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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Recent studies have shown that sunlight-induced immunosuppression negatively alters the skin response to mantoux test. This study aimed to compare the response of the skin to mantoux test over the volar forearm surface, the traditional site, which is exposed to sunlight and the inner thigh, an area which is not. In all, 45 children had the mantoux test administered using 0.1 mL of 5TU purified protein derivative. Reactive induration to the mantoux test was recorded in five of these children. The average induration of the volar surface was 8.2 mm, while that at the inner thigh was 11.6 mm. The results have highlighted the potential of an enhanced mantoux test result, if parts of the body that are not exposed to high doses of ultraviolet light are used as the site for mantoux test.

SummaryIn Nigeria, as part of the National Programme on Immunization (NPI), BCG should be given at birth. A survey of the ages at which mothers bring their children for BCG vaccination showed that only 22% of children receive their BCG within the first 3 days of life and 36.2% within the first 7 days of life. The place of birth and whether a child was sick enough at birth to require hospital admission appears to be an important factor affecting the age at BCG administration Introduction.

Objectives Cesarean section is the most common obstetric surgical procedure, with associated risks for adverse neonatal outcomes. The interplay of perinatal factors associated with neonatal admissions following cesarean delivery remains poorly understood in developing countries. We examined how perinatal and facility-based factors affect Neonatal Intensive Care Unit (NICU) admission after cesarean delivery in northern Nigeria. Methods A prospective cohort study involving 200 women undergoing cesarean section were consecutively enrolled with subsequent follow-up of their infants in the post-natal period. Data were abstracted from the medical record using an interviewer-administered questionnaire. The primary outcomes were NICU admission and intrauterine or early neonatal deaths. Binary logistic regression modelling was used to identify variables independently associated with the outcomes. Results Over the study period (six months), there were 200 cesarean sections. A total of 30 (15.0%) neonates were admitted into the NICU following the procedure. No stillbirths or early neonatal deaths were recorded. NICU admission was associated with gestational age (preterm vs. term [adjusted odds ratio, aOR: 18.9, 95% confidence interval (CI): 4.0–90.4]), birth weight (small vs. appropriate [aOR: 6.7, 95% CI 1.9–22.7] and large vs. appropriate birth weight [aOR: 20.3, 95% CI 2.9–143.7]) and the number of indications for cesarean section (≥2 vs. one [aOR: 0.2, 95% 0.1–0.8]). Conclusions Prematurity, small and large for gestational age neonates; and indications for cesarean section were associated with increased likelihood of neonatal admission following cesarean delivery. These findings could inform ongoing quality enhancement initiatives to improve NICU admission outcomes at the study site, and other similar settings.