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Background Exposure to the sunlight contributes largely to the production of vitamin D. However, vitamin D deficiency is a reality in tropical countries, despite enjoying enough sunlight, especially bearing women in their last trimester whose foetuses exclusively depend on their reserves. This work aimed at demonstrating the state of vitamin D in mother–baby pairs and associated factors in one of the University Hospitals in Rwanda. Methods This cross-sectional prospective study was performed on mother–baby pairs at Kigali University Hospital. Mother’s serum 25-hydroxyvitamin D levels were considered as outcomes compared with demographic, clinical and biological markers. Correlation analysis was conducted in order to assess the association between serum 25-hydroxyvitamin D levels for the couple mothers–babies. Results Approximately 38% of women and 65% of neonates had deficiency in 25-hydroxyvitamin D ( Conclusions There was a high rate of vitamin D deficiency in mothers and their babies. Babies born from women with deficiency were likely to develop low levels of vitamin D. This stresses on the need to strengthen the interventions for preventing vitamin D deficiency in the couple mothers–babies such as supplement in vitamin D before and after delivery, improving the quality of meals and regular contact with sunlight. more...

Introduction: small for gestational age (SGA) is defined as birth weight less than the 10th percentile with a population prevalence of 17% in sub-Saharan Africa. Mortality and morbidity are worse in SGA neonates and there are long term implications from fetal growth restriction. Objective: the goal of this study was to evaluate and report the case-load, associated characteristics and outcomes of neonates admitted with SGA at the largest tertiary public hospital in Kigali, Rwanda. Methods: a prospective, cross-sectional, observational study was performed. We defined SGA as birth weight less than10th percentile by gender according to the Alexander reference population. Eligible infants were identified through the neonatal registry. Results: of 1184 admitted neonates, 38% were SGA. Mortality in these SGA neonates (16%) was higher than appropriate for gestational age neonates (AGA, 13.4%) (AOR=2.03, CI: 1.1-3.5, p=0.011). SGA neonates, compared to their AGA peers, had a more extended hospital stay, and displayed faster postnatal growth. Conclusion: the case-load of SGA neonates in this reference hospital setting is high. The poorer outcomes in SGA neonates speaks to the need for: i. continued improvements in antenatal care throughout the health system to decrease the prevalence of small for gestation age and therefore case-load and ii. Optimisation of direct care for SGA neonates in order to minimise negative outcomes. more...

Aims To evaluate the prevalence, risk factors and outcomes of small for gestation age (SGA) neonates admitted to a neonatal unit born SGA and the impact of SGA on outcomes. Methods A prospective cross-sectional study was undertaken. The data was collected from July 2013 up to September 2017 using the Rwanda Neonatal Database (NDB). We defined SGA neonates as birth weight less than 10th percentile by gender using Alexander reference population US national reference. The primary outcome was mortality. Results 1184 admitted neonates have been included in the study, of which 444 (38%) were SGA. SGA neonates had increased the risks of mortality (16% vs 13%) (AOR=2.0, CI: 1.1–3.5, p=0.01). SGA neonates had a longer length-of-stay (LoS) (5.3 days versus 2.2 days, p=0.001). Conclusion SGA is a common indication for admission and is associated with significantly increased mortality and length of stay. Neonatal mortality continues to be significant in Rwanda and globally. Improved maternal antenatal care along with bespoke neonatal care could see improvements in outcomes for these high-risk neonates. Table 1: Significant risk factors and outcomes for SGA. more...

Introduction: Congenital heart diseases (CHD) are commonly associated with genetic defects. Our study aimed at determining the occurrence and pattern of CHD association with genetic defects among pediatric patients in Rwanda.Methods: A total of 125 patients with clinical features suggestive of genetic defects were recruited. Echocardiography and standard karyotype studies were performed in all patients.Results: CHDs were detected in the majority of patients with genetic defects. The commonest isolated CHD was ventricular septal defect found in many cases of Down syndrome. In total, chromosomal abnormalities represented the majority of cases in our cohort and were associated with various types of CHDs.Conclusion: Our findings showed that CHDs are common in Rwandan pediatric patients with genetic defects. These results suggest that a routine echocardiography assessment combined with systematic genetic investigations including standard karyotype should be mandatory in patients presenting characteristic clinical features in whom CHD is suspected to be associated with genetic defect.Key words: Congenital heart disease, genetic defects, pediatric patients, Rwanda more...