Background: Congenital malformations (CM) are significant causes of childhood morbidity and mortality impacting negatively on the affected family’s emotional and financial life. It also results in an enormous burden on a nation’s health and socio-economic systems. However, few studies on CM have emanated from developing countries including Nigeria and specifically from Yenagoa, Bayelsa State which is located in the oil rich Niger Delta region. We therefore analyzed the prevalence, pattern and outcome of management of babies with CM seen at the Neonatal unit (SCBU) of the Federal Medical Centre, Yenagoa. This could be used as evidence for policy makers to develop and implement CM surveillance, prevention and supportive programs. Methods: This was a descriptive observational study of all neonates with CM admitted into the Special Care Baby Unit (SCBU) over a one year period from 1st February 2017 to 31st January 2018. Identification and confirmation of congenital anomalies was done by physical examination, diagnostic investigations and surgical interventions. The conditions were classified organ and system-wise except for the chromosomal abnormalities. The prevalence and pattern of defects were determined, while factors related to the outcome of the anomalies were calculated with odds ratio and 95% confidence interval. Data entry and analysis were performed using excel and SPSS version 22. Results: Among the 502 newborn admissions during the study period, congenital anomalies were found in 61 newborns, giving a prevalence rate of 12.2% with a female preponderance of 55.7%. The commonest CM were those related to the cardiovascular system (47.5%) followed by the digestive system (32.8%) then musculoskeletal system (19.7%). The mean duration of care was 9.7± 9.0 days with mortality of 30.5% recorded at that period. Babies with CM affecting the cardiovascular system and chromosomal anomalies were less likely to survive although these relationships were not statistically significant (p > 0.05). However, duration of care showed a statistically significant relationship with outcome as babies who spent one day and less in the neonatal unit  had  reduced odds of a favourable outcome (OR – 0.07). An increased odd of survival (OR – 2.09) was seen in babies with only one congenital birth defect. Conclusion: A high prevalence of Congenital malformations in newborns was demonstrated in this study. This has highlighted the need for a well-designed surveillance, prevention and supportive hospital, State and National programme for affected babies and their families.

Caregiver satisfaction has the potential to promote equity for children living with HIV, by influencing health-seeking behaviour. We measured dimensions of caregiver satisfaction with paediatric HIV treatment in Nigeria, and discuss its implications for equity by conducting facility-based exit interviews for caregivers of children receiving antiretroviral therapy in 20 purposively selected facilities within 5 geopolitical zones. Descriptive analysis and factor analysis were performed. Due to the hierarchical nature of the data, multilevel regression modelling was performed to investigate relationships between satisfaction factors and socio-demographic variables. Of 1550 caregivers interviewed, 63% (95% CI: 60.6–65.4) reported being very satisfied overall; however, satisfaction varied in some dimensions: only 55.6% (53.1–58.1) of caregivers could talk privately with health workers, 56.9% (54.4–59.3) reported that queues to see health workers were too long, and 89.9% (88.4–91.4) said that some health workers did not treat patients living with HIV with sufficient respect. Based on factor analysis, two underlying factors, labelled Availability and Attitude, were identified. In multilevel regression, the satisfaction with availability of services correlated with formal employment status (p < .01), whereas caregivers receiving care in private facilities were less likely satisfied with both availability (p < .01) and attitude of health workers (p < .05). State and facility levels influenced attitudes of the health workers (p < .01), but not availability of services. We conclude that high levels of overall satisfaction among caregivers masked dissatisfaction with some aspects of services. The two underlying satisfaction factors are part of access typology critical for closing equity gaps in access to HIV treatment between adults and children, and across socio-economic groups.

Background: The aim of this study was to investigate the echocardiographic findings of stable HIV positive children on Highly Active Anti-retroviral Therapy (HAART) attending routine Paediatric Infectious disease clinics in the Niger Delta region of Nigeria. Methods: Over a 3 month period (1st October to 31st December 2019) 71 apparently stable HIV positive children who had been on HAART for at least 3 months had a transthoracic echocardiogram done after written informed consent. A proforma containing their clinical and socioeconomic information and the echocardiographic findings was filled. Data was entered into an Excel spread sheet and analysed using SPSS 22.0. Results: Among the 71 children studied, 34 (47.89%) were aged 6 – 10 years, 42 (59.15%) were females while 15 (26.01%) belonged to social class 3. Of the 71 participants studied, forty-four (61.97%) had abnormal echocardiographic findings on echocardiogram. Mild pulmonary regurgitation was the commonest finding and occurred in 32 (45.07%) of the patients. This was followed by Left Ventricular diastolic dysfunction (LVDD) which occurred in 9 (12.68%) patients, while Left Ventricular systolic dysfunction (LVSD) and Congenital heart defects occurred in 6 (8.45%) subjects each. There was no significant association between occurrence of echocardiographic findings and age, gender, duration of HIV disease, type of HAART and stage of disease at diagnosis and at the time of the study (p<0.05). Conclusion: This study shows that mild pulmonary regurgitation is the commonest echocardiographic finding among stable HIV patients followed by left ventricular dysfunction. Routine baseline and intermittent echocardiography are recommended for initial evaluation and continued care for early detection and quick intervention of cardiac diseases of children with HIV disease.

This report is on holoprosencephaly (HPE) sequence with other clinical and radiographic anomalies of other organs. This condition which has never been reported in Yenagoa, an oil rich Niger Delta Region was observed simultaneously in two neonates within a period of two months at different hospitals in this area. The inhabitants who include pregnant mothers with their fetuses are predisposed to health challenges associated with the exposure to toxic chemicals derived from environmental degradation and pollution due to oil spillage/processing. This report is therefore aimed at providing a description of HPE associated with varying multi-systemic conditions in order to motivate researches on prevalence of congenital anomalies and induce support in ensuring appropriate health care services. The approach to clinical evaluation and experience on diagnostic evidence is discussed. The importance of karyotyping which could not be carried out cannot be overlooked. However, the clinical and radiological

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