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Published:
Jul 10, 2013Keywords:
Hypoglycaemia Post-neonatal Paediatric emergencies Nigeria.
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Post-Neonatal Hypoglycaemia and Paediatric Emergency Room Admissions: A Study In The University Of Port Harcourt Teaching Hospital.
Abstract
Background: Hypoglycaemia, a common complication of many childhood diseases, significantly increases disease-related morbidity and mortality. The objective of this study is to determine the prevalence, morbidity pattern and outcomes of hypoglycaemia at admission of postneonatal children in the Children's Emergency Ward (CHEW) of the University of Port Harcourt Teaching (UPTH).
Methods: All post-neonatal children admitted into the UPTH CHEW from September 2007-January 2008 who met the inclusion criteria were prospectively studied using a pre-tested proforma which obtained their sociodemographic and clinical data. In all subjects, plasma glucose was determined on admission (using glucometer and glucose oxidase tests) before management. Data analysis was with EPI Info version 6.04 and statistical significance was set at 0.05.
Results: Three hundred and seventy children aged 1month-15 years (mean 36.7±40 months) with 272(78.9%) under-fives were studied. Their plasma glucose levels ranged from 1.0-12mmol/l with 19(5.1%) children among whom were 15(78.9%) under-fives being hypoglycaemic (plasma glucose-1.0-2.4mmol/l, mean 1.4 + 0.2mmol/l). All cases of hypoglycaemia were detected by both methods of estimation. The commonest diseases diagnosed in the study population, irrespective of the plasma glucose level, were malaria, anaemia and diarrhoea. Overall, 49 (13.2%) children of whom 7(14.3%) were hypoglycaemic died. Hypoglycaemia was associated with longer hospital stay and higher mortality rate (36.8%) (p=0.001).
Conclusion: Hypoglycaemia, detectable by bedside glucometer test, significantly increases morbidity and mortality associated with common childhood diseases. There is therefore a need for its prevention, early diagnosis and prompt management in all paediatric care settings, especially in resource-limited countries, as recommended in the Integrated Management of Childhood Illness algorithm.
Keywords: Hypoglycaemia; Post-neonatal; Paediatric emergencies; Nigeria.
Methods: All post-neonatal children admitted into the UPTH CHEW from September 2007-January 2008 who met the inclusion criteria were prospectively studied using a pre-tested proforma which obtained their sociodemographic and clinical data. In all subjects, plasma glucose was determined on admission (using glucometer and glucose oxidase tests) before management. Data analysis was with EPI Info version 6.04 and statistical significance was set at 0.05.
Results: Three hundred and seventy children aged 1month-15 years (mean 36.7±40 months) with 272(78.9%) under-fives were studied. Their plasma glucose levels ranged from 1.0-12mmol/l with 19(5.1%) children among whom were 15(78.9%) under-fives being hypoglycaemic (plasma glucose-1.0-2.4mmol/l, mean 1.4 + 0.2mmol/l). All cases of hypoglycaemia were detected by both methods of estimation. The commonest diseases diagnosed in the study population, irrespective of the plasma glucose level, were malaria, anaemia and diarrhoea. Overall, 49 (13.2%) children of whom 7(14.3%) were hypoglycaemic died. Hypoglycaemia was associated with longer hospital stay and higher mortality rate (36.8%) (p=0.001).
Conclusion: Hypoglycaemia, detectable by bedside glucometer test, significantly increases morbidity and mortality associated with common childhood diseases. There is therefore a need for its prevention, early diagnosis and prompt management in all paediatric care settings, especially in resource-limited countries, as recommended in the Integrated Management of Childhood Illness algorithm.
Keywords: Hypoglycaemia; Post-neonatal; Paediatric emergencies; Nigeria.
