Post-neonatal medical admissions into the paediatric ward of Ebonyi State University Teaching Hospital, Abakaliki: the initial experience and outcome
AbstractBackground: In spite of its limitations, hospital-based data on diseases and deaths in children serve as a pointer to what exists in the community at large. Information obtained from such reviews is usually beneficial in re-evaluating existing services, the pattern of illnesses and deaths or changes if any, and in improving facilities and patient care.
Objective: To document the admission diagnoses and deaths among post-neonatal medical cases admitted to the paediatric ward of the Ebonyi State Teaching Hospital (ESTH), Abakaliki during the first two years of its functional operation. Design: A retrospective study of hospital records.
Patients and Methods: The case files of all patients aged above one month to 15 years, admitted to the paediatric ward of ESTH, Abakaliki from January 1, 1999 to December 31, 2000, were reviewed and analyzed. Surgical and trauma cases were excluded.
Results: Of the 718 patients admitted during the period, 484 patients met the criteria for the study. The youngest child was six weeks old and the oldest, 15 years; 69.1 percent were aged five years and below with a male preponderance. There was a discharge rate of 82.6 percent and a mortality of 12.2 percent with 71.2 percent and 52.5 percent of deaths occurring in the under-fives and within 24 hours of presentation, respectively. The commonest causes of admission in the group as a whole were severe malaria (22.3 percent), gastroenteritis (12.8 percent), pneumonia (10.5 percent) and measles with complications (6.8 percent). In the under-five age group, severe malaria (24.6 percent), gastroenteritis (17.4 percent), pneumonia (14.1 percent), measles with complications (7.4 percent) and HIV/AIDS (5.9 percent) were the commonest causes of admission. Bronchopneumonia (19.1 percent), HIV/AIDS (14.3 percent) and measles with complications (11.9 percent) and gastroenteritis with severe dehydration (9.5 percent) were the major causes of death. In the above-fives, severe malaria (17.3 percent), congenital/acquired heart diseases (10.7 percent), meningitis (10.7 percent) and malignancy (10.0 percent) were major causes of admission, while meningitis (29.4 percent) and cerebral malaria (17.6 percent) were the leading causes of death.
Conclusion: The morbidity and mortality in the children were mostly due to infectious and communicable diseases. The study indicates that improvement in health care policy, with particular attention to health education, socio-economic conditions and comprehensive immunization against communicable diseases, should reduce the disease burden and increase survival rate of children in our environment. Measures to prevent paediatric HIV infection are also advocated.
Keywords: post-neonatal, medical admissions, diseases, deaths, under-fives, above-fives, Abakaliki
Nigerian Journal of Paediatrics Vol. 31(3) 2004: 79-86