Morbidity and mortality pattern at the emergency paediatric unit of Mother and Child Hospital Akure, Nigeria

Abstract

Background: Morbidity and mortality pattern differs among regions. Also, there may be variations within a nation partly due to availability and cost of health services as well as the health-seeking behavior of the people.

Aims: To describe the spectrum and outcome of paediatricmedical emergencies in a free integrated maternal and child health facility in south western Nigeria. Also, the likelihood of death from specific diseases in the setting was evaluated.

Methods: The data were analyzed using the Software Package for Social Science (SPSS) version 20.0 (Windows Inc; Chicago, IL, USA). Categorized data were presented as percentages. Using inferential analysis, Odds ratio (OR) and 95% confidence interval (CI) were calculated for common disorders as possible predictors of under-five mortality. P-value <0.05 was considered significant.

Results: The total number of under-fives admitted in the EPU during the study period was 2361, with a male preponderance (53.5%); 21.3% were neonates (<1month old), 38.8% post-neonatal infants (1-12months) and the rest (39.9%) aged 13-60months.The commonest emergencies seen in the unit were severe malaria (31.2%), gastroenteritis (16.9%) and pneumonia (8.6%). The overall mortality rate was low (3.7%) with a majority (96.6%) of deaths occurring in the first 24 hours.The commonest causes of death were infections. The case fatality rates (CFR’s) were as follows: septicemia (38.5%), aspiration pneumonitis (10.5%), meningitis (10.0%), severe malnutrition (7.0%), severe malaria (5.6%), gastroenteritis (4.3%), pneumonia (2.9%) and neonatal disorders (2.2%). The most significant predictors of death were septicemia (OR = 17.06, 95% C.I. = 5.46-53.26)and severe malaria (OR = 1.98, 95% C.I. = 1.29-3.03).

Conclusion: Infectious diseases are the leading paediatric emergencies and commonest causes of deaths among under-five children in our hospital. The overall outcome of childhood disorders managed in our cost-free facility compared favorably with findings in fee-paying health systems elsewhere in Nigeria.

Keywords: morbidity, mortality, paediatric emergencies, Mother and Child Hospital