African Journals OnLine
Nigerian Journal of Paediatrics

Vol 29, No1, January 2002
Abstracts

Exco of PAN Reviewers

An Official Journal of the Paediatric Assocation of Nigeria

Published Quarterly

Ikefuna AN, Emodi IJ. An Assessment of Factors influencing Hospital Discharges Against Medical Advice of Paediatric Patients in Enugu: A Review of 67 Cases. Nigerian Journal of Paediatrics, 2002; 29:1. A study was carried out with the aim of determining the prevalence of discharges against medical advice (DAMA) at the University of Nigeria Teaching Hospital, Enugu as well as identifying the reasons for such requests. Data in respect of 67 patients who fulfilled the criteria for DAMA were analysed. A prevalence rate of 1.8 per cent was obtained for DAMA out of 4443 admissions over the study period. Poor financial support was the commonest reason for discharge against medical advice. Septicaemia was the commonest cause of admission accounting for 17 (25.4 per cent) followed by HIV/pulmonary tuberculosis in 15 (22.4 per cent) cases. Fifty-three (79.1 per cent) children were admitted without a formal referral letter and 51 (76.2 per cent) children were discharged within two weeks of admission while 45 (67.2 per cent) children belonged to the lower social classes. It is concluded that parental low social class, poor financial support and unpreparedness for hospital admission are risk factors for DAMA. A case is made for the implementation of the National Health Insurance Scheme as well as a review of the methods of counseling parents who ask for DAMA for their children or wards. This is important since the children are not directly involved in their parents'/guardians' decision to seek their discharges.

Oyedeji GA, Oyedeji AO, Ajibola AJ. The Association between Social Disadvantage and Morbidity in Hospitalised Children. Nigerian Journal of Paediatrics 2002; 29:5. The nutritional status, length of hospitalization and the diagnoses in 207 socially disadvantaged and 232 non-disadvantaged controls admitted into the Wesley Guild Hospital, Ilesa, over a six-month period were compared. The patterns and frequencies of the diseases diagnosed in the two groups were similar. However, compared with controls, significantly greater percentages of disadvantaged children were hospitalized for over six days (p<0.005), and were malnourished by weight (p<0.001) and by height/length (p<0.005). The findings suggest the need to generate more data on social disadvantage in developing countries and to recognize and give affected children and families special attention at the various health and social care service points. Moreover, services should be provided in the community with a view to reducing the incidence of social disadvantage and at mitigating their effects on child health.

Key words: Social, Disadvantage, Morbidity, Hospitalised children

Fawehinmi Y, Fageeh N, Asindi A. Congenital Stridor as seen in a Neonatal Intensive Care Unit in Saudi Arabia. Nigerian Journal of Paediatrics 2002; 29: 11. A prospective study was carried out to determine the prevalent causes and management of congenital stridor in a referral neonatal intensive care unit of Assir Central Hospital, Abha, Saudi Arabia, between 1996 and 1999. Forty cases consisting of 25 males and 15 females were identified during the period . The predominant cause was laryngomalacia in 25 (62.5 per cent) of the cases. Other causes included subglottic stenosis 5 (12.5 per cent), tracheo-oesophageal fistula 3 (7.5 per cent), bilateral vocal cord palsy 2 (5 per cent), vascular compression 2 ( 5 per cent) and one each of laryngeal web, subglottic haemangioma and cystic hygroma. A majority of the laryngomalacia cases resolved spontaneously by the age of 2 years without surgical intervention.

Key words: Congenital stridor, neonates

Ikpatt OF, Ekanem EE, Calabro L, Ogon PM, Chieco-Bianchi L. Seroprevalence of Human Herpes virus-8 (HHV-8) among Children Attending an Emergency Room in South-Eastern Nigeria Nigerian Journal of Paediatrics 2002; 29:14. The seroprevalence of Human herpesvirus-8 (HHV-8) was studied in 56 children aged two to 14 years. Subjects were children seen consecutively in the Children Emergency Room of the University of Calabar Teaching Hospital in January 2000. Sera from the children were screened for antibodies to the small capsid related protein encoded by ORF 65 (Lytic antigen) by the ELISA technique and Latency Associated Nuclear Antigen (LANA) by the immunoflourescent assay. Of the 56 children, 42 (76.9 per cent) had antibodies to at least, one of the antigens. The rate of infection correlated positively with age (r= 0.45; p<0.002), with a double peak of 90 per cent and 85 per cent at ages five to seven and 11-14 years, respectively. Infection was also highest in children from low socio-economic background. It is concluded that the prevalence of HHV-8 is high among children in this environment, sexual route of transmission is unlikely, and that low socio-economic status, and possibly crowding, are important parameters associated with the infection. The role of droplets in the transmission of HHV-8 should be investigated.

Fawehinmi Y. Acute Suppurative Parotitis and Parotid Abscess in Young Children. Nigerian Journal of Paediatrics 2002; 29:17. Acute suppurative parotitis in three children, aged between eight months and two years who presented within a period of one month is described. Despite prompt treatment with intravenous antibiotics, the swellings in two of the three progressed to abscesses whose identification was facilitated by ultrasonic examination. The organism isolated from purulent specimens from the drained abscesses consisted of Staphylococcus aureus, while one of the two that progressed to an abscess had in addition, an anaerobic organism, Fusobaccterium nucleatum. All the three recovered completely. Based on our experience, it is advocated that the management of infants with suppurative parotitis should include adequate antibiotic cover for streptococcus, staphylococcus and bacteroides, while drainage, using Blair's modified incision should be undertaken where an abscess is present. The efficacy of ultrasound examination in the diagnosis of parotid gland abscess is highlighted.