Discharge against medical advice (Dama) in children’s ward the Awka, South East Nigeria experience.

Background: Until recovery, discharge against medical advice (DAMA) is a rare thing that does happen when one is admitted in a Healthfacility, but these days it appears to be a common occurrence due to some factors.Objective: To evaluate the factors responsible for DAMA in children’s ward of Amaku general hospital Awka (AGHA)Patients and method- The case files of children admitted into the children’s ward of AGHA from January 1, 2007 to December 31, 2009 werereviewed and analysedResults: Of the 498 patients admitted, 10 were DAMA giving a prevalence of 2%. Their ages ranged between 3 months – 9 years. Most of them(75%) belonged to lower social class. HIV/AIDS (62.5%) and protein energy malnutrition PEM (25%) were the predominant disease conditionof affected patients. At the time of DAMA, 75% of them were too ill to go home. The major reason for requesting for DAMA was lack offinance.Conclusion: The findings indicate that lack of finance was the major reason for DAMA. Appeal for government at all levels to adopt policy ofNational Health Insurance scheme to cover all children in Nigeria, will help to discourage the issue of DAMA

Pattern of Morbidity and Mortality in a Children’s Ward – the Awka Experience

Pattern of morbidity and mortality in children in a hospital setting is essential because it serves as a guide to what happens in the larger society. By these findings, health facilities could be modified and improved upon for better management of those cases. To document the pattern of morbidity and mortality in children’s ward of Amaku General Hospital Awka (AGHA) Anambra State, the hospital records of children aged above one month to 18 years admitted to the children’s ward of AGHA from 1st January 2007 to 31st December 2008 were retrieved and reviewed. Of the 491 patients admitted during the period, 400 patients met the criteria for the study. The youngest child was 7 weeks old and the oldest 18 years. The commonest causes of admission were severe malaria (21.75%), Gastroenteritis (15.50%), febrile convulsion (14.75%), pneumonia (13.75%) andHIV/AIDS (10%). The commonest causes of death were severe malaria with anemic heart failure (30.61%), Gastroenteritis with severe dehydration (20.41%), pneumonia (16.33%) and HIV/AIDS (12.25%). Among the deaths, infancy period was mostly affected (36.74%). Having seen the pattern of morbidity and mortality in our area to be infection related, we recommend to government and society the improvement in our environmental sanitation, sustained health education, reducing poverty while promoting routine immunization, growth monitoring, Breastfeeding of our children and introduction of new vaccines.Keywords: Pattern, morbidity, mortality, children’s ward, Awk

Socio-demographic and clinical characteristics of children who received emergency blood transfusion in a secondary health facility at Awka.

Background: Severe anaemia is one of the major causes of morbidity and mortality in children in developing countries and could be managedby urgent blood transfusion to save life, though with its attendance risks like exposure to human immunodeficiency virus (HIV) and other bloodborne infections.Objective: To determine the socio demographic and clinical characteristic of children found to have received emergency blood transfusion inAwka, Anambra state.Patients and methods: The hospital records of children aged above one month to 18 years who received emergency blood transfusion atchildren’s ward of Amaku General Hospital Awka (AGHA) between march 1, 2007 to August 31st, 2009 were studies.Results: Of the 391 patients and admitted during the period, 35 (8.9%) had emergency blood transfusion. The youngest child was 7 months andoldest 14 years. More than 65% of those transfused were less than 5 years. There was no statistically significant sex difference among thosetransfused ( p > 0.05). The middle socio-economic class patients presented with severe anaemia more than other social class. Malaria was the commonest cause of anaemia requiring emergency blood transfusion accounting for 51.4% as a single entity or 28.6% in combination with otherconditions.Conclusion: Severe anaemia requiring urgent blood transfusion was caused mostly by malaria. Measures aimed at addressing poverty andmalaria attacks were suggested as a way forward. These will help reduce the incidence of severe anaemia and thus the need for emergency bloodtransfusion

Diagnosis and Management of Paediatric Hepatitis C Virus Infection

Background: HepatitisC virus is a chronic life-long infection in themajority of patientswho are infected with the virus.Without accurate diagnosis and follow up, these children cannot be offered optimal care, and are at risk of presenting in adult life with significant liver pathology and long-term sequelae.Objective: To explore the possible diagnostic andmanagementoptions available to those affected.Materials and Method: Source of informationwasmainly from published works in and outside Nigeria. The information was extracted over a period of 12months fromJanuary to December 2007.Results: Treatment options available are use of immune response modifiers (interferons), antiviral agents (ribavirin), combination therapy with interferon and ribavirin, and liver transplantation.Conclusion: Early identification and optimal treatment to thosein which treatment are indicated.Niger Med J. Vol. 49, No. 4, Oct. – Dec., 2008: 96 – 100.Keywords:Acute infective hepatitis;Catalase; LiverFunction Tests;Malondialdehyde; Superoxide dismutas

Prevalence Of Intestinal Helminthiasis In Nursery And Primary School Children In Enugu Metropolis,

Context: Intestinal helminthiasis affect the nutritional status of school aged children. Objective: o determine the prevalence of intestinal helminthiasis in nursery and primary school children in Enugu. Methods: A cross-sectional survey on 460 nursery and primary school children from Enugu metropolis. The prevalence of helminthiasis in children aged 1 -10 years was determined using the kato-katz method. Stool samples were collected from nursery and primary school children into appropriately labeled clean specimen containers for examination. Questionnaires were administered by the researchers to obtain data from the children and from their guardians or parents. Results: Out of 460 nursery and primary school children who completed the study, only 32.6% of them had intestinal helminths demonstrated in their stool samples. The prevalent intestinal helminths included Ascaris lumbricoides (14.6%), hookworm (12.8%) and Trichuris trichiura (5.2%).The highest prevalence was seen in those aged between 9 and 10 years. Conclusion: There is high prevalence of intestinal helminths in Enugu. Attention should be given by the government to periodically carry out mass de worming exercise among nursery and primary school children in Enugu. Keywords: Children, Enugu, helminthes, Intestinal, prevalence Ebonyi Medical Journal Vol. 7 (1&2) 2008: pp. 42-4

Common intestinal helminthiasis in children: A review.

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