Poor weight gain and its predictors among preterm neonates admitted at Muhimbili National hospital in Dar-es-salaam, Tanzania from September 2018 to February 2019

2021 ◽  
Author(s):  
Victoria Paul Ndembo ◽  
Helga Naburi ◽  
Rodrick Kisenge ◽  
Germana H. Leyna ◽  
Candida Moshiro
Keyword(s):  
Weight Gain ◽  
Preterm Delivery ◽  
Maternal Education ◽  
Previous History ◽  
Feeding Practices ◽  
Preterm Neonates ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Female Ratio ◽  
Poor Weight Gain

Abstract Background: Preterm delivery is among the major public health problems worldwide and the leading cause of morbidity and mortality among neonates. Postnatal poor weight gain, which can contribute to mortality, can be influenced by feeding practices, medical complications and quality of care that is provided to these high-risk neonates. This study aimed to investigate the proportion and predictors of poor weight gain among preterm neonates at Muhimbili National Hospital (MNH), from September 2018 to February 2019.Methods: A hospital-based prospective cohort study involving preterm neonates with Gestation age (GA) <37 weeks receiving care at MNH. Eligible preterm, were consecutively recruited at admission and followed up until discharge, death or end of neonatal period. Poor weight gain was defined as weight gain less than 15g per kg per day. The risk factors associated with poor weight gain were evaluated. Predictors of poor weight gain were evaluated using a multivariate analysis. Results were considered statistically significant if P -value was ˂ 0.05 and 95% confidence interval (CI) did not include 1 Results: A total of 227 preterm neonates < 37 weeks GA, with male to female ratio of 1:1.2 were enrolled in the study. The overall proportion of preterm with poor weight gain was 86.8% (197/227). Proportion of poor weight gain among the early and late preterm babies, were 88.5% (100/113) and 85.1% (97/114) respectively. Predictors of poor weight gain were low level of maternal education (AOR=2.58; 95%Cl: 1.02-6.53), cup feeding as the initial method of feeding (AOR=8.65; 95%Cl: 1.59-16.24) and delayed initiation of the first feed (AOR=10.06; 95%Cl: 4.14-24.43). A previous history of preterm delivery was protective against poor weight gain (AOR=0.33; 95% Cl: 0.11-0.79). Conclusion and recommendation: Poor weight gain was a significant problem among preterm receiving care at MNH. This can be addressed by emphasizing on early initiation of feed and tube feeding for neonates who are not able to breastfeed. Health education and counselling to mothers focusing on feeding practices as well as close supervision of feeding especially for mothers experiencing difficulties in feeding their preterm will potentially minimize risk of growth failure.

scholarly journals Poor weight gain and its predictors among preterm neonates admitted at Muhimbili National Hospital in Dar-es-salaam, Tanzania: a prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Victoria Paul Ndembo ◽  
Helga Naburi ◽  
Rodrick Kisenge ◽  
Germana H. Leyna ◽  
Candida Moshiro
Keyword(s):  
Cohort Study ◽  
Weight Gain ◽  
Preterm Delivery ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Feeding Practices ◽  
Preterm Neonates ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Poor Weight Gain

Abstract Background Preterm delivery is among the major public health problems worldwide and the leading cause of morbidity and mortality among neonates. Postnatal poor weight gain, which can contribute to mortality, can be influenced by feeding practices, medical complications and quality of care that is provided to these high-risk neonates. This study aimed to investigate the proportion and predictors of poor weight gain among preterm neonates at Muhimbili National Hospital (MNH), from September 2018 to February 2019. Methods A hospital-based prospective cohort study involving preterm neonates with Gestation age (GA) < 37 weeks receiving care at MNH. Eligible preterm, were consecutively recruited at admission and followed up until discharge, death or end of neonatal period. Poor weight gain was defined as weight gain less than 15 g per kg per day. The risk factors associated with poor weight gain were evaluated. Predictors of poor weight gain were evaluated using a multivariate analysis. Results were considered statistically significant if P -value was < 0.05 and 95% confidence interval (CI) did not include 1. Results A total of 227 preterm neonates < 37 weeks GA, with male to female ratio of 1:1.2 were enrolled in the study. The overall proportion of preterm with poor weight gain was 197/227 (86.8%). Proportion of poor weight gain among the early and late preterm babies, were 100/113 (88.5%) and 97/114 (85.1%) respectively. Predictors of poor weight gain were low level of maternal education (AOR = 2.58; 95%Cl: 1.02–6.53), cup feeding as the initial method of feeding (AOR = 8.65; 95%Cl: 1.59–16.24) and delayed initiation of the first feed more than 48 h (AOR = 10.06; 95%Cl: 4.14–24.43). A previous history of preterm delivery was protective against poor weight gain (AOR = 0.33; 95% Cl: 0.11–0.79). Conclusion and recommendation Poor weight gain was a significant problem among preterm neonates receiving care at MNH. This can be addressed by emphasizing on early initiation of feed and tube feeding for neonates who are not able to breastfeed. Health education and counselling to mothers focusing on feeding practices as well as close supervision of feeding especially for mothers experiencing difficulties in feeding their preterm will potentially minimize risk of growth failure.

scholarly journals Etiology, pattern and outcome of management of facial lacerations in Dar es Salaam, Tanzania

2020 ◽  
Vol 21 (2) ◽  
pp. 1-10
Author(s):  
Karpal Singh Sohal ◽  
Jeremiah Robert Moshy
Keyword(s):  
Road Traffic ◽  
Tissue Injury ◽  
Maxillofacial Surgery ◽  
Soft Tissue Injury ◽  
Health Facilities ◽  
Road Traffic Crash ◽  
Oral And Maxillofacial Surgery ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Female Ratio

Background: Facial laceration is amongst the commonly encountered soft tissue injury in the care of the traumatized patients, and its optimal treatment is important for minimizing subsequent complications. This study aimed at determining the etiology, pattern, and outcome of management of facial lacerations among patients attended at Muhimbili National Hospital, Tanzania. Methods: This was a four months’ prospective study of all consecutive patients with facial lacerations who were attended in the department of oral and maxillofacial surgery of the Muhimbili National Hospital (MNH). The variables examined included socio-demographic characteristics, etiology of a facial laceration, prior management before referral to MNH, and the outcome of treatment. The data were analysed using IBM SPSS statistics for windows version 22 (Armonk, NY: IBM Corp) software. Results: Seventy-six patients with facial lacerations were included in the study. The male to female ratio was 8:1. The age of the patients ranged from 16 to 57 years, with a mean age of 31.63 ± 10.02 years. Motor traffic crashes (51, 67.1%), violence (18, 23.7%) and falls (7, 9.2%) were the etiological factors. The commonest affected facial esthetic zones were forehead (25, 32.9%), and the upper lip (24, 31.6%). The majority (60%) of wounds that were sutured/repaired in other health facilities prior to referral to MNH had a poor approximation of wound edges. Scarring was the commonest complication. Conclusion: Facial laceration affected males eight times more than females. Road traffic crash was the most common etiological factor. The forehead was the most frequently affected facial esthetic zone. The majority of patients treated in other health facilities prior to referral to a tertiary hospital had poorly approximated wound edges. Scarring was the most common complication of facial lacerations.

Epileptic Spasms at Muhimbili National Hospital Tanzania, A Retrospective Study.

2020 ◽  
Author(s):  
Joseph Mwalongo ◽  
Edward Kija
Keyword(s):  
Age Of Onset ◽  
Early Recognition ◽  
Epileptic Encephalopathy ◽  
High Dose ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
Epileptiform Discharges ◽  
Epileptic Spasms

Abstract Background; Epileptic spasms (ES) is an epileptic encephalopathy occurring during infancy and early childhood. Early recognition and management is important to prevent severe neurological impairment. This study aimed at describing the clinical presentation, management and outcome of patients with Epileptic Spasms attending Muhimbili National Hospital (MNH), in Dar Es Salaam, Tanzania. Methods; A retrospective cross sectional study of all patients diagnosed with epileptic spasms was conducted at MNH from July 2016 to October 2018. Results; A total of 40 patients diagnosed with epileptic spasms were retrieved with male to female ratio of 3:2. In this study, 17 (42.5%) patients had a documented history of perinatal insult. The median age of onset of spasms was 5 months (IQR 1–12 months). In 14 (80%) out of 17 patients whom electroencephalography ( EEG) findings were retrieved had abnormal EEG findings showing either generalized epileptiform discharges 7(41%), generalized slowing 5(30%), hypsarrthymia 1(6%), or abnormal focal epileptiform discharges 2 (12%). Twenty-nine (73%) received prednisolone, with a median time of spasms subsiding of 1 month with a range of 10 days to 3 months in about 90% of them. Conclusion; The median age of onset of epileptic spasms at MNH is 5 months with the most common cause being perinatal insult in more than 40% of the patients. High dose prednisolone showed a good response in patients with epileptic spasms at MNH.

scholarly journals The types, incidence and demographic distribution of benign oral and maxillofacial neoplasms among patients attending Muhimbili National Hospital in Tanzania, 2008-2013

2016 ◽  
Vol 18 (2) ◽  
Author(s):  
Jeremiah R. Moshy ◽  
Karpal S. Sohal
Keyword(s):  
Maxillofacial Surgery ◽  
Ossifying Fibroma ◽  
Histopathological Diagnosis ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Maxillofacial Region ◽  
Female Ratio ◽  
Oral And Maxillofacial Region ◽  
Histological Results ◽  
Demographic Distribution

Background: Pathological processes of oral and maxillofacial region are generally classified as benign or malignant based on specific histological criteria, including the presence or absence of necrosis, mitotic figures as well as basic understanding of the entity. The objective of this study was to determine the types, prevalence and demographic distribution of benign oral and maxillofacial tumours among patients treated at Muhimbili National Hospital in Tanzania.Methods: In this retrospective study, data on histological results of lesions of the oral and maxillofacial region were retrieved from the archives at the Department of Oral and Maxillofacial Surgery of Muhimbili National Hospital were analysed. The tumour type, age, sex, file number and histopathological diagnosis of the patient were recorded. The study covered a period of from January 2008 to December 2013. The top ten lesions with higher frequency of occurrence from January to were picked for analysis.Results: A total of 897 (males=388; females=509) histological results of patients with benign oral and maxillofacial lesions were obtained during the period under review. The age ranged from 0 to 88 years, mean age being 32.63 ± 17.1 while the age group of 20-29 and 30-39 were the most affected. A total of 136 different types of benign lesions were reported and ameloblastoma was the most common benign lesion (27.4%) followed by ossifying fibroma (18.7%), pyogenic granuloma (11.4%), pleomorphic adenoma (10.0%), and fibrous dysplasia (9.6%). Females were more affected than males, with a male to female ratio of 1:1.4 however the difference was statistically insignificant (p= 0.055).Conclusion: Ameloblastoma and ossifying fibroma were the most common oral and maxillo-facia neoplasms at Muhimbili National Hospital. The young age groups were the most affected by these lesions.

scholarly journals Epidemiology of preterm deliveries in Southeast Brazil: a hospital-based study

2001 ◽  
Vol 1 (3) ◽  
pp. 263-268 ◽  
Author(s):  
Luiz Fernando Costa Nascimento
Keyword(s):  
Weight Gain ◽  
Tract Infection ◽  
Prenatal Care ◽  
Arterial Hypertension ◽  
Vaginal Bleeding ◽  
Statistical Significance ◽  
Previous History ◽  
Genitourinary Tract ◽  
Southeast Brazil ◽  
Poor Weight Gain

OBJECTIVES: to evaluate the role of some factors in the genesis of preterm deliveries in Southeast Brazil. METHODS: a cohort hospital-based study of 589 mothers who delivered in Taubaté, a middle-size city in the state of São Paulo, Brazil, between May 1, and October 31, 1999. The statistical approach was Risk Ratio with statistical significance established at alpha: 5%. RESULTS: 70 preterm newborns were identified representing 11,9% of the total birth rate. The variables holding statistical significance were: previous history of stillbirth delivery, smoking during pregnancy, poor weight gain, arterial hypertension, vaginal bleeding, genitourinary tract infection and five or less medical visits for prenatal care. CONCLUSIONS: this study indicates that good quality prenatal care has a great value in preventing preterm births, for poor weight gain, arterial hypertension, vaginal bleeding, genitourinary tract infection and smoking are conditions that can be controlled in the course of pregnancy.

scholarly journals “PATTERN AND DETERMINANTS OF COMPLEMENTARY FEEDING PRACTICES AMONG 6-24 MONTHS CHILDREN OF RURAL INDIA”

2021 ◽  
pp. 1-3
Author(s):  
Nikki Kumari ◽  
Khodaija Mahvish ◽  
Binod Kr Singh
Keyword(s):  
Maternal Education ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Feeding Practices ◽  
Rural India ◽  
Hospital Data ◽  
Significant Positive Association ◽  
Cross Sectional ◽  
Female Ratio ◽  
Diet Diversity

Background and objectives: Complementary feeding (CF) means introducing other foods when breast milk alone is not enough to meet the nutritional requirements of infants. WHO recommends starting complementary feeding after 6 months of age while continuing breast feeding up to 2 years of age for continued benefits. WHO also emphasizes on diet diversity to ensure a heterogeneous nutrient intake that provides all nutrients needed by the growing infant. In context of rural India, in-depth studies of complementary feeding practices are limited, revealing a clear knowledge gap. The present study was undertaken to assess the complementary feeding practices and factors influencing them among mothers of 6-24 months children. Methodology: This hospital based descriptive cross-sectional study was conducted over 2 years from April 2018-March 2020 including children aged >6 months and <24 months belonging to rural area visiting OPD or admitted in I.P.D of our hospital. Data was collected by direct interviewing of mothers regarding various aspects of breastfeeding and complementary feeding. Results: Over the study period, we enrolled 226 children in our study. Mean age was 9.7 months (SD 3.4months). Male: female ratio was 1.3:1. Mean age of mothers was 24.1 ± 4.2 years. Breastfeeding was initiated within 1 hour of birth in only 118(52.2%) babies. Complementary feeds were started at the end of 6 months in dismally low 21.2% children. It was started between 6-9 months in 38.5%, 9-12 months in 25.7% and after 12 months in 7.5% children. Proportion of infants getting minimal meal frequency was 59.3%, minimum dietary diversity only 45.6% and minimum acceptable diet only 47.8%%. The most commonly used complementary food was milk and milk & cereal based preparations (61.5%). There was a statistically significant positive association between socioeconomic class and correct time of initiating CF as well as maternal education and minimum acceptable diet (p <0.01). However, a significant negative association was found between working mother and proper consistency of feeds (p<0.01). Conclusion: Our findings clearly indicate that lot more needs to be done for rural children. Whenever there is opportunity for health care workers, mothers should be educated about proper complementary feeding practices.

scholarly journals LINC-28. EPIDEMIOLOGICAL CHARACTERISTICS AND SURVIVAL OUTCOMES OF CHILDREN WITH MEDULLOBLASTOMA TREATED AT THE NATIONAL CANCER INSTITUTE (INCA) IN RIO DE JANEIRO, BRAZIL

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii383-iii384
Author(s):  
Gabriela Oigman ◽  
Diana Osorio ◽  
Joseph Stanek ◽  
Jonathan Finlay ◽  
Denizar Vianna ◽  
...  
Keyword(s):  
High Risk ◽  
Maternal Education ◽  
Survival Outcomes ◽  
Middle Income ◽  
Female Ratio ◽  
High Risk Patients ◽  
Presenting Symptoms ◽  
Risk Patients ◽  
Epidemiological Characteristics ◽  
Standard Risk

Abstract BACKGROUND Medulloblastoma (MB), the most malignant brain tumor of childhood has survival outcomes exceeding 80% for standard risk and 60% for high risk patients in high-income countries (HIC). These results have not been replicated in low-to-middle income countries (LMIC), where 80% of children with cancer live. Brazil is an upper-middle income country according to World Bank, with features of LMIC and HIC. METHODS We conducted a retrospective review of 126 children (0–18 years) diagnosed with MB from 1997 to 2016 at INCA. Data on patients, disease characteristics and treatment information were retrieved from the charts and summarized descriptively; overall survival (OS) and event-free survival (EFS) were calculated using the Kaplan-Meier Method. RESULTS The male/female ratio was 1.42 and the median age at diagnosis was 7.9 years. Headache (79%) and nausea/vomiting (75%) were the most common presenting symptoms. The median time from onset of symptoms to surgery was 50 days. The OS for standard-risk patients was 69% and 53% for high-risk patients. Patients initiating radiation therapy within 42 days after surgery (70.6% versus 59.6% p=0.016) experienced better OS. Forty-five patients (35%) had metastatic disease at admission. Lower maternal education correlated with lower OS (71.3% versus 49% p=0.025). Patients who lived &gt;40km from INCA fared better (OS= 68.2% versus 51.1% p=0.032). Almost 20% of families lived below the Brazilian minimum wage. CONCLUSIONS These findings suggest that socioeconomic factors, education, early diagnosis and continuous data collection, besides oncological treatment must be adressed to improve the survival of children with MB.

scholarly journals The effect of early versus late lipid infusion in parenteral nutrition on the biochemical and cortical auditory evoked potential parameters in preterm neonates

2019 ◽  
Vol 67 (1) ◽  
Author(s):  
Rania Mohamed Abdou ◽  
Hoda Mahmoud Ibrahim Weheiba
Keyword(s):  
Weight Gain ◽  
Parenteral Nutrition ◽  
Biochemical Parameters ◽  
Evoked Potential ◽  
Demographic Data ◽  
Auditory Evoked Potential ◽  
Preterm Neonates ◽  
Lipid Infusion ◽  
Significant Difference ◽  
Cortical Auditory Evoked Potential

Abstract Background As brain activity depends greatly on the functions provided by lipid membranes, dietary fat in early life can affect the developing nervous system. Despite the adoption of an early more aggressive parenteral nutrition approach with amino acid infusions still reluctance to the early use of intravenous lipids in neonates. Aim To compare the effect of delayed versus early introduction of intravenous lipid in preterm on the biochemical parameters and on brain development by the cortical auditory evoked potential (CAEP) latency and amplitude. Methods This is a comparative study included 49 neonates admitted at the ain shams university NICUs. Participants were divided into two groups: 26 in group of early lipid infusion and 23 in late lipid infusion, Demographic data, and biochemical parameters were documented during the 1st 2 weeks of life. The CAEP was performed at age of 6 months. The latency and amplitude of P1 were recorded and compared between both groups. Results In the present work we found that group of early lipid infusion had reach their full oral intake earlier with shorter duration of parenteral nutrition and length of stay. They had better weight gain and significantly better glucose level control than group of late lipid infusion. There was no significant difference in the other chemical parameters between both groups expect for the higher incidence of cholestasis in the group of late lipid infusion. At 6 months of age, the group of early lipid infusion had significantly shorter latency and amplitude of P1 than the group of late lipid infusion. Conclusion Early effective nutrition positively affect feeding tolerance and weight gain and maturation of higher brain centers brain.

scholarly journals Protocol for iGrow (Infant Growth and Development Study): biopsychosocial predictors of childhood obesity risk at 2 years

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Esther M. Leerkes ◽  
Cheryl Buehler ◽  
Susan D. Calkins ◽  
Lenka H. Shriver ◽  
Laurie Wideman
Keyword(s):  
Weight Gain ◽  
Childhood Obesity ◽  
Growth And Development ◽  
Maternal Sensitivity ◽  
Feeding Practices ◽  
Infant Growth ◽  
Obesity Risk ◽  
Development Study ◽  
Early Weight Gain ◽  
Infant Weight Gain

Abstract Background Childhood obesity remains a significant public health problem. To date, most research on the causes and correlates of obesity has focused on a small number of direct predictors of obesity rather than testing complex models that address the multifactorial nature of the origins of obesity in early development. We describe the rationale and methods of iGrow (Infant Growth and Development Study) which will test multiple pathways by which (a) prenatal maternal psychobiological risk predicts infant weight gain over the first 6 months of life, and (b) this early weight gain confers risk for obesity at age 2. Infant hormonal and psychobiological risk are proposed mediators from prenatal risk to early weight gain, though these are moderated by early maternal sensitivity and obesogenic feeding practices. In addition, higher maternal sensitivity and lower obesogenic feeding practices are proposed predictors of adaptive child self-regulation in the second year of life, and all three are proposed to buffer/reduce the association between high early infant weight gain and obesity risk at age 2. Methods iGrow is a prospective, longitudinal community-based study of 300 diverse mothers and infants to be followed across 5 data waves from pregnancy until children are age 2. Key measures include (a) maternal reports of demographics, stress, well-being, feeding practices and child characteristics and health; (b) direct observation of maternal and infant behavior during feeding, play, and distress-eliciting tasks during which infant heart rate is recorded to derive measures of vagal withdrawal; (c) anthropometric measures of mothers and infants; and (d) assays of maternal prenatal blood and infant saliva and urine. A host of demographic and other potential confounds will be considered as potential covariates in structural equation models that include tests of mediation and moderation. Efforts to mitigate the deleterious effects of COVID-19 on study success are detailed. Discussion This study has the potential to inform (1) basic science about early life processes casually related to childhood obesity and (2) development of targeted intervention and prevention approaches that consider mother, infant, and family risks and resources.

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