Background: The exclusive breastfeeding rate in Sub-Saharan Africa is abysmally low, and based on current trends, achieving the World Health Organization's (WHO) global nutrition goal of a 50% exclusive breastfeeding rate by 2025 will require an additional three decades. Methods: This is a cross-sectional study involving healthcare workers (HCWs) providing direct care to breastfeeding mothers in six geopolitical zones in Nigeria. HCWs were recruited using a stratified random sampling method, with a minimum sample size of 1537. Data was collected through validated-interviewer-administered-questionnaires. Results: The mean age of the 1294 respondents was 35.2 ± 10.0 years, with a male-to-female ratio of 1:3. Overall, breastfeeding knowledge was subsufficient (41.2% across three domains), with specific knowledge gaps observed in breastfeeding for mothers with breast cancer (13.4%) and hepatitis B (59.4%). Only 18.9% correctly identified laid-back and cross-cradle breastfeeding positions. High school and tertiary education were significantly associated with sufficient breastfeeding knowledge (AOR: 2.2, 95% CI 1.299–3.738; AOR: 2.0, 95% CI 1.234–3.205). Negative attitudes toward breastfeeding support were associated with being female (AOR: 1.5, 95% CI 1.094–1.957), while being a doctor was linked to the lowest instructional support (AOR: 0.3, 95% CI 0.118–0.661). Positive attitudes toward breastfeeding support were significantly associated with sufficient knowledge (AOR: 2.4, 95% CI 1.833–3.161; p < 0.001), but not with technical knowledge (AOR: 0.8, 95% CI 0.629–0.993). Conclusion: Healthcare workers showed subsufficient overall breastfeeding knowledge, especially regarding breastfeeding in maternal illnesses and positioning. Targeted programs are needed to improve breastfeeding support knowledge, instructional support and attitudes, especially among female HCWs and physicians.

Background: Several studies have shown that the impact of maternal mental health disorders on newborns’ well-being in low and middle-income countries (LMIC) are underreported, multi-dimensional and varies over time and differs from what is reported in high-income countries. We present the prevalence and risk factors associated with common mental disorders (CMDs) among breastfeeding mothers whose infants were admitted to Nigerian tertiary care facilities. Methods: This was a national cross-sectional study involving mothers of hospitalised babies from eleven Nigerian tertiary hospitals. We used the WHO self-reporting Questionnaire 20 and an adapted WHO/UNICEF ten-step breastfeeding support package to assess mothers’ mental health and breastfeeding support. Results: Only 895 of the 1,120 mothers recruited from eleven tertiary healthcare nurseries in six geopolitical zones of Nigeria had complete datasets for analysis. The participants’ mean age was 29.9 ± 6.2 years. One in four had CMDs; 24.0% (95% CI: 21.235, 26.937%). The ages of mothers, parity, gestational age at delivery, and length of hospital stay were comparable between mothers with and those without CMDs. Antenatal care at primary healthcare facilities (adjusted odds ratio [aOR:13], primary education [aOR:3.255] living in the south-southern region of the country [aOR 2.207], poor breastfeeding support [aOR:1.467], polygamous family settings [aOR:2.182], and a previous history of mental health disorders [aOR:4.684] were significantly associated with CMDs. In contrast, those from the middle and lower socioeconomic classes were less likely to develop CMDs, with [aOR:0.532] and [aOR:0.493], respectively. Conclusion: In Nigeria, the prevalence of CMDs is relatively high among breastfeeding mothers with infants admitted to a tertiary care facility. Prior history of mental illness, polygamous households, mothers living in the southern region and low or no educational attainment have a greater risk of developing CMDs. This study provides evidence for assessing and tailoring interventions to CMDs among breastfeeding mothers in neonatal nurseries in LMIC.

Background: Dialysis provides prompt treatment for severe acute kidney injury (AKI) and limits morbidity and mortality. This study compared the current dialysis services for paediatric AKI in Nigeria with earlier studies. Methods: Twenty-four of 34 conveniently sampled paediatric nephrology units across Nigeria responded to an online questionnaire.Results: Responding centres (16, 67%) from the six geopolitical zones were urban tertiary federal/state-owned and mainly in the south. Nineteen centres (79%) offered both peritoneal dialysis (PD) and haemodialysis (HD), 4 (17%) provided HD services only, whereas 1 centre offered PD only. Ten (42%) centres also provided dialysis to neonates. Concerning PD consumables, 75% used improvised PD catheters, with the most common (50%) being nasogastric tubes. In 60% of centres, PD catheter insertion was performed by a paediatrician/paediatric nephrologist; 90% used improvised PD fluids, and all performed PD manually. Concerning HD consumables, 10 (44%) facilities ‘sometimes’ have paediatric dialyzers/bloodlines but mostly these are unavailable for children under five. Challenges with dialysis access include financial constraints, lack of paediatric dialyzers/bloodlines and PD fluids (100%, 75% and 75%, respectively). Compared with earlier studies, current facilities providing dual PD/HD services have significantly (P = 0.021) increased but challenges are unchanged.Conclusion: In Nigeria, dialysis services for paediatric AKI have increased with more facilities providing both HD and PD. Whereas HD is mainly available for older children, acute PD remains predominantly improvised. Continuous kidney replacement therapy is unavailable. There is a need for concerted collaboration between the government and healthcare facilities to ensure consistent availability of age-appropriate dialysis machines/consumables and subsidized paediatric dialysis services.

Introduction: Multicystic dysplastic kidney disease (MCDK) is a notable congenital anomaly of the kidney and urinary tract, with potential risk for chronic kidney disease, yet data from sub-Saharan Africa remain scarce. This study examined the pattern of MCDK, associated contralateral kidney abnormalities, determined the predictors of MCDK involution and assessed short-term outcomes in children followed beyond one year in South Africa. Method: This retrospective study involved children under 13 years of age with suspected unilateral MCDK, confirmed on kidney ultrasound and [ ^99m Tc]Tc-MAG3 scans at the Red Cross War Memorial Children’s Hospital between January 1, 2014, and December 31, 2023. Demographic, clinical, and radiologic data were obtained. The Log-rank test and Cox Proportional Hazards regression analyses were used to identify predictors of MCDK involution. Results: Among 1,581 new cases, 98 (6.2%) had unilateral MCDK. 50% were male, and 57.1% had left-sided involvement. Median follow-up was 60 months (IQR: 12–72). Contralateral kidney abnormalities occurred in 17 (17.3%), most commonly duplex kidney (35.3%) and ureteropelvic junction obstruction (29.4%), but no vesicoureteric reflux was noted. Of 81 children followed beyond a year, 80.2% demonstrated contralateral hypertrophy, and 69.1% exhibited involution of the affected kidney. Initial kidney size ≤ 5.0 cm was the sole predictor of involution (Hazard Ratio: 2.42, 95% CI: 1.31–4.48). Urinary tract infections occurred in 18.5%, proteinuria in 2.5%, hypertension in 1.2%, and 2.5% developed chronic kidney disease related to contralateral dysplasia. One nephrectomy was performed, and no malignancies or deaths. At last follow-up, 28.4% were lost to follow-up, and 12.3% had transitioned to adolescent clinics. Conclusion: All MCDK cases were unilateral, with duplex kidney being the most common contralateral abnormality, a distinctive finding previously unreported. Follow-up into adolescence may be beneficial, as progression of chronic kidney disease is rare in those without contralateral anomalies. Multicentre long-term studies are needed to provide standardised follow-up guidelines.

Neonatal seizures are a significant contributor to neonatal morbidity and mortality in Nigeria and the magnitude of the burden is unknown. A comprehensive systematic review is needed to determine the pooled magnitude and causes of neonatal seizures in Nigeria since the true estimate is yet to be determined. Therefore, this study aims to develop a protocol to assess the burden and causes of neonatal seizures in Nigeria. A search strategy is developed using MeSH terms, text words, and entry terms. Nine databases will be searched including Pub- Med, African journals online, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Psych Info, Web of Science, Scopus, and Research Gate. Only observational studies, retrievable in the English language and conducted in Nigerian neonates will be included. The primary outcome of this study is the pooled prevalence of neonatal seizures in Nigeria. The secondary outcomes include the seizure types, causes, method of detection, and outcome in the neonates. Screening of identified studies will be done in End Note version 20 and duplicates removed, before exporting to Microsoft 365 excel sheet for data extraction by independent reviewers. Studies will be assessed for methodological, clinical, and statistical heterogeneity and if required, a meta-analysis will be done. Stata 16 IC will be used for data analysis. Various subgroup analyses will also be done. A funnel plot will be used for the assessment of publication bias. Results will be presented in tabular formats, narrative synthesis, and regression plots. The data from this review will reveal the pooled prevalence of neonatal seizures in Nigeria. It will create an avenue for discussion on the types, causes, and outcome of neonatal seizures. The findings will also enable discussions on how to address the causes of neonatal seizures in Nigeria and provide evidence for policy recommendations to reduce morbidity and mortality resulting from neonatal seizures in Nigeria. Trial registration number: This protocol is registered in PROSPERO with registration number CRD42020220097.