Admission profile and management of community acquired pneumonia in Nigeria-5 year experience in a tertiary hospital

SummaryBackgroundStudies examining the prevalence, baseline characteristics and outcome of patients admitted with Community Acquired Pneumonia (CAP) are not readily available in Nigeria. This study aims to evaluate the management of CAP at a tertiary hospital in Nigeria with a view to determining the prevalence, characteristics, severity and outcome of the admitted patients.MethodsWe retrospectively collected data from 160 admitted patients with final diagnosis of CAP who met the inclusion criteria. Data relating to their age, gender, clinical details, severity assessment using CURB65 score, laboratory results, initial antibiotics prescribed, and outcome (length of stay, hospital mortality) were collected. Descriptive statistics of demographic and clinical variables were calculated and presented as frequencies, percentage, means, standard deviation and range.ResultsCAP accounted for 2.5% of all medical admissions during the study period. The mean age of the admitted patients was 52.9 ± 18.98 years with about 35% of the patients being at least 65years and above. Sputum culture, Fasting blood sugar and HIV screening were requested for in 49(30.6%), 50(31.3%) 56(35%) patients respectively. None of the patients had severity score documented on admission and only 32(20%) patients had severity score of ≥3 when calculated. Commonly prescribed antibiotics were a combination of intravenous ceftriaxone and metronidazole. Hospital mortality rate was 11.9%ConclusionWe suggest multicenter prospective studies to determine the prevalence and burden of CAP in Nigeria. There is need for an improved assessment and appropriate use of guidelines in the management of patients presenting with CAP

Malaria parasitaemia among febrile under-five children at Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-East, Nigeria

Background: Malaria is an infectious disease caused by Plasmodium and transmitted by the bite of an infected female Anopheles mosquito. It continues to be a global challenge with about half of the world's population being at risk of the disease and under–5 children being the most vulnerable.Aims and Objectives: To determine the prevalence of malaria parasitaemia and some associated symptoms among febrile under-five children presenting at Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria.Materials and Methods: A total of 200 children under the age of five years were recruited for the study. Data on socio-demographic characteristics and symptoms were collected through interviewer administered questionnaire. They were physically examine and blood sample was collected from each of them. The Blood smear was Giemsa stained and examined microscopically for malaria parasite.Result: There were 118 males and 82 females, giving a male: female ratio of 1.44:1. Their ages ranged from 3-59 months and the average age was 27+17.49 months. Those in the age range of 12-23 months and 24-35 months constitute the highest number (23%) each. Forty-seven (23.5%) came from the rural area while 153(76.5%) came from the urban area. Average number of days the subjects had fever before presentation were 3.78+1.95 days with a range of 1-30 0 days. Body temperature ranged from 35.9-40.4 C with average of 37.7+0.8oC. Forty (20%) were positive to microscopy. Those in the age range of 47-59 months have the highest prevalence of malaria. Parasite density ranged from 40-136,000/μL with a mean of 18,687.2+3360/μL. All the children who are positive by microcopy had Plasmodium falciparium as the specie causing malaria.Conclusion: Malaria parasitaemia among these under-5 children is 20%.Keywords: Malaria, parasitaemia, under-

Respiratory symptoms and ventilatory function tests in Nigerians with HIV infection

Background: The impact of the human immunodeficiency virus (HIV) infection on the respiratory system of Africans has been little studied. This study aimed to determine the pattern of respiratory symptoms and ventilatory functions in HIV infected Nigerians. Methods: In this cross sectional study, Respiratory symptoms frequency, Forced vital capacity (FVC), Forced expiratory volume in one second (FEV1), FEV1/FVC ratio, Forced expiratory flow between 25% and 75% of FVC, were determined in 100 HIV positive subjects and compared with values in 100 HIV negative controls. Results: HIV positive patients had significantly more respiratory symptoms and lower ventilatory function tests values compared to the matched controls (