Etiology and clinical pattern of cervical lymphadenopathy in Sudanese children.

Cervical lymphadenopathy (CLA) is a common childhood problem in clinical practice which poses diagnostic difficulties to pediatricians. The aims of this study were to determine the causes of CLA in Sudanese children and to evaluate the value of routine laboratory tests in determining the etiology. Demographic and clinical data were prospectively collected from eighty children with palpable cervical nodes. Children were then subjected to complete blood count, ESR, Mantoux test, aspiration cytology of a lymph node and serological tests for HIV agglutination test, ELISA for Epstein-Barr virus and toxoplasma gondii. The age ranged 1-13 years with a mean of 5.8 ±3.1SD years with no gender difference. Specific etiologies of CLA were determined in 62.5% of patients. Ninety five percent of the causes were due to non-specific reactive hyperplasia of lymph nodes (NSRH) (37.5%), toxoplasmosis (27.5%), infectious mononucleosis due Epstein-Barr virus (13.8%), tuberculous adenitis (10%), acute adenitis (6.2%), whereas malignancy (Hodgkin's lymphoma) constituted 5% of causes of CLA. The clinical characteristics were insignificantly associated with the causes of lymphadenopathy (p>0.05). However, mobile lymph nodes were significantly associated with inflammatory conditions (P<0.05). Inflammatory causes accounted for the majority of the etiologies whereas Hodgkin's lymphoma was the only identified malignancy. Laboratory tests such as, ESR, TWBC, hemoglobin and Mantoux test should be used in adjunct with cytology and serology for diagnosis.

Differences in anthropometric measurements between Sudanese newborn twins and singletons.

UNLABELLED: Twin pregnancies are associated with disturbed fetal growth and a higher risk of low birthweight (LBW), which is one of the most important determinants of perinatal morbidity and mortality in Africa. In this study, we compare anthropometric measurements in Sudanese twins and their mothers with singletons. METHODS: In 1000 Sudanese mothers with singleton births and 30 mothers with twins, maternal (weight, height, mid-arm circumference) and 11 newborn anthropometric measurements were taken within 24 hours of delivery. Maternal education and socio-economic status were additionally recorded. RESULTS: Mothers of twins had a significantly higher body weight (p = .045) and lean body mass (p = .02) after delivery, and were from higher social classes in general (p = .014). In addition to gestational age, twins displayed a statistically significant reduction in all anthropometric data, compared to singletons, mainly in terms of birth-weight, chest and head circumference, whereas differences in triceps and subscapular skin fold thickness and ponderal index were distinctly lower. The LBW rate in twins was markedly higher than that in singletons (43.3% vs. 8.3%, p < .001). In 20 out of 30 twins (66.7%), Twin A weighed more than Twin B (difference (SD) of 443 (335) g), and in the remaining 10 cases (33.7%), the weight of Twin B was equal to or more than that of twin A (difference (SD) of 211 (240) g, p = .039). In unlike-sex pairs, the mean (SD) difference between Twins A and B in birthweight was 459 (481) g, which was distinctly higher, compared to same-sex pairs (boys, 180 (325) g and girls, 36 (413) g). CONCLUSIONS: Sudanese twins displayed significantly reduced anthropometric measurements compared to singletons, but to different degrees. Gender had a higher impact on birthweight in twins than in singletons.

Relationship between maternal and newborn anthropometric measurements in Sudan.

BACKGROUND: The aim of the present study was to investigate the relationship between maternal and newborn anthropometry. METHODS: In 1000 Sudanese mothers and newborns anthropometric measurements were taken within 24 h of birth. The relationship between maternal characteristics including age, years of education, social class and anthropometry, and newborn characteristics including gestational age, weight, body length, body circumference and skin-fold thickness, was investigated on multiple regression with backward selection, and multivariate anova (where appropriate) to identify the most important associations. RESULTS: Maternal age and anthropometry were significantly associated with newborn anthropometry to a variable extent. The strongest associations (R2 > 5-6%) were found for mid-arm circumference, supine length and birthweight. The postpartum maternal lean body mass (LBM) was significantly associated with birthweight, body length and body circumference (P < 0.001), while skin-fold thickness was mainly associated with maternal age and maternal body mass index (BMI). Gestational age was only weakly associated with the maternal height (R2 > 1.3%) and the association between maternal anthropometry and the ponderal index (PI) of the newborn was negligible (R2 < 1%). Maternal education was significantly associated with birthweight and body circumference (except the abdominal), and the PI and the latter increased significantly with increasing number of years of education. No association between social class and newborn anthropometry was obtained. CONCLUSION: There was a significant association between maternal LBM and newborn size and between maternal BMI and newborn fat stores. Maternal education and not social class was associated with newborn size.

The effect of maternal anthropometric characteristics and social factors on gestational age and birth weight in Sudanese newborn infants.

BACKGROUND: In Africa low birth weight (LBW) (<2500 g), is the strongest determinant of infant morbidity and mortality. The aim of this study was to quantify the effect of maternal anthropometry, education and socio-economic status on gestational age and birth weight. METHODS: In 1000 Sudanese mothers with singleton births, anthropometric measurements (weight, height, mid-arm circumference) and newborn birth weight were taken within 24 hours of delivery. Furthermore, maternal education and socio-economic status were recorded. The effect of these maternal variables on gestational age and birth weight was investigated by receiver operating characteristic (ROC) curves and by multivariate logistic regression analysis. RESULTS: Although maternal height was significantly correlated (p = 0.002) with gestational age, we did not find maternal characteristics of value in determining the risk for preterm birth. Birth order was the strongest determinant of birth weight compared to other maternal characteristics. The LBW rate of first born babies of 12.2% was nearly twice that of infants of multiparous mothers. Maternal age and all maternal anthropometric measurements were positively correlated (p < 0.001) with birth weight. A maternal height of <156 cm, a maternal weight of <66 kg, a maternal mid arm circumference of <27 cm and years of education of 12 years of education. CONCLUSION: Birth order and maternal height were found to be the most important maternal parameters which influences birth weight and the risk for LBW. The duration of maternal education and not social class was found to significantly affect the risk for LBW.

Correlation between anthropometric measures and birthweight of infants: value in measuring actual birthweight.

Birthweight (BW) is an important predictor of newborn morbidity and mortality. In Africa, infant mortality is very high mainly due to low birthweight (LBW). Most deliveries occur at home where scales are not always available. The aim of this study was to find a simple formula to predict birthweight using anthropometric measurements. In 1000 singleton Sudanese newborns, anthropometric measurements were taken within 24 hours of birth. Multiple regression analysis with backward selection was used to analyze data. The mean (standard deviation) of BW was 3131.7 (538.9) g and that of gestational age was 39.1 (1.8) weeks. All anthropometric parameters were strongly correlated with BW ( P < 0.001). The highest correlations were obtained with chest (CC), midthigh (MT), and head circumferences (HC). Using these three parameters, a simple formula was obtained to predict BW as follows: BW(g) = 97*CC + 74*MT + 85*HC - 4000 with a standard error of 285 g. For birthweights < 2000 g, specificity is near 100% and the sensitivity is > 80%. Applying a cutoff point of 2500 g, all infants (100%) with a birthweight < 2000 g are correctly identified. Our model by allowing for actual measurement of BW will enable the health worker in developing countries to select appropriate LBW infants for referral to an equipped health facility.