53 Nigerian infants with neonatal meningitis were prospectively studied. The striking features were: (a) the higher predisposition (26.7-fold) of LBW infants to developing meningitis than has been previously reported in the literature; (b) the predominant role of E. coli and Staphylococcus aureus; and (c) the rarity of salmonella organisms and the conspicuous absence of group B streptococcus as aetiological pathogens. The outcome was related to the age of onset and type of micro-organism. The presence of neurological signs, particularly nuchal rigidity and bulging anterior fontanelle, carried a poor prognosis. The overall mortality was 37.7%.

Pioneer investigators in Nigeria have presented a gloomy picture of epilepsy as a highly infectious and disastrous disease in the eyes of the public. As a result, epileptic persons suffer untold social deprivations and discrimination in education, employment, housing, marital life, etc. These assertions have been repeated over the years more as a result of incidental observations while reviewing hospital cases than as products of attitude research on the subject. We assumed, therefore, that these statements should be considered as impressive hypotheses needing to be tested. By employing the Osgood semantic differential and the behavioral differential of Triandis, we assessed the attitude of the normal literate general public toward persons with epilepsy and "cured" psychotic patients and how closely the public would associate or socialize with these people. We also inquired into the public's opinion about the causes of epilepsy and psychosis, since this knowledge is necessary for attitude formation and change. On the whole, the general attitude toward epileptic patients is negative, and toward "cured" psychotic patients, positive. There are sex differences, in that males perceive epileptic patients more favorably than females do. However, both males and females would discriminate against both the epileptic and "cured" psychotic person in terms of employment, residential accommodation, friendship, and marital relations. The major perceived causes of epilepsy reported were heredity, witchcraft, and brain damage, in that order, not infection. About 25% admitted ignorance of the cause of epilepsy, as against 1% for psychosis. The psychoses were reportedly caused mainly by Indian hemp smoking, drug abuse, brain damage, and witchcraft, in that order.(ABSTRACT TRUNCATED AT 250 WORDS)

A prospective study of 55 infants with neonatal seizures admitted to the Special Care Baby Unit of the University of Benin Teaching Hospital over a 5.5-year period revealed that perinatal asphyxia and hypoglycemia were the principal aetiologic factors in about 71% of the cases. The most frequently encountered seizure types were unilateral clonic (51.5%). Generalized clonic and massive generalized myoclonic seizures were found in 14 (25.5%) and seven (12.7%) cases, respectively, and subtle seizures in three. The overall incidence was 3.5/1000 live births, with a preponderance of male infants in the seizure population, among whom preterm infants were significantly more common. The mortality, (34.5%) was closely related to the etiology. Since the associated adverse perinatal events are largely preventable, improved prenatal and perinatal health care delivery should lead to a decline in the frequency of neonatal seizures.

In a prospective study of high-risk newborn infants, the specificity and sensitivity of CSF/blood glucose ratio were studied in 35 newborn infants with meningitis and 100 high-risk neonates without meningitis. High CSF/blood glucose ratios of 0.93 (0.17) (Mean (S.D.) ) for preterm infants and 0.96 (0.30) (Mean (S.D.) ) for term infants were observed. The CSF/blood glucose ratios of less than 0.6 for preterm meningitic and less than 0.5 for term meningitic infants had the highest specificity (100%). The corresponding sensitivity of these ratios in the diagnosis of meningitis was 74.3% and 71.4% respectively. Similarly, an absolute CSF glucose value of less than 1.3 mmol/l in infants with meningitis was highly specific. Nevertheless, complete clinical evaluation of the infant is important if bacterial meningitis is suspected and the decision to treat should not be based on CSF glucose findings alone.

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