Determinants of Outcome in Febrile Children Admitted into the Emergency Rooms of Two Tertiary Hospitals in Enugu Southeast Nigeria

Introduction: Febrile illnesses have continued to be the highest causes of mortalities in children admitted to the children emergency roomsin Nigeria. This study was carried out to review the determinants of outcome in children admitted for febrile illness into the emergency roomsof two tertiary institutions in Enugu, Nigeria. Materials and Methods: This was a retrospective study of 335 children who presented with fever to the emergency rooms over one year (January–December 2018). Their case records were retrieved, and the necessary information was obtained using a structured questionnaire. Statistical analysis included odds ratio and Chi‑square test. Results: The mean age of the children was 43.20 ± 50.30 months. The mean temperature at presentation was 38.2°C ± 0.9°C. Fever of 39.0°C or above at presentation and fever duration of >2 days were significantly associated with fatal outcome. Children residing in rural areas or referred from other health facilities were more likely to die. The risk of dying from fever was highest when it was associated with diarrhea, weakness, pallor, convulsions, unconsciousness, and difficult/fast breathing. Conclusion: Most of the factors responsible for mortality in febrile children are largely preventable and treatablewhen the presentation is early. Keywords: Determinants, emergency room, febrile children, Nigeria, outcom

A Comparison of the Performance of the Midarm Circumference and the Nelson Weight Estimation Formulas in Nigerian Children

Background: In emergencies, two commonly used weight estimation methods are Nelson and mid‑arm circumference (MAC)‑based formulae. Nelson’s method requires the child’s age while the MAC formula offers weight estimation without any prior details of the child, which is useful in our environment due to the lack of proper vital statistics documentation. Methodology: We measured the weight, height, and MAC of 1390 children aged 1–12 years. Values got from the measurements were substituted in MAC and Nelson formulae for weight estimation. The estimated weights were compared to the actual weights of the children. Results: Atotal of 1390 children were enrolled. The mean of enrolled children’s actual weight was significantly higher than the mean weight estimated using MAC and Nelson formula. MAC method overestimated weight in children 1–7 years and underestimated weight in those 8–12 years old. On the other hand, the Nelson formula underestimated weights in children 2–11 years and overestimated weight in 1 and 12-year olds. Conclusions: Both the MAC and Nelson method have their deficiencies in weight estimation. Though the Nelson formula  appears slightly more accurate than the MAC, weight estimates from both methods were mostly within the actual weight agreement limits. Keywords: Actual weight, children, comparison, formulae, mid‑arm circumference, nelso

Validation of Pediatric Height Estimation Formulae in Suburban Communities in South-east Nigeria: A Cross-sectional Study.: Validation of Pediatric Height Estimation Formulae

Background: Height measurement is one of the common essential anthropometric measurements in clinical pediatrics. The most accurate method of determining a child  height is to  measure the height. However, in emergency situations and some resource limited settings, obtaining the actual height of a child may not be feasible hence the need to estimate. The most common age-based formulae for height estimation in children is 6n + 77 where n = age in years. The accuracy of this height estimation formulae has not been assessed in developing setting like ours with high prevalence of malnutrition. This study therefore sought to evaluate the accuracy of the height estimation formula in children in communities across Enugu southeast Nigeria. Method: Children 2-12 years old who met the inclusion criteria were enrolled over 12 months from three of the 17 Local Government Area of Enugu State. Height was measured using a standard stadiometer and estimated height was calculated 6n + 77. Data collected was analyzed using SPSS. Result: Of the 4046 children enrolled, majority (86.1%) were of normal height for age while 2.6% were stunted. The formula underestimated height of children in younger age bracket and overestimated height in older children. Overall, the estimated height using the formula was within ±10% agreement of the actual height of surveyed children in 77.0% of children surveyed. Conclusion: The 6n + 77 formula is a reasonable but not entirely accurate for height estimation for children in our setting. Keywords: Children, Height, Estimation, Accurac