Institute of Child Health
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Item Pediatric head and neck malignancies in sub-Saharan Africa(2012) Adeyemo, A. A.; Okolo, C. A.Introduction: Cancers are relatively rare in children however recent reports suggest that malignancies are becoming a major source of pediatric deaths. Method: Using the database of the cancer registry of the University College Hospital, Ibadan we reviewed all newly diagnosed cases of head and neck cancers in children under 19years old at the hospital between 1981 and 2008. Results: A total of 1,021 cases of Head and Neck cancers were seen in children. The hospital based incidence of pediatric head and neck cancers is 36 cases per year. There were 627 males and 394 females [M:F ratio of 1.6:1] with mean ages of 8.21 and 7.70 years respectively. Boys were more affected than girls in all years of life while the peak age of onset for both sexes is the third year of life. The commonest anatomical site involved is the eye/orbit; other common sites were the nasopharynx, paranasal sinuses, nasal cavity and thyroid gland. Neural malignancies constitute the commonest malignancies seen (35.3%), other are lymphomas (33.1%), squamous cell carcinoma (9.1%) and soft tissue sarcoma (8.6%). Retinoblastoma is the commonest lesion seen among the patients with a slight male preponderance [M:F ratio of 1.2:1] Burkitt lymphoma (BL) is seen in all age groups but there is greater frequency in the older ages. The incidence of carcinomas is higher in the older age groups, relatively rare lesions like Hodgkins lymphoma and thyroid malignancies are almost exclusive to older children. Conclusion: The pattern of head and neck malignancies in children in sub-Saharan Africa is changing; dominant lesions like lymphomas are being gradually replaced by other malignancies such as neural malignancies, soft tissue sarcomas and squamous cell carcinomaItem Otolaryngologic lesions among human immunodeficiency virus-infected children(Indian Society of Otology, 2018) Babatunde, O. D.; Adeyemo, A. A.; Oladokun, R. E.Background Otolaryngologic (ORL) lesions are common in children. ORL lesions occur even more commonly and more severely in HIV-infected children. The few avail- able literature has reported a high prevalence in human immunodeficiency virus (HIV)- infected children; however, there are inadequate data on the impact of HIV infection on hearing and the pattern of manifestations of ORL lesions among African children. Objectives This study was conducted to describe the prevalence and manifestations of ORL lesions among HIV-infected children and controls in Nigeria. Materials and Methods A prospective comparative cross-sectional study design was adopted. Clinical evaluation was done, and hearing assessment was done using oto- acoustic emission for all participants and pure tone audiometry for participants aged s 5 years. Hearing thresholds were defined according to the World Health Organization classification. Results One hundred children were studied: 50 HIV-infected and 50 HIV-negative children. The prevalence of ORL lesions among HIV-infected children was 66%, whereas it was 46% (p = 0.044) among HIV-negative children. ORL lesions were more prevalent among children between the 18-month and 5-year age group (p = 0.003) irrespective of HIV status. The lesions that were associated with HIV infection were cervical ade- nopathy (44%, p = 0.010) and hearing loss (36%, p = 0.023). Conclusion The frequency of ORL lesions is high in HIV-infected children, but improved outcomes following use of medications may be responsible for the slight disparity in prevalence when compared with HIV-negative childrenItem Pediatric hearing thresholds post-bacterial meningitis(2020-07) Jatto, M. E.; Adeyemo, A. A.; Ogunkeyede, S. A.; Lagunju, I. A.; Nwaorgu, O. G.Introduction: Disabling hearing loss as a sequela of bacterial meningitis results from damage to the auditory system. This study was designed to ascertain the hearing thresholds in survivors of bacterial meningitis and the risk factors of hearing loss in childhood bacterial meningitis. Methodology: One hundred and two children admitted and treated for bacterial meningitis were recruited prospectively along with 102 age- and sex-matched controls who had auditory evaluation using otoacoustic emission and auditory brain stem response tests 48 h prior to hospital discharge. This was also repeated at the follow-up clinic at 1 month after hospital discharge, irrespective of the initial hearing assessment results. Result: There were 57 (55.9%) males and 45 (44.1%) females among the cases (mean age, 5.34 ± 4.40 years) and 55 (53.9%) males and 47 (46.1%) females among the controls (mean age, 5.31 ± 3.15 years). The prevalence of hearing loss was 30.4% among the cases, while it was 6.9% among the controls. The risk factors of hearing impairment in this study were the presence of anemia, leukocytosis, and hypoglycorrhachia. Conclusion: Hearing impairment with varying degrees of severity is a frequent complication of bacterial meningitis in childrenItem Audit of open pediatric tracheostomies at the university college hospital, Ibadan(2020-06) Oyelakin, O.A.; Adeyemo, A. A.Background: Tracheostomy is the creation of a communication between the trachea and the overlying skin, maintained by a tube. This is done either by an open or percutaneous technique. Anatomical and physiological variation of the paediatric trachea and adjoining structures necessitates finite skills and consistent competence in performing pediatric tracheostomies, lack of which may cause higher mortality and morbidity outcome in tracheostomies in the pediatric age group. Objectives: There are inadequate local data on the outcomes of pediatric tracheostomies; therefore, we conducted a local audit of pediatric tracheostomy to describe our experience. Methods: A retrospective study of pediatric patients who had tracheostomies from June 2011 to December 2017 was done. Results: Thirty‑four patients were identified, all of whom had an open tracheostomy. The age range was 3 weeks to 16 years; M: F ratio was 2.4:1. Indications for surgery were obstructive (88.2%) and prolonged‑assisted intubation (11.8%). Recurrent respiratory papillomatosis, retropharyngeal abscess, and foreign‑body aspiration were the main obstructive causes. Three patients (8.8%) had repeat procedures, and these patients were initially discharged on tracheostomy tube and instructions were given for home care. Conclusion: Despite the evolving local challenges peculiar to clinical practice in developing countries, the outcome of pediatric tracheostomy in our hospital is good