Fidelia Bode-thomas - Academia.edu (original) (raw)

Papers by Fidelia Bode-thomas

BACKGROUND There are few reports of the prevalence of CHD in the neonatal period in sub-Saharan A... more BACKGROUND There are few reports of the prevalence of CHD in the neonatal period in sub-Saharan Africa. The only available study in Nigeria was carried out before the widespread availability of echocardiography in the country. We sought to determine the prevalence and spectrum of congenital heart defects (CHD) among neonates in Jos, Nigeria. METHODS This cross-sectional study enrolled neonates less than one week of age from the two largest hospitals and their immunisation centres. Relevant information was obtained and an echocardiogram was performed on each neonate. RESULTS There were 3 857 neonates recruited over a two-year period; male-to-female ratio was 1.1:1. A total of 111 babies had CHD, with a prevalence of 28.8 per 1 000. Sixty-four neonates had mild CHD, with a prevalence of 16.6 per 1 000, while moderate and severe CHD were found in 27 (7.0 per 1 000) and 20 (5.2 per 1 000), respectively. CONCLUSIONS CHD is prevalent in Nigerian neonates and there is therefore a need for ...

Italian Journal of Pediatrics, 2019

Introduction Evidence of kidney damage is observed in children with sickle cell anaemia (SCA) and... more Introduction Evidence of kidney damage is observed in children with sickle cell anaemia (SCA) and this continues through adulthood with progression to severe functional impairment in some. One of the earliest features of kidney damage associated with SCA is microalbuminuria. Our objective was to determine the risk factors of microalbuminuria in these children and its relationship with estimated glomerular filtration rate. Methods This was a cross-sectional and comparative study involving three hundred and twenty three children with SCA in steady state and equal numbers of apparently healthy age and sex matched haemoglobin AA (HbAA) control, aged 6 months to 18 years. They were consecutively recruited over a 6 month period. Result Microalbuminuria was present in 26% of the study subjects compared with 1.85% of control P = 0.001). Anaemia and high estimated glomerular filtration rate (eGFR) showed strong positive correlation with microalbuminuria (OR = 3.19, CI 0.953–1.116, p = 0.003 ...

Journal of Advances in Medicine and Medical Research, 2017

British Journal of Medicine and Medical Research, 2016

Background and Objective: There is a dearth of literature on tricuspid atresia among African peop... more Background and Objective: There is a dearth of literature on tricuspid atresia among African people. The current study aims to document the clinical profile and prevalence of tricuspid atresia amongst children in a tertiary hospital in South Western Nigeria. Methods: A prospective review of all consecutive cases of tricuspid atresia diagnosed by echocardiography at the Lagos State University Teaching Hospital (LASUTH) between January 2007 and December 2015. The hospital is located in South Western Nigeria. The subjects were all children with an echocardiographic diagnosis of tricuspid atresia made at the study center. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20. Level of significance set at p< 0.05.

Nigerian Journal of Surgical Research, 2010

Infantile haemangioendothelioma is a rare tumour of infancy arising from mesenchymal tissue. The ... more Infantile haemangioendothelioma is a rare tumour of infancy arising from mesenchymal tissue. The liver is the commonest site for this tumour in children. This is a report of a 3 month old boy who presented with hepatomegaly, hypertension, congestive cardiac failure and protracted diarrhea. Abdominal ultrasonography demonstrated diffuse hepatic nodules involving the whole liver. A diagnosis of infantile hepatic haemangioendothelioma was made on histologic examination of tissue following an open liver biopsy. The patient died 3 days after liver biopsy. We report this case to raise awareness of this rare tumour of infancy in our environment.

Circulation, Jan 4, 2016

Background There are few contemporary data on the mortality and morbidity associated with rheumat... more Background There are few contemporary data on the mortality and morbidity associated with rheumatic heart disease (RHD) or information on their predictors. We report the two year follow-up of individuals with RHD from 14 low and middle income countries in Africa and Asia.. Methods Between January 2010 and November 2012, we enrolled 3343 patients from 25 centers in 14 countries and followed them for two years to assess mortality, congestive heart failure (CHF), stroke or transient ischemic attack (TIA), recurrent acute rheumatic fever (ARF), and infective endocarditis (IE). Results Vital status at 24 months was known for 2960 (88.5%) patients. Two thirds were female. Although patients were young (median age 28 years, interquartile range 18 to 40), the two year case fatality rate was high (500 deaths, 16.9%). Mortality rate was 116.3/1000 patient-years in the first year and 65.4/1000 patient-years in the second year. Median age at death was 28.7 years. Independent predictors of death were severe valve disease (hazard ratio (HR) 2.36, 95%

African journal of medicine and medical sciences, 2012

Since the first report on device closure of patent ductus arteriosus (PDA) by Porstmann et al in ... more Since the first report on device closure of patent ductus arteriosus (PDA) by Porstmann et al in 1967, the procedure has gained wide acceptance and has been used all over the world, including parts of Africa. The advantages when compared to surgical closure include shorter procedure time and hospital stay and no scar being left. This mode of treatment was not available in Nigeria prior to this with patients having to travel abroad to benefit. Cardiac catheterisation laboratory became available in Lagos, Nigeria in 2009 and in October 2010, the laboratory collaborated with Lagos State University College of Medicine (LASUCOM) and Lagos State University Teaching Hospital (LASUTH), to perform a device closure on a 3-year old girl with PDA who had presented to LASUTH with heart failure at the age of 6 months. To the best of our knowledge, this is the first time the procedure has been performed in Nigeria The patient made a successful recovery and is haemodynamically stable, on no medicat...

Study questionnaire developed specifically for use in this study. (DOCX 16 kb)

Valvular heart disease Characteristics, complications, and gaps in

Nigerian quarterly journal of hospital medicine, 2014

Background: Preeclampsia has remained an important public health problem in the developing world ... more Background: Preeclampsia has remained an important public health problem in the developing world where it is associated with a five-fold increase in perinatal morbidity and mortality. Objective: We set out to compare neonatal outcomes between women with preeclampsia and those with normal pregnancy. We also sought to evaluate factors associated with poor outcome in the neonates. Materials and Methods: This was a prospective cohort study that enrolled 90 women (45 with preeclampsia and 45 with normal pregnancy) after 20 weeks gestation. Maternal socio-demographic and clinical information was obtained at enrolment and delivery using questionnaire. Neonatalanthropometric and physiologic data was obtained at delivery and used for classifying the birth weight according to the WHO classification. APGAR score was used to evaluate the presence of birth asphyxia. We defined poor outcome as the presence of at least one of low birth weight, prematurity, birth asphyxia and need for admission. S...

Introduction Rheumatic heart disease still remains a cause of morbidity and mortality in low and ... more Introduction Rheumatic heart disease still remains a cause of morbidity and mortality in low and middle income countries, despite its eradication in developed societies. The study aimed to document the features of children with rheumatic heart disease using clinical evaluation and echocardiography and compare it with reports from other part of the country. Methods A review of a prospectively collected data of patients with rheumatic heart disease who had echocardiography done from April 2007-Dec 2016. Information obtained from patients include age, sex, clinical indication for echocardiography, echocardiographic characterization of the valvular lesions and associated complications. Results A total of 324,676 patients were seen at the Paediatric unit of LASUTH from 2007 to 2016, out of which 36 had Rheumatic heart disease. This translates to a prevalence of 1.1 per 10,000 patients who presented at the study site during the study period. The prevalence of RHD amongst all the patients ...

JAMA Cardiology

Importance Rheumatic heart disease (RHD), a sequela of rheumatic fever characterized by permanent... more Importance Rheumatic heart disease (RHD), a sequela of rheumatic fever characterized by permanent heart valve damage, is the leading cause of cardiac surgery in Africa. However, its pathophysiologic characteristics and genetics are poorly understood. Understanding genetic susceptibility may aid in prevention, control, and interventions to eliminate RHD. Objective To identify common genetic loci associated with RHD susceptibility in Black African individuals. Design, Setting, and Participants This multicenter case-control genome-wide association study (GWAS), the Genetics of Rheumatic Heart Disease, examined more than 7 million genotyped and imputed single-nucleotide variations. The 4809 GWAS participants and 116 independent trio families were enrolled from 8 African countries between December 31, 2012, and March 31, 2018. All GWAS participants and trio probands were screened by use of echocardiography. Data analyses took place from May 15, 2017, until March 14, 2021. Main Outcomes and Measures Genetic associations with RHD. Results This study included 4809 African participants (2548 RHD cases and 2261 controls; 3301 women [69%]; mean [SD] age, 36.5 [16.3] years). The GWAS identified a single RHD risk locus, 11q24.1 (rs1219406 [odds ratio, 1.65; 95% CI, 1.48-1.82; P = 4.36 × 10-8]), which reached genome-wide significance in Black African individuals. Our meta-analysis of Black (n = 3179) and admixed (n = 1055) African individuals revealed several suggestive loci. The study also replicated a previously reported association in Pacific Islander individuals (rs11846409) at the immunoglobulin heavy chain locus, in the meta-analysis of Black and admixed African individuals (odds ratio, 1.16; 95% CI, 1.06-1.27; P = 1.19 × 10-3). The HLA (rs9272622) associations reported in Aboriginal Australian individuals could not be replicated. In support of the known polygenic architecture for RHD, overtransmission of a polygenic risk score from unaffected parents to affected probands was observed (polygenic transmission disequilibrium testing mean [SE], 0.27 [0.16] SDs; P = .04996), and the chip-based heritability was estimated to be high at 0.49 (SE = 0.12; P = 3.28 × 10-5) in Black African individuals. Conclusions and Relevance This study revealed a novel candidate susceptibility locus exclusive to Black African individuals and an important heritable component to RHD susceptibility in African individuals.

BMC Obesity

Background: Several studies examining the association and discriminative ability of adiposity mea... more Background: Several studies examining the association and discriminative ability of adiposity measures for prehypertension and hypertension among adolescents have reported varying outcomes. We aimed to determine the discriminative ability of the Body Mass index (BMI), Waist Circumference (WC), and Waist-to-Height Ratio (WHtR) adiposity measures for elevated blood pressure (prehypertension and hypertension combined) among adolescents in Gombe, northeast Nigeria. Methods: This cross-sectional study used a multi-stage sampling technique and involved 367 secondary school adolescent (10-18 years) boys and girls in Gombe Local Government Area, Gombe State, northeast Nigeria from January to September 2015. We examined and compared the associations and discriminative ability of the BMI, WC and the WHtR for elevated blood pressure using multiple logistic regression and receiver operating characteristics (ROC) curves. Area under the curves (AUC), odds ratio (OR) and 95% confidence intervals (CI) are reported. Results: All three measures of adiposity were strongly and positively associated with elevated blood pressure. The BMI obesity showed the strongest association with elevated blood pressure with odds that was double the odds of WC and triple that of WHtR [adjusted OR for BMI 15.3, 95% CI (4.8-27.9)]. The discriminative ability of adiposity measures for elevated blood pressure using AUC was comparable (0.786 for BMI, vs 0.780 for WC, vs 0.761 for WHtR). Conclusion: We provide evidence, here on the BMI, WC and WHtR to support the use of simple indirect measures of adiposity in evaluating adiposity-related risk including prehypertension and hypertension among Nigerian adolescents.

International Journal of Research in Medical Sciences

Background: Neonatal jaundice (NNJ) remains a major cause of neonatal morbidity and mortality in ... more Background: Neonatal jaundice (NNJ) remains a major cause of neonatal morbidity and mortality in Nigeria with significant contribution to the global figures. Effective phototherapy can reduce the complications associated with NNJ. The effectiveness of a phototherapy device (PD) depends mainly on the emitted irradiance of the device. We, therefore, assessed the irradiance of the PDs in Jos, North Central Nigeria in order to determine the effectiveness of the devices and to highlight the need for routine assessment of irradiance levels of PDs in low-middle income settings.Methods: This was a cross- sectional study involving 14 hospitals with a total of 38 functional PDs comprising of 25 (65.8%) locally fabricated, eight (21.0%) light- emitting diode (LED) and five (13.2%) conventional patented devices. The irradiance was measured using the BiliBlanket® light meter II.Results: The irradiance of the PDs ranged from 2 to 102μW/cm2/nm with a median value of 10.6 (IQR 6-18μW/cm2/nm). Six...

Lipids in Health and Disease, May 6, 2003

To determine the cholesterol content and fatty acid composition of red cell membrane phospholipid... more To determine the cholesterol content and fatty acid composition of red cell membrane phospholipids (PL) of children with sickle cell disease (SCD) and to correlate these levels with whole body phase angle that is related to the integrity and function of cell membranes. Blood samples were obtained from 69 children with SCD and 72 healthy age- and gender-matched controls in Nigeria for the determination of the cholesterol content and proportions of fatty acids in red cell PL. Bioelectrical impedance analysis was used to obtain resistance (R) and reactance (Xc) from which phase angle was calculated as arctan Xc/R. Cholesterol (normalized to lipid phosphorus) and the proportions of individual fatty acids were correlated with phase angle. The proportions of palmitic (p < 0.001), stearic acid (p = 0.003) and cholesterol (p < 0.001) were significantly higher in the red cells of children with SCD, whereas the proportions of arachidonic acid and docosahexaenoic acid were reduced (p = 0...

African Journal of Paediatric Surgery, 2005

La sicklanemie est associee a une hypoxie tissulaire chronique (et souvent a une ischemie) qui s&... more La sicklanemie est associee a une hypoxie tissulaire chronique (et souvent a une ischemie) qui s'aggrave pendant les crises et peut atteindre le myocarde. La prolongation de l'intervalle QT a ete observee chez l'adulte avec ischemie cardiaque et predispose a la mort subite. Le but de cette etude est de determiner si l'intervalle QT est prolonge chez les enfants sicklanemiques et si il est majore pendant les crises vasoocclusives. Nous avons compare les intervalles QT corriges (QTc) dans 3 groupes d'enfants apparies pour l'âge et le sexe : a) des sicklanemiques en crise (34), b) des sicklanemiques en etat d'equilibres (34) et c) des entants anemiques sans sicklemie (34). La moyenne des intervalles QT etait identique dans les 2 groupes de sicklanemiques (0,420 + 0,028 vs 0,424 + 0,027, p > 0,1). Elle etait plus elevee chez l'ensemble des sicklanemiques que chez les anemiques non sicklanemiques (0,422 + 0,027 vs 0,402 + 0,028 p < 0,001). De meme la...