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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Association of blood lead level with neurological features in 972 children affected by an acute severe lead poisoning outbreak in zamfara state, Northern Nigeria
PLoS ONE, Volume 9, No. 4, Article e93716, Year 2014
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Description
Background: In 2010, Médecins Sans Frontières (MSF) investigated reports of high mortality in young children in Zamfara State, Nigeria, leading to confirmation of villages with widespread acute severe lead poisoning. In a retrospective analysis, we aimed to determine venous blood lead level (VBLL) thresholds and risk factors for encephalopathy using MSF programmatic data from the first year of the outbreak response. Methods and Findings: We included children aged ≤5 years with VBLL ≥45 mg/dL before any chelation and recorded neurological status. Odds ratios (OR) for neurological features were estimated; the final model was adjusted for age and baseline VBLL, using random effects for village of residence. 972 children met inclusion criteria: 885 (91%) had no neurological features; 34 (4%) had severe features; 47 (5%) had reported recent seizures; and six (1%) had other neurological abnormalities. The geometric mean VBLLs for all groups with neurological features were >100 μg/dL vs 65.9 mg/dL for those without neurological features. The adjusted OR for neurological features increased with increasing VBLL: from 2.75, 95%CI 1.27-5.98 (80-99.9 μg/dL) to 22.95, 95%CI 10.54-49.96 (≥120 μg/dL). Neurological features were associated with younger age (OR 4.77 [95% CI 2.50-9.11] for 1-<2 years and 2.69 [95%CI 1.15-6.26] for 2-<3 years, both vs 3-5 years). Severe neurological features were seen at VBLL <105 μg/dL only in those with malaria. Interpretation: Increasing VBLL (from ≥80 μg/dL) and age 1-<3 years were strongly associated with neurological features; in those tested for malaria, a positive test was also strongly associated. These factors will help clinicians managing children with lead poisoning in prioritising therapy and developing chelation protocols. © 2014 Greig et al.
Authors & Co-Authors
Greig, Jane E.
Unknown Affiliation
Thurtle, Natalie
Unknown Affiliation
Cooney, Lauren
Unknown Affiliation
Ariti, Cono A.
Unknown Affiliation
Ahmed, Abdulkadir Ola
Unknown Affiliation
Ashagre, Teshome
Unknown Affiliation
Ayela, Anthony
Unknown Affiliation
Chukwumalu, Kingsley
Unknown Affiliation
Criado-Perez, Alison
Unknown Affiliation
Gómez-Restrepo, Camilo
Unknown Affiliation
Meredith, Caitlin
Unknown Affiliation
Neri, Antonio James
Unknown Affiliation
Stellmach, Darryl
Unknown Affiliation
Sani-Gwarzo, Nasir
Unknown Affiliation
Nasidi, Abdulsalami Salam
Unknown Affiliation
Shanks, Leslie
Unknown Affiliation
Dargan, Paul I.
Unknown Affiliation
Statistics
Citations: 50
Authors: 17
Affiliations: 8
Identifiers
Doi:
10.1371/journal.pone.0093716
e-ISSN:
19326203
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Locations
Nigeria