Morbidity pattern and outcome among under-fives at the children’s emergency room of Federal Medical Center Umuahia

Background: The patterns and outcome of under-five morbidity in health care facilities are invaluable tools that reflect the disease burden and health care needs of the children in the community. Efforts are being made over the past few years to improve child care services in our centre. A preliminary report therefore will assist in goal-targeted intervention strategies and serve as a baseline for subsequent reviews. Aim: To evaluate the morbidity pattern and outcome of under-fives at the Children’s Emergency Room of the Federal Medical Centre (FMC) Umuahia. Subjects and methods: A retrospective review of post-neonatal children aged 1 to 59 months seen over a period of five years. Information such as age, gender, month of admission, diagnosis and outcome were analyzed. Results: Of the 5,884 under-fives admitted over the study period, 56% were males with a male to female ratio of 1.2:1. The month with highest admissions was January. The leading causes of morbidity were malaria, diarrheal diseases and respiratory tract infections accounting for 79.9%. Sepsis was the most common morbidity noted among infants (p< 0.001). Mortality rate was 4%. Death rate among infants was significantly higher than in those beyond infancy, p < 0.001. Conclusion: Preventable infections are the leading causes of post-neonatal under-five morbidity in Federal Medical Centre Umuahia

Prevalence and reasons for missed opportunities for vaccination in a Nigerian hospital

Background: Missed Opportunity for Vaccination (MOV) is a significant cause of low immunisation coverage and resurgence of vaccine preventable diseases. Hence, identifying the causes of MOV in our health facilities and eliminating them will help improve immunisation coverage in the area. Objectives: To determine the prevalence and reasons for MOV in children aged 0 to 23 months at the Federal Medical Centre, (FMC) Umuahia, Abia State. Methods: Exit interviews were conducted for 300 mother/child pairs of children aged 0 to 23 months consecutively as they visited the preventive and the curative sections of FMC Umuahia. Results: Of the 300 children recruited, 158 (52.7%) were males and 142 (47.3%) were females with a M:F ratio of 1.1:1.Thirty six (12%) of all the children had missed opportunities for vaccination. MOV rate was significantly higher among the in-patients (p= 0.02). The reasons for MOV noted were; presentation of the children on the ‘wrong’ immunisation days (72.2%), false contraindications to vaccination by the health workers (13.9%), unavailability of vaccines (8.3%) and refusal to open a new vial by the health workers (5.6%). The commonest remote reason why the children who presented on the ‘wrong’ immunisation days missed their previous immunisation appointments was because of non-availability of the mothers due to illness, parent’s travel and farm work. Conclusion: The prevalence of MOV at FMC Umuahia is 12% and the commonest reason was that the children presented on the ‘wrong’ immunisation days. Hence, all the vaccines should be made available to every eligible child on any day of the week in order to effectively eliminate MOV