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Biomedical subjects

N O Bwibo

Publications and source records attributed to N O Bwibo.

At least 19 recordsLinked to original sources
PubMed2006

Early growth of very low birth weight infants.

BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth.

Anthropometry↗
PubMed2006

Two year neurological outcomes of Very Low Birth Weight infants.

BACKGROUND: High risk newborns such as the Very Low Birth Weight (VLBW) require long term follow up to ascertain their subsequent survival and quality of life (based on neurological intactness). Though such data is now standard in the developed world, little is known in published literature about the situation in resource constrained countries. OBJECTIVE: To describe the neurological outcomes of VLBW infants evaluated at two years of age. DESIGN: Longitudinal descriptive survey. SETTING: Kenyatta National Hospital's Newborn Unit during the year 2002. SUBJECTS: One hundred and twenty infants born weighing 1000 grams and 1500 grams followed up until the age of 24 months. RESULTS: Of the 120 infants evaluated, 14 (11.7%; 95% CI 6.2-17.1) had cerebral palsy, 11 (9.2%; 95% CI 4.8-16.9) were delayed on cognitive assessment while 32 (26.7%; 95% CI 9.3-38.1) were found to have functional disabilities. The factors associated with functional disability in the cohort included; neonatal illness (P = 0.005, 95% CI 1.26<2.43<4.69), exclusive use of breast milk in the first month (P = 0.02, 95% CI 1.10<2.04<3.78), neonatal weight gain less than 15 grams/kg/day (P = 0.014, 95% CI 1.13<2.24<4.42), history of re-hospitalisation (P<0.001, 95% CI 1.72<3.33<6.34) and weight less than the third percentile at two years (P = 0.019, 95%1.09<2.22<4.53). CONCLUSIONS: Neurological dysfunction was more frequent in this cohort than presently reported from other centres. The cross-tabulations indicate that history of neonatal illness, choice of early nutrition, slower growth and post discharge morbidity were associated with subsequent neurological dysfunction. The factors associated with developmental delay in this cohort should be explored further in order to determine the manipulations required in the newborn period for improvement of neurological outcomes among these high risk infants.

Breast Feeding↗
PubMed1993

Child battering in Nairobi, Kenya.

A survey of battered children was carried out at Kenyatta National Hospital, Nairobi between 1st May 1989 and 30th April 1990. Twenty eight cases were identified and compared with twenty six controls, matched for age and sex. The battered children were likely to be aged between three and four years, with slight male predominance. The abusing parents tended to live in crowded environments, were younger in age, less educated and were less likely to be practising contraception. They were relatively new migrants to Nairobi and were socially isolated. The socio-economic and cultural issues are discussed.

Adolescent↗
PubMed1989

A study of the efficacy and safety of albendazole (Zentel) in the treatment of intestinal helmenthiasis in Kenyan children less than 2 years of age.

One hundred children comprising of 57 males and 43 females aged between 8 and 24 months entered the study. 46 children had single and 54 children had multiple helminth infections. All children received albendazole 200 mg (10 ml) suspension as a single dose. Albendazole proved very effective and safe in the treatment of single and multiple helminth infections in children under 2 years of age, achieving cure rates of 100% in both Ascaris lumbricoides and Necator americanus respectively, 83% in Trichuris trichiura and 66% in Hymenolepis nana. Treatment of polyparasitism appears to be of benefit in improving nutritional status using haemoglobin concentrations as an index.

Albendazole↗
PubMed1988

Analysis of false positive HIV-1 serologic testing in Kenya.

Sera of 95 mothers and 129 children from Nairobi, Kenya, collected in 1976, and of 466 adults and 193 children of Embu District, Kenya, collected in 1984 and 1985, were analyzed for the presence of human immunodeficiency virus type 1 (HIV-1) antibodies. Although no HIV-1 seropositivity was demonstrated by western blot analysis in both study groups, 7% of Nairobi mothers and 10% of adult females from Embu District had false positive results by enzyme immunoassay (EIA) compared with less than 1% seroreactivity rates observed in adult males and children. False positive results were not due to simian T lymphotropic virus type III (STLV-IIIAGM)/human T lymphotropic virus type IV (HTLV-IV) seropositivity. Sixty-one percent of the HIV-1 EIA reactive sera could not be explained by cytotoxic activity to lymphocytes bearing the HLA-DR4 or HLA-DQw3 phenotype. We conclude that false positive HIV EIA tests are frequently encountered in East Africa. Seroprevalence rates in rural Africa must be interpreted with caution due to the decreased specificity of HIV EIAs.

Adult↗
PubMed1985

Birthweights of infants of teenage mothers in Nairobi.

Teenage pregnancies lower average birthweight. In the NBS, teenage mothers had significantly lower average birthweight of 2 920 +/- 553 g compared with 3 133 +/- 533 g among women in the general population. A high rate of LBW on the infants of the teenage mothers was the significant factor in lowering the average birthweight. In both NBS and the PMHS the incidence of LBW 18% and 15% respectively as well as the rate of preterm delivery of 24% and 23% respectively were high. In PMHS although the numbers were small, the incidence of LBW was high (13%) in the 14-year-olds and in the 15-year-olds it was 4.8% which was much lower than that for 17- and 18-year-olds. In a large series in Nigeria the incidence of LBW was 27% in mothers aged less than 15 years, 26% in mothers aged 15-19, 20% in those aged 20-24 and least (18%) in the 25-29 year age group. Many unfavourable socioeconomic circumstances and lack of adequate antenatal supervision contribute to these high rates. Some of the teenage mothers-particularly the very young, below 16 years-are physically immature and are still growing children themselves. Their nutrient intake is shared between their own growth needs and those of their foetuses. In the Nigerian study, administration of folic acid and iron together with antimalarials to pregnant mothers resulted in increased maternal height as well as foetal growth, thus stressing the importance of nutritional care for the teenage mothers.

Adolescent↗
PubMed1982

Hematopathological observations in Kenyan children with sickle cell anemia in the first decade of life.

This paper reviews clinicopathological and hematological manifestations of sickle cell anemia as seen in Kenyan children in the first decade of life. The information is based on a study of 447 patients. The findings are similar to those that are well documented from America, West Africa, and other parts of Africa. However, local variations and complications such as malnutrition and topical infections that may affect prognosis are high-lighted.

Anemia, Sickle Cell↗