PAEDIATRICS

Emergency Paediatrics:

This began as a Children’s Emergency Room in the Medical Outpatients Department (MOP) which closed at 6.00pm at which time children who were too ill to go home were transferred to the Casualty Department together with the adults.  Later, a part of the Casualty Department was set aside for children. In 1988, after the Casualty Department moved to the new Accident and Emergency Department, the Department of Paediatrics took over the old Casualty Department with the support and generous donation from a Nigerian philanthropist, Otunba Subomi Balogun. In view of this, the Unit was re-designated the Otunba Tunwase Children’s Emergency Ward (OTCHEW) in his honour.

Postgraduate Training:

Initially, postgraduate training was inclusive of a one/two year training experience within UCH while preparing for foreign professional Membership/Fellowship postgraduate examinations for which such trainees went abroad. In 1975, a Master in Medicine (M.Med) Postgraduate training started in Nigeria, but the Department of Paediatrics did not enrol any student on this Programme before it was overtaken by the National Postgraduate Medical College of Nigeria in 1976.  Currently, the Department presents candidates for the National Postgraduate Medical College Examinations in Paediatrics as well as the West African College of Physician Examination of which Ibadan is the regional headquarters.  The Doctor of Medicine (MD) programme in Paediatrics was inaugurated in 1973 and till date has been awarded to eight deserving teachers/clinicians/researchers.

The UCH Department of Paediatrics retains the leading position among similar departments in Nigeria. It has trained a number of specialists since the inception of the Postgraduate programme in Nigeria and has 17 consultants in charge of the various units in the department.

Research:

The department was a pioneer in most areas of paediatric research in Nigeria. A Paediatrics Research laboratory was established where bilirubin estimation on samples obtained within and outside the hospital was carried out.  This laboratory set the pace in research into neonatal jaundice, malaria and sickle cell disease in children. The department’s cytogenetic facility was for many years, the only one of its kind in Nigeria. The prevailing economic situation in the hospital and Nigeria, forced a discontinuation of this facility several years ago. The department has also established a modification for the qualitative estimation of peroxidase haemolysis as an indirect measure of vitamin E which impacts on several research areas. The research laboratory maintains its leadership position in research on G6PD and neonatal jaundice.

Research funds have come from the World Health Organization (WHO), the United Nations International Children Emergency Fund (UNICEF), while some have come from local sources such as the Senate of the University of Ibadan.  However, much of the work done within the Department, are performed through the sheer ingenuity of the staff often supplemented by money from their own pockets. Senior Registrars working for the Postgraduate professional part II (Final) examination sometimes receive small grants from the UCH, in addition to some funds from their own pockets, particularly in undertaking studies which are not completely covered by the research facilities of their supervising consultants.

The Paediatrics Department pioneered the work on primary stroke prevention in children with sickle cell disease (SCD) in Nigerian through routine Trans Cranial Doppler (TCD) screening.  The Department established the first routine TCD clinic at the CHOP arena in July 2009. More than 750 children with SCD have been enrolled in the programme with the achievement of a drastic and remarkable decline in childhood stroke burden in South West Nigeria.

The Neonatology Unit of the University College Hospital, Ibadan is part of the African-Asia site that took part in the research into the possible serious bacterial infection management using simplified antibiotics. This has led to the development of a new WHO algorithm on the management of newborn infections when referral is not possible. The unit has also successfully developed newborn kidney, Liver and Spleen monograms.

The Paediatric Nephrology division has contributed to pioneering work on the description of Quartian Malaria Nephropathy, a form of nephrotic syndrome in children that is usually steroid resistant, and tends to progress to end stage kidney disease. The earliest reports of paediatric penitoneal dialysis in Nigeria are also from this Unit. The unit was one of the pioneers of peritoneal dialysis in Nigeria using adaptations.  This adaptation has saved the lives of children with acute kidney injury and has also inspired other centres to use adaptations for peritoneal dialysis when the recommended gadgets are not available. Additionally, the Unit has provided intensive care for the most vulnerable babies from 25 weeks gestation upwards. The Paediatrics Department, UCH, Ibadan is also one of the first centres in the country to embrace Kangaroo mother care for small babies.

Furthermore, the department has trained many resident doctors some of whom have become foremost neonatologists within and outside the country. Doctors and nurses of the department are part of the national trainers in neonatal resuscitation and essential newborn care. The department is also involved in collaborative research within and outside the Country.