Paediatrics- Scholarly Publications

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    Open Access
    Duration of diabetes and glycemic control: impact on echocardiography findings in children and young adults with diabetes mellitus in Lagos
    (Springer, 2013) Adeniyi, O.F.; Oduwole, A.O.; Okoromah, C.A.N.; Ekure, E.; Fajolu, I.B.; Ladapo, T.A.
    The influence of disease duration and glycemic control on cardiac function in type 1 diabetes mellitus (T1DM) patients remains controversial. There is little data on young patients in the Sub-Saharan continent. The aim of this study was to determine the effect of disease duration and glycemic control on the cardiac function of children and adolescents with diabetes using echocardiography. In this cross sectional study, 26 T1DM subjects and 33 matched controls had conventional echocardiography done. The relationship between their cardiac parameters, disease duration and glycated hemoglobin (HbA1c) level was assessed with correlation and regression analysis. Five (19.2 %) subjects had evidence of abnormal fractional shortening. There was no significant difference in systolic function between the diabetics and controls. The isovolumic relaxation time and Deceleration time were significantly prolonged in the diabetics (P = 0.034, P = 0.001 respectively). There was a significant correlation between disease duration and end diastolic diameter (EDD) (P = 0.000) and Left ventricular mass (P = 0.000). Disease duration was also an independent predictor of EDD (P = 0.007), even after adjusting for age, body mass index and mean arterial pressure. There were no significant correlations between HbA1c and measures of cardiac structure or function. The right ventricular diastolic function was poorer in the T1DM subjects compared to the controls. Thus, the disease duration independently predicts left ventricular enlargement in this population of Sub-Saharan youths (who have relatively poor glycemic control.
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    Open Access
    Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020
    (BMJ, 2021) Ademola-Popoola, D.S; Fajolu, I.B; Gilbert, C; Olusanya, B.A; Onakpoya, O.H; Ezisi, C.N; Musa, K.O; Chan, R.V.P; Okeigbemen, V.W; Muhammad, R.C; Malik, A.N.J; Adio, A.O; Bodunde, O.T; Rafindadi, A.L; Oluleye, T.S; Tongo, O.O; Badmus, S.A; Adebara, O.V; Padhi, T.R; Ezenwa, B.N; Obajolowo, T.S; Olokoba, L.B; Olatunji, V.A; Babalola, Y.O; Ugalahi, M.O; Adenekan, A; Adesiyun, O.O; Sahoo, J; Miller, M.T; Uhumwangho, O.M; Olagbenro, A.S; Adejuyigbe, E.A; Ezeaka, C.V.C; Mokuolu, O; Ogunlesi, T.A; Ogunfowora, O.B; Abdulkadir, I; Abdullahi, F.L; Fabiyi, A.T; Hassan, L.H.L; Baiyeroju, A.M; Opara, P.I; Oladigbolu, K; Eneh, A.U; Fiebai, B.E; Mahmud-Ajeigbe, F.A; Peter, E.N; Abdullahi, H.S
    Objectives: Retinopathy of prematurity (ROP) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for ROP between 2017 and 2020 as well as the outcome of these activities in Nigeria. Design: Descriptive case study. Setting: Neonatal intensive care units in Nigeria. Participants: Staff providing services for ROP, and 723 preterm infants screened for ROP who fulfilled screening criteria (gestational age <34 weeks or birth weight ≤2000 g, or sickness criteria). Methods and analysis: A WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity-building, national and international collaborative activities between 2017 and 2018. A national protocol for ROP was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017-2018 and to assess challenges in service provision. Results: In 2017 only six of the 84 public neonatal units in Nigeria provided ROP services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any ROP; and 29 (22.8%) developed type 1 ROP. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challenges included lack of equipment to regulate oxygen and to document and treat ROP, and lack of data systems. Conclusion: ROP screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and ROP treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential.
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    Open Access
    Perspectives on simulation-based training from paediatric healthcare providers in Nigeria: a national survey
    (BMJ, 2020) Umoren, R; Ezeaka, V.C; Fajolu, I.B; Ezenwa, B.N; Akintan, P.N; Chukwu, E; Spiekerman, C
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    Open Access
    Burden of disease and risk factors for mortality amongst hospitalized newborns in Nigeria and Kenya.
    (PLOS ONE, 2021) Nabwera, H. M; Wang, D; Tongo, O.O; Andang'o, P.E.A; Abdulkadir, I; Ezeaka, C.V; Ezenwa, B.N; Fajolu, I.B; Imam, Z.O; Mwangome, M.K; Umoru, D.D; Akindolire, A.E; Otieno, W; Nalwa, G.M; Talbert, A.W; Abubakar, I; Embleton, N.D; Allen, S.J; Neonatal Nutrition Network, (NeoNuNet)
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    Open Access
    Congenital heart defects in orofacial cleft: A prospective cohort study
    (Medknow publications, 2021-10) Erinoso, O. A.; James, O.; Sokunbi, O. J.; Adamson, O. O.; Adekunle, A.A.; Agbogidi, O. F.; Ogunlewe, A. O.; Ekure, E. N.; Adeyemo, W.L. ; Ladeinde, A. L.; Ogunlewe, O. M.
    Background: Congenital heart defects (CHDs) are one of the most common associated anomalies in patients with an orofacial cleft (OFC). However, few studies have shown the association between cleft type and CHDs in our population. This study aimed to assess the prevalence of CHDs in a cohort of OFC patients at a tertiary health facility in Nigeria, as well as assess the risk of CHD by OFC type. Materials and methods: This was a prospective study design. Patients with an OFC were consecutively enrolled at a single OFC treatment facility. All subjects were assessed by a paediatric cardiologist and had echocardiography done. They were categorised based on the presence of CHDs, as well as the OFC phenotypic type (cleft lip and/or alveolus, cleft lip and palate and cleft palate only). Statistical analysis was done using STATA version 14 (College Station, Texas), and significance was set at P < 0.05. Results: A total of 150 subjects enrolled in the study over a period of 2 years (2018-2020). The median age of subjects was 6 months (interquartile range: 2-24), and 54.7% were female. The prevalence of CHDs in the subjects reviewed was 30.7%. Based on the severity of CHDs, the majority presented with simple defects (95.6%). Overall, the most common presentation was patent foramen ovale (12.7%), followed by septal defects (8.0%). There was no significant association between cleft type and the odds of a CHD. Conclusion: The study reports a relatively high prevalence of CHDs in patients with OFC; however, there was no association between the risk of CHD by cleft type. Although a majority of CHDs may pose a low operative risk, cardiac evaluation is recommended for all cases of OFC to aid the identification of potentially high-risk cases.