusion: The prevalence of HIV status disclosure to HIV-positive children was low in this study. Health-care workers can provide support to encourage and better prepare parents/caregivers for the process of disclosure.

Diabetes-related knowledge, attitude, and practice among outpatients of a tertiary hospital in North-western Nigeria.

Introduction:One of the challenges facing the management of diabetes is the misconception and inadequate knowledge about the disease. We assessed the level of diabetes-related knowledge, attitude, and practice (KAP) among patients with diabetes in North-western Nigeria.Materials and Methods:This was a hospital-based cross-sectional study. A total of 400 participants were recruited. A KAP questionnaire was used to assess the KAP of the patients. Glycated hemoglobin was used to measure the level of glucose control of the study participants.Results:The mean age of the patients was 51 years, majority being females 233 (58.3%). The mean knowledge score was 6.2 ± 3.1 points (out of 15), average attitude score was 2.5 ± 1.5 points (out of 5), and the mean practice score was 2.1 ± 1.3 points (out of 6). The level of KAP was found to be directly related to glycemic control (P < 0.01). The level of education (odds ratio [OR]: 5.0 and 95% confidence interval [CI]: 0.196–0.452) and monthly income (OR: 4.4 and 95% CI: 0.123–0.326) were found to be independent predictors of diabetes-related KAP.Conclusion:The study has demonstrated poor diabetes-related KAP. The patient's level of education and income plays a major role in the management of diabetes.

A review of presentations and outcome of severe malaria in a tertiary hospital in northwestern Nigeria

Background: Severe malaria is a major public health challenge and a leading cause of morbidity and mortality in tropical countries. Severe malaria is defined as life-threatening manifestation in the presence of asexual forms of Plasmodium falciparum in the peripheral blood; it is also caused by Plasmodium vivax and Plasmodium knowlesi. Materials and Methods: This was a 2-year point retrospective review of cases of severe malaria seen in the Emergency Pediatric Unit of Federal Medical Centre, Birnin Kudu, Jigawa state, between August and November, for each of the years 2016 and 2017. Results: Two hundred and fifty-seven cases of severe malaria were recorded during the study period: 106 (41.2%) cases in 2016 and 151 (58.8%) cases in 2017. There were 156 (60.7%) males and 101 (39.3%) females with a male-to-female ratio of 1.5:1. Their ages ranged from 0.3 to 14.0 years, with a mean age of 4.4 ± 3.6 years. Prostration was the most common form of severe disease; this was followed by multiple convulsion and severe malarial anemia. The year 2017 recorded more cases of severe malaria in all the age groups and majority of the cases were 5 years and below; and these observations were statistically significant for those with hypoglycemia (χ2 = 9.834, df = 2, P = 0.007) and hyperparasitemia (χ2 = 6.226, df = 2, P = 0.044). Majority of the subjects fitted with more than one form of severe malaria; most had two to three combinations. This observation was also statistically significant (χ2 = 12.950, df = 6, P = 0.042). Conclusion: Severe malaria remains a huge strain on the health system; prostration, multiple convulsion, and severe malaria anemia are the most common forms.

Measurements of Rates and Parameters in Newborn Babies Fit for Discharge at a Tertiary Hospital in North-Western Nigeria

Introduction: The arrival of a newborn brings a mixture of excitement and anxiety, due to a wide variation in physical and physiologic findings. Neonatal morbidity and mortality remain alarmingly high in North-western Nigeria, and failure to recognize a sick neonate that needs medical attention contributes to these dire statistics. Therefore, an understanding of the variations of newborn parameters allows health-care personnel to address families' concerns and support parents. Materials and Methods: The study was a retrospective descriptive review of birth records, of live neonates delivered at a tertiary hospital who were referred for a pediatrician's assessment and subsequently certified stable and fit for discharge. Their parameters were described, and sub-groups were compared. Results: There were 224 newborns examined, with a male:female ratio of 1:1.1. Majority (99.1%) of the babies were examined within 24 h of life, and the mode of delivery was through cesarean section in 70.1% of the newborns. Their mean gestational age was 39.3 (±1.2 standard deviation [SD]) weeks, with 37 (16.5%) late preterm and 187 (83.5%) term babies. They had birth weight 3.1 kg (±0.6 SD) and 2.6 (±0.6 SD), P = 0.0001; length 49.2 cm (±2.9 SD) and 47.0 (±3.0 SD), P = 0.017; occipitofrontal circumference 34.6 cm (±1.7SD) and 33.6 (±1.3 SD), P = 0.001; respiratory rate 52 (±12 SD) and 54 (±14 SD), cycles (cpm) P = 0.291; heart rate 141 (±13SD) and 145 (±15SD) beats (bpm), P = 0.129; for the term and late preterm babies, respectively. Conclusions: Referred newborns who were assessed and certified stable and discharged, had comparable parameters, with average respiratory rate of 51 cycles, and heart rate of 140 beats. There were no statistical differences in the vital signs between late preterm and term newborns.