
Lawal Waisu UmarAhmadu Bello University | ABU · Department of Paediatrics
Lawal Waisu Umar
MB BS, FWACP (Paed)
Co-investigator, External Validation study of WHO TB Algorithms for treatment decision in Children <10 years in Nigeria
About
97
Publications
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357
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Introduction
Professor of Paediatrics, Ahmadu Bello University (ABU) Zaria; Consultant Paediatrician, ABU Teaching Hospital (ABUTH)
Coordinator, Institute of Child Health, ABUTH; Member, National ART Task Team, Federal Ministry of Health (FMOH); Member National PMTCT Task Team (FMOH); Examiner in 4 Universities; Chairman, National Steering Committee on Childhood TB (FMOH); Vice Chairman, Stop TB Partnership Board Nigeria, Former Vice President, Nigeria Society for Paediatric Infectious Diseases (NISPID).
Additional affiliations
January 2008 - November 2022

Position
- Head of Paediatric Infectious Diseases Unit; Chairman National Steering Committee on Childhood TB, National TB Control Programme; Secretary, Nigerian Society for Paediatric Infectious Diseases (NISPID)
Description
- 2nd Vice Chairman Stop TB Partnership Board Nigeria; Member, Paediatric Association of Nigeria Committee on Childhood Pneumonia; National Co-Investigator in the National transitioning of children to Peadiatric Delutogravir ART formulations (TORPEDO Study), Member in the National Core Team for the Global Alliance to end HIV in Children; Member in the National Survey Team for the External Validation of WHO Diagnostic Algorithms for Clinical Decision Making on Childhood TB.
January 2018 - present
October 2014 - December 2017
Ahmadu Bello University Teaching Hospital
Position
- Professor (Associate)
Description
- 1. Lecturer for Undergraduate, postgraduate and In-service trainings on Infectious Diseases, PMTCT and child survival 2. Member, accreditation teams for Nigerian Medical Council and the West African College of Physicians.
Publications
Publications (97)
Introduction: Since 2022, Nigeria has experienced an unprecedented reemergence of the severe forms of diphtheria. This has prompted the country to introduce reactive vaccination campaigns targeting children under fourteen. Here, we report a case of fatal malignant diphtheria in a 7-year-old Nigerian girl who had received booster diphtheria vaccine....
Introduction: Nigeria has been experiencing a reemergence of diphtheria including the severest forms of the disease, since 2022. In this review, we describe the cases of diphtheria admitted into the paediatric wards of the ABUTH, Zaria over a one-year period.
Methods: The hospital records of all patients admitted into the Paediatric wards between 1...
BACKGROUND: Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice. METHODS: We conducted a 6-countr...
Background:
Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice.
Methods:
We conducted a 6-cou...
The Paediatric Association of Nigeria first published management guideline for community-acquired pneumonia in 2015 and covered available evidence at that time.
This update represents a review of available recent evidence statements regarding the management of pneumonia in children, while at the same time incorporating relevant materials from the...
IMPORTANCE Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. OBJECTIVE To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. DESIGN, SETTING, AND PA...
IMPORTANCE Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. OBJECTIVE To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. DESIGN, SETTING, AND PA...
IMPORTANCE Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. OBJECTIVE To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. DESIGN, SETTING, AND PA...
Importance: Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. / Objective: To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. / Design, Setting,...
Globally, there are prevailing knowledge gaps in the epidemiology, clinical manifestations, and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among children and adolescents; and these gaps are especially wide in African countries. The availability of robust age-disaggregated data is a critical first step in impr...
• Nigeria has the largest number of children living with HIV and has been recognized as
important for the global control of the epidemic.
• However, poor retention of children in HIV care has emerged as a major obstacle to
attaining the 90-90-90 targets for children in the country.
• A cumulative average loss-to-follow-up (LTFU) rate of 29.3% wa...
Loss-to-follow-up (LTFU) of clients on antiretroviral
therapy (ART) is a serious challenge to the success of HIV
control worldwide 1
• The WHO has reported an overall LTFU of patients
enrolled into HIV of 23% from enrolment to success 1
• In Nigeria, a systematic review has revealed a LTFU rate
of 37% by the first infant PMTCT clinic visit (4 weeks...
Globally, there are prevailing knowledge gaps in the epidemiology, clinical manifestations, and outcomes of SARS-CoV-2 infection among children and adolescents; however, these gaps are especially wide in African countries. The availability of robust age-disaggregated data is a critical first step in improving knowledge on disease burden and manifes...
In the African context, there is a paucity of data on SARS-CoV-2 infection and associated COVID-19 in pregnancy. Given the endemicity of infections such as malaria, HIV, and tuberculosis (TB) in sub-Saharan Africa (SSA), it is important to evaluate coinfections with SARS-CoV-2 and their impact on maternal/infant outcomes.
Robust research is criti...
Background: Rational prescribing is essential to prevent medication errors, antibiotic resistance, and treatment failure. Assessment of prescribing practices helps monitor the utilization of medicines. Objectives: The aim of this study was to evaluate the prescribing pattern and utilization of antibiotics for children attending outpatient units. Ma...
Child sexual assault has gained global attention as a medico-social problem with significant immediate and long-term impact on victims, their families and society. This abhorrent deviant act may present with bizarre manifestations including various objects inserted into body orifices of victims. We report a bizarre case of anal impaction of an orga...
Background
Diagnostic delay constitutes an impediment to control the global tuberculosis epidemic. AFB microscopy has poor sensitivity, while culture, although the gold standard, has longer turnaround time and biosafety challenges. The Xpert MTB/RIF (Cepheid) assay, has been shown to improve TB diagnostic yield especially in people living with HIV...
Background
In 2016, the National Tuberculosis and Leprosy Control Programme (NTBLCP) conducted an assessment of Nigeria’s Childhood TB control efforts using the KNCV Childhood TB benchmarking tool. It is a self-assessment tool comprising standards for monitoring progress in the realization of policies within the framework of a National TB programm...
Background
Children are generally recognized as among the highest risk groups for acquisition and progression of tuberculosis (TB). The WHO estimates that childhood TB accounts for between 10-15% of global figures. In 2011 the National programme initiated the documentation of bacteriologically diagnosed adult separately from clinically diagnosed wh...
Background
Tuberculosis preventive therapy (TPT) is a core strategy for attaining the End TB targets and under-five children (U5C) are a priority group. Nigeria has up to four U5C contacts to every TB infected adult that are TPT eligible. In line with commitments of the September 2018 UN High Level Meeting on TB, Nigeria is expected to have placed...
Background: Waning of measles herd immunity in vaccinated subjects with time since vaccination is one of the factors implicated in the persistence of the infection.
Objective: To determine the relationship between measles herd immunity and time since vaccination in vaccinated under-fives in Zaria, Nigeria
Methods: The study was cross-sectional, d...
Confirmatory diagnosis of tuberculosis (TB) in children and human immunodeficiency virus-infected individuals continues to pose a challenge in resource-limited settings. Although the Xpert MTB/RIF assay is sensitive and rapid, its ability to detect Mycobacterium tuberculosis is low in smear-negative TB, a compelling situation to resort to empirical...
Liver disease is the most common non-AIDS related cause of death among HIV-infected adults in the western world accounting for 14-18% of all deaths.[1,2,3,4] Very limited literature on hepatobiliary disease is available in the paediatric population, hence inferences drawn from this system are from the adults.[3] Hepatobiliary disease in people livi...
Necrotising pneumonia (NP) is a rare complication of bacterial pneumonia which is associated with severe morbidity and mortality. Pneumonia of polymicrobial aetiology predicts worse pathology with fulminating clinical course. Reports of necrotising pneumonia from multiple bacterial infections are scanty in published literature. We report a case of...
Shobowale et al.[1] in their article on neonatal sepsis, reported about findings suggesting that the prevalence of neonatal sepsis was higher in “out born” neonates, those with prematurity, premature rupture of membranes (PROMs) and those aged <3 days. There are, however, up to 17 notably contentious identifiable issues that cast some doubt about t...
Background:
Nigeria has the highest burden of paediatric HIV infection, and the success of control efforts in the country is crucial to the global control of the HIV epidemic. However, defaults from schedules of care pose a threat to paediatric HIV control in Nigeria. This study was conducted in a pioneer facility for the implementation of the Nat...
Background
Nigeria has the highest burden of paediatric HIV infection, and the success of control efforts in the country is crucial to the global control of the HIV epidemic. However, defaults from schedules of care pose a threat to paediatric HIV control in Nigeria. This study was conducted in a pioneer facility for the implementation of the Natio...
A case report on impacted corn cob in a child victim of serial sexual assault
Introduction: Necrotizing pneumonia is a rare entity associated with severe morbidity and mortality but reported consistently with single bacterial aetiology. Multiple bacterial aetiology predicts worse pathology with fulminating clinical course. Reports of necrotizing pneumonia from multiple bacterial infections are scanty in published literature....
worldwide and threatens to reverse the gains of increased access to HIV care in Nigeria. Knowledge of the extent of LTFU could help inform evidence-based strategies for improved retention in care.
Objective: To evaluate the magnitude of LTFU at a pioneer Paediatric Antiretroviral therapy (ART) Clinic.
Subjects and Methods: This was a retrospective...
Background: Nigeria has the largest number of children living with HIV and the control of paediatric HIV in the country is crucial to Global HIV control efforts. In spite of numerous consequences of poor retention in care there is paucity of reports on caregiver perspectives on reasons for default from care. We aimed to explore these reasons from p...
Background: Nigeria has the highest burden of paediatric HIV infection and the success of control efforts in the country is crucial to the global control of the HIV epidemic. However, defaults from schedules of care poses a threat to paediatric HIV control in Nigeria. This study was conducted in a pioneer facility for the implementation of the Nati...
Background: Nigeria has the largest number of children living with HIV and the control of paediatric HIV in the country is crucial to Global HIV control efforts. In spite of numerous consequences of poor retention in care there is paucity of reports on caregiver perspectives on reasons for default from care. We aimed to explore these reasons from p...
Background:
Assessment of patterns of drug to detect performance problems and compliance with standards facilitates objective comparisons and impact evaluation. Children are at higher risk of consequences of irrational prescribing and antibiotic misuse.
Objective:
The objective of the study was to evaluate the prescribing pattern and utilization...
Background:
Neonatal deaths contribute significantly to slower progress in under-5 mortality reduction. Lack of sufficiently trained birth assistants partly contributes to early neonatal deaths. Resuscitation training equips frontline health-care workers (HCWs) with requisite knowledge and skills to prevent birth asphyxia.
Objective:
The objecti...
Llewelyn and his colleagues,[1] have identified the lack of evidence to support the continued use of the
information message advising patients to always complete their antibiotic course and suggested replacing it
with advice to “stop treatment when the patient feels better”. But it could be argued that this communication
message is still rather as...
Purpura fulminans is a rare consequence of sepsis that could be complicated by DIC and gangrene. We report the case of a 2-months-old infant who developed gangrenous limbs. He presented with fever, diarrhoea, vomiting and irritability for 5 days and was dehydrated and unconscious with global hypertonia. With a clinical impression of sepsis antibiot...
Background: Osteomyelitis is a debilitating disease often associated with higher morbidity among children with sickle cell anaemia (SCA). The leading aetiologic agents among children with SCA are Staphylococcus and Salmonella species. Although recent observations reveal varying patterns, reports on isolation of drug resistant Klebsiella pneumoniae...
Background: Multidrug resistant tuberculosis (MDR-TB) is an emerging global scourge increasingly affecting children. The challenges of MDR-TB management are further aggravated by concomitant HIV infection, often leading to higher mortality. Inappropriate management of TB cases could lead to transmission to the most vulnerable groups. There are only...
Background:
Blood lipid profiles are known to be under the influence of genetic and environmental factors, with considerable age variation. While lipid levels are generally lower in childhood and may predict future risk for atherosclerosis, normal ranges in cord blood have not been fully evaluated in developing countries.
Objective:
To evaluate t...
Ceftriaxone is a third-generation cephalosporin with a wide spectrum of activity against both gram-negative and gram-positive organisms. Ceftriaxone has proven efficacy against severe and difficult-to-treat community-acquired infections including typhoid fever and other sepsis syndromes caused by multi-drug resistant organisms. Several studies incl...
ABSTRACT
Background
The risk of HIV transmission could persist despite preventive interventions. Feeding practices may continue to influence HIV transmission and morbidity-free survival amongst exposed infants.
Objective
To study the relationship between feeding, postnatal HIV transmission and morbidity amongst HIV exposed infants.
Methodology
A...
Infection prevention and control is a vital component of healthcare delivery targeted at reducing the risk of acquiring and transmitting infections in patients, health care workers and visitors to the facility. Healthcare associated infections (HAIs), also termed as nosocomial infections, are those infections in hospitals or healthcare service unit...
The broad learning objectives of this Chapter are to foster the increased awareness, in-depth knowledge and improved understanding of the importance, epidemiology, diagnosis and management of viral haemorrhagic fevers (VHFs), particularly Lassa fever and Ebola. The former has been endemic in the Sub-Region for decades while the latter announced its...
Infection prevention and control (IPC) are vital components of healthcare delivery targeted at reducing the risk of acquiring and transmitting infections among patients, health care workers (HCWs) and visitors. Healthcare associated infections (HAIs) or nosocomial infections, are infections in hospitals or healthcare service units, that first appea...
The broad learning objectives of this Chapter are to foster the increased awareness, in-depth knowledge and improved understanding of the importance, epidemiology, diagnosis and management of viral haemorrhagic fevers (VHFs), particularly Lassa fever and Ebola. The former has been endemic in the Sub-Region for decades while the latter announced its...
Multicystic dysplastic kidney (MCDK) is one of the most common forms of congenital cystic diseases of the kidney that usually occurs sporadically and may rarely be associated with concomitant anomalies of the heart, spine, brain, and gastrointestinal system. The disorder is known to be commonly associated with a normally situated functional contral...
Caregiver satisfaction has the potential to promote equity for children living with HIV, by influencing health-seeking behaviour. We measured dimensions of caregiver satisfaction with paediatric HIV treatment in Nigeria, and discuss its implications for equity by conducting facility-based exit interviews for caregivers of children receiving antiret...
ABSTRACT
Introduction
Diagnosing TB in children remains challenging and treatment requires specific considerations. The WHO has developed a benchmarking tool containing standards to guide countries on addressing childhood TB. It is a self-assessment tool for monitoring progress in the realization of policies within the framework of a National TB pr...
Introduction
Confirmatory diagnosis of tuberculosis (TB) in children and HIV infected individuals continues to pose a challenge in resource-limited settings. Although the MTB/Rif GeneXpert is a sensitive and rapid test, it is not yet widely available and its ability to detect MTB is still limited in children, a compelling situation for empirical an...
Background Although the HIV epidemic has mostly stabilized worldwide, the steady rise in the number of children orphaned by AIDS in sub-Saharan Africa currently accounts for an increase in the total population of orphans. The quality of alternative care will depend on the caregiver and the setting. Information on caregivers and the care settings fo...
Background
The risk of postnatal HIV transmission could still prevail despite availability of proven PMTCT interventions. The HIV free survival of infants may still be influenced by feeding practices and poor adherence to care services.
Objective
To study the relationships between infant feeding patterns on a background of ARV use and risk of po...
Introduction: Leaving hospital care prematurely could threaten the healthy survival of and expose children to a risk of harmful alternatives. It is also a concern and a challenge to health-care providers and the health sys-tem. A better understanding of its characteristic could help mitigate the impact on children. Objective: To determine the preva...
BACKGROUND
As the global community seeks to achieve universal access to ART by 2015 and look ahead to reach the 90-90-90 targets by 2020, a key challenge is ensuring that antiretroviral drugs for children are adapted to the context of resource-limited settings.
The World Health Organization (WHO) is currently updating the consolidated guidelines on...
Background: Under-five mortality rate is an important index for assessing achievements by countries and thus its targeted reduction is adopted as bench-mark towards realising the Millennium Development Goal number 4 by 2015. With less than 24 months to the deadline, West Africa still contributes significantly to the global burden of child mortality...
Background
Childhood tuberculosis (TB) remains largely neglected and underreported globally despite efforts towards realising the MDG targets for reduction of its prevalence. While Nigeria ranks among the 22 highest burden countries, the challenges of management of childhood TB pose serious threats to the country’s progress. We report the pattern a...
TOWARDS ATTAINING THE MDG4 IN WEST AFRICA:
THE PROGRESS, CHALLENGES AND PROSPECTS
Dr. L. W UMAR MBBS, FWACPaed
Infectious Disease Unit, Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
Abstract
The Millennium Development Goal 4 (MDG4) is a global commitment to reduce the under-five mortality levels of 1990 by...
The Millennium Development Goal 4 (MDG4) is a global commitment to reduce the under-five mortality levels of 1990 by two-thirds, come 2015. In West Africa, over half of under-five child deaths are caused by infectious diseases, followed closely by neonatal problems. Whereas other regions halved their under-five mortality rates the West and Central...
Objective: Human Immunodeficiency Viral infection and Protein Energy Malnutrition (PEM) are highly prevalent in Nigeria and when they occur together, the outcome is usually severe as both conditions lead to immune suppression. HIV alone accounts for 14.0% of childhood mortality even though children constitute only 6% of global HIV infection burden....
Typhoid fever is a systemic infection caused by the Gram-negative bacilli Salmonel-lae, transmitted via the feaco-oral route. It commonly affects chil-dren, leading to complications and death if untreated. This is a report of typhoid fever admissions as seen at ABU Teaching Hospital Zaria over a 13-month period. Objectives: To describe the clini-ca...
Background
Varicella Zoster virus (VZV) infection is a serious co-infection in HIV infected children and may lead to visceral dissemination in the severely immune-compromised with risk of high mortality.
Objective
To report a case of fulminant cutaneous form of varicella infection unaccompanied by visceral involvement in a severely immune-suppress...
BACKGROUND
Symmetric peripheral gangrene is a rare but grievous complication of sepsis and hypernatraemia in children.
OBJECTIVE: To present the case of a 2 months old infant admitted with a diagnosis of severe sepsis and shock, whose illness became complicated by symmetric gangrene of the lower limbs.
METHOD: Case report
RESULTS: A.M presented w...
Background
Child survival after cancer diagnosis is generally limited in sub-Saharan Africa and HIV/AIDS is associated with a high risk of cancer and its mortality. Scanty reports exist of cancer survival of HIV infected children.
Objective
To report the rare survival of an HIV infected adolescent eight years after occurrence of dual neoplasms.
R...
In 2008, several Nigerian children developed acute kidney injury (AKI) after ingesting teething syrup contaminated with diethylene glycol (DEG). Because there are limited diagnostic facilities in resource-constrained countries, this study investigated whether AKI associated with DEG could be identified by other means.
This was a multicenter study....
Multiple choice questions (MCQs) have emerged as an objective and veritable means of assessing knowledge of Resident Doctors in various sub-specialties of post graduate training not just in West Africa but the World over. MCQs have therefore become the standard in this regard and Paediatric specialty is not an exception. Indeed the MCQs have become...
Background:
Multicystic dysplastic kidney (MCDK) is the commonest cause of abdominal masses found in newborns and the commonest cystic malformation of the kidney in infancy. Though MCDK disease is often associated with contralateral genitourinary tract abnormalities it is rarely combined with ectopic kidney.
Objective: To report the rare associati...
Introduction:
Leaving hospital care prematurely could threaten the healthy survival of and expose children to a risk of harmful alternatives. It is also a concern and a challenge to healthcare providers and the health system. A better understanding of its characteristic could help mitigate the impact on children.
Objective:
To determine the preva...
Background: Multi-cystic dysplastic kidney (MCDK) is the commonest cause of cystic abdominal mass in infancy. Though often associated with contra-lateral genitourinary tract anomalies, it is rarely combined with renal ectopia.
Objective: To report a rare occurrence in infancy of a non-functional ipsi-lateral multi-cystic dysplastic kidney with a fu...
BACKGROUND
The prevalence of neurologic dysfunction in untreated vertically acquired HIV infection ranges between 30-60% and 90% for progressive and static encephalopathy respectively. Features typically appear from infancy to 5 years with one or more signs that include failure to attain/loss of developmental milestones, loss of intellect, microce...
BACKGROUND
The impact of the HIV epidemic has potential for exacerbation by orphan hood and vulnerability due to risk of early sexual exposure. Adolescents are especially at such risk and that of unwanted pregnancy. Reports of HIV-associated vulnerability transmitted across generations of a family are rather scanty from Nigeria.
OBJECTIVE
To highl...
BACKGROUND
Decisions to terminate hospital care poses threats to healthy survival and exposes children to risks of harmful alternatives. The associated child right issues expose responsibility gaps of caregivers and the health system. Understanding the factors associated with premature discharge could help improve adherence to hospital care.
OBJECT...
Background: Sexual abuse of children is a global health and human rights problem that has been largely underreported and understudied in sub-Saharan Africa. Little is therefore known regarding information on the nature of child sexual abuse and the predisposing factors in our communities. Objective: To study the demographic features of individuals...
Background:
Child sexual abuse is a widespread form of child abuse that has remained the most under-reported. In our communities, much remains unknown of this act which often leaves victims traumatised with unsavory memory that tends to affect their psychosocial development. The study evaluted the socio-demographic features and the nature of sexua...
Background
Sexual assault is an elusive but widespread form of abuse for which a lot more remains unknown. It often leaves child victims physically traumatised with unpleasant memory that tends to affect psychosocial development.
Objective
To study the demographic features of individuals involved in sexual abuse and the pattern of presentation of...
Background
Sexual abuse is an under-studied and under-reported global health and human-rights problem. Little is therefore known on its magnitude and predisposing factors especially in children.
Objective
To study the demographic features of individuals involved in sexual assault and the pattern of presentation of cases at the General Hospital Sul...
We report an unusual case of lower limb gangrene in a pubertal boy following a typical clinical presentation of septicaemia due to Salmonella typhi. After an initial response to presumed appropriate antibiotic and supportive therapy, the patient developed tissue ischaemia in both feet. There were no clinical or laboratory evidence suggestive of DIC...
SInce the discovery of the Human immunodeficiency virus (HIV) in the early 1980s, great strides had been recorded in better laboratory diagnosis, pathogenesis, case definition, preventive strategies and treatment options.
In the last three decades despite all the gains made, the infection and the disease have continued to rise globally with greates...
BACKGROUND: The incidence of malignancies associated with HIV/AIDS is increasing. Management involves the use of Antiretroviral (ARV) drugs (to improve immunity), and treatment of the malignancy.
METHOD: Case report of an 11 year old girl with AIDS (WHO clinical stage 4) and Kaposi sarcoma who had been on ARV therapy for four years. A major challe...
BACKGROUND
Nocturnal enuresis (NE) is believed to be commoner in children with homozygous sickle cell disease (SCD-SS) than in those with normal haemoglobin. The reasons for this have not been established and its prevalence and pattern have not been adequately described in the tropics.
OBJECTIVE
To determine the prevalence and describe the pattern...