Forty-two babies were found to have neural tube defects during a 3-year prospective study in a large cosmopolitan West African city. An incidence of 7/1000 deliveries was noted. The commonest defect was meningomyelocele, in 45 per cent of cases. Other defects comprised anencephaly (5 per cent), Arnold-Chiari malformation (7 per cent), encephalocele (19 per cent), occipital meningocele (14 per cent) and spina bifida occulta (10 per cent). No case of consanguinity was encountered. More defects were found among females and low birth weight infants among those whose mothers were aged between 20 and 30 years, and in mothers with parity of four and above. The commonest associated defect was talipes equinus in 15/42 (36 per cent) infants. Developmental assessments (neurological follow-up status) done at the age of 18 months on five surviving cases of meningomyelocele showed very poor development.

A study of 57 infants with neonatal seizures admitted to the Special Care Baby Unit of the Jos University Teaching Hospital over a 3-year period showed perinatal asphyxia and hypoglycaemia as the principal aetiologic factors in 47 and 19 per cent of the cases, respectively. Seizures were commoner in preterm infants, and among them outcome was also poorer. As regards aetiological factors, outcome was poorest with perinatal asphyxia; with a mean (SD) mental age of 72.5 (9.1) weeks at a chronological age of 24 months. Outcome in infants with seizures and coma was most favourably predicted by the absence of abnormal neurological signs, and the way the infant was feeding at 7-10 days. All infants who were clinically and neurologically normal and taking more than half their estimated requirements by mouth at 7 days were not handicapped. The overall incidence was 7.5/1000 live births. The mortality (19.3 per cent) was closely related to the aetiology. In view of the fact that 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.

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was found to be more common in situations where a child's HIV status was only known to the primary caregiver [7]. The findings of this study, however, were questioned because children on syrups and suspensions were excluded. Another study found similar levels of self-reported adherence in children receiving ART in Kampala, Uganda, which were comparable to the reported levels in resource-rich settings [8]. In addition, the study found that financial constraints in purchasing ARV medications were a major barrier to adherence. An earlier report also found financial constraints to be the most common reason for non-adherence among children on ART in Nigeria [9]. However, this study had a sample size of 40 children and it would be difficult to draw comparative conclusions given the small sample size. While studies of African adults showed that good adherence to ART is possible despite poor social circumstances [10-12], there are limited data on ART adherence among African children, and hence the need for the current study. To address this, our study determined the rates and factors associated

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