Pattern and outcome of postneonatal pediatric emergencies in Nnamdi Azikiwe University Teaching Hospital, Nnewi, South East Nigeria

Abstract

Background: Nigeria is still battling with preventable childhood deaths, being one of the six countries in which 50% of all global child deaths occur. Regular community and health facility audits are needed to determine morbidity and mortality patterns in children which will guide preventive and therapeutic interventions.
Objectives: The objective was to determine morbidity and mortality patterns, and identify factors influencing poor outcome of the disease in children seen in the emergency room of Nnamdi Azikiwe University Teaching Hospital, Nnewi.
Materials and Methods: This was a 2‑year retrospective study (March 2012 to February 2014) involving all children admitted into the children emergency room (CHER). Information on the patients’ biodata, diagnosis, and outcome were retrieved from the CHER doctors’ log. Analysis was done using Microsoft Office Excel 2007 and Statistical Package for Social Sciences version 20.
Results: The total of 1964 patients were seen (1088 males, 845 females, 31 unspecified) with a male to female ratio of 1.3:1. Under‑fives constituted 78.8% of the study population. Mean duration of illness before presentation was 18.71 ± 71.94 days. Malaria, diarrheal disease, and respiratory tract infections were the most common morbidities. Sepsis had the highest case fatality rate (CFR) and was the most common cause of death among the 247 patients that died – mortality rate of 12.6%. Most deaths were in under‑fives (CFR = 13.9, 2 = 25.553, P = 0.000), with 74.1% of the mortalities occurring within 24 h of presentation. Patients who presented within a day and those that presented in the 2nd and 3rd weeks of onset of symptoms had CFR of 6.4–15.2%, respectively.
Conclusion: Infectious diseases remain a menace in our environment with the eventual outcome worsened by late presentation to an appropriate health facility. There is an urgent need to create public awareness on the need to seek prompt medical attention for sick children.

Key words: Emergency, morbidity, mortality, outcome