Pediatrics and Pediatric Surgery

Biography

Biography: HIPPOLITE O AMADI

Abstract

Successive demographic reports of UNICEF and WHO, since 2007, shows that Nigeria’s early neonatal deaths has remained high, at 79%. There was no significant improvement all through the years of MDG as almost 50% of deaths before age of five are currently neonatal. Neonatal mortality rate (NNMR) increases sharply with decreasing birthweight and postnatal age; hence, there is little chance of survival for over 90% of extremely low birthweight (ELBW) neonates at most Nigerian newborn centres. We preliminarily carried out a nationwide investigation and confirmed consistency in excessive long periods of time before most deceased neonates attained thermal stability within acceptable physiological range of 36.5°C–37.4°C. We investigated high climatic ambient temperatures and found adverse corelation with neonatal thermal morbidity. We concluded that such overpowering physiological thermal deficiencies might be responsible for mortalities within first week of life; hence the need for innovation of devices and protocols that could reverse this. We devised the recycled incubator technology to create affordable alternative for incubator intervention. We define the etiology of climate-induced neonatal evening-fever syndrome (EFS) and synthesised a nursery-building parttern that lowers climatic harsh impact on neonates. We innovated the Handy-approach and initial-setpoint-algorithm temperature protocols that enabled patient-specific interactive technique for quick attainment of neonatal normotherm. Comparative studies of the outcome of these innovations against facility-based national averages showed, among others: improved availability and sustainability of functional incubators (average: 18 systems vs. 3); early mortality of ELBW reduced (average: <1% vs. 80%); overall facility-based NNMR reduced (average: 31/1000 vs. 245/1000).