Hypoxaemia and its clinical predictors among children with pneumonia at a tertiary centre in Osogbo, Southwestern, Nigeria

Objective: Hypoxaemia is a feature of severe pneumonia particularly among children aged less than five years. This study aimed to determine the prevalence and clinical predictors of hypoxaemia among children with pneumonia.Methods: It was a hospital-based cross-sectional observational study involving 129 children aged 1 - 59 months with both clinical and radiological pneumonia. The haemoglobin oxygen saturation (SPO ) was 2 obtained at presentation. Hypoxaemia was defined as SPO < 90 percent. 2Result: Of the129 subjects studied, 49 (38.0%) had hypoxaemia. The clinical signs that were significantly associated with hypoxaemia were central cyanosis (p= 0.012), grunting (p= 0.014), nasal flaring (p< 0.001), lethargy (p< 0.001), restlessness (p= 0.002), loss of consciousness (p< 0.001), and inability to feed (p< 0.001). A combination of nasal flaring with central cyanosis, grunting or tachypnoea were significant predictors of hypoxaemia (p= 0.029, 0.017 and <0.001 respectively). Tachypnoea and nasal flaring had the highest sensitivity and specificity among the clinical signs for hypoxaemia. Prolonged hospital stay (> 5 days) and mortality were significantly associated with hypoxaemia (p< 0.001).Conclusion: Hypoxaemia is common among children hospitalized for pneumonia. It is an important determinant of hospital stay and outcome. Keywords: Hypoxaemia, pneumonia, hospitalized children, under-fives, clinical predictors

Complications of pneumonia and its associated factors in a pediatric population in Osogbo, Nigeria

Introduction: Pneumonia is one of the leading causes of morbidity and  mortality in underfive children. Nigeria still has a high burden of  child death due to pneumonia. Many of these deaths result from the development of complications. This study was done to determine the pattern of pneumonia complications and its associated factors amongst underfive children with pneumonia. Methods: It was a hospital-based cross-sectional observational study involving 129 children aged 1 - 60 months with a diagnosis of pneumonia. The participants were recruited over a nine-month period. Clinical signs were recorded, and a confirmatory chest radiograph was obtained within 24hours of admission. Result: Of the129 subjects studied, 70 (54.3%) had complications. Children less than 24 months had a higher frequency of complications at  presentation. Heart failure and anemia occurred more commonly. Other complications were pleural effusion, empyema, pneumatocele and  pneumothorax. More than half (57.1%) of those with complication were hypoxaemic at presentation. Complicated pneumonia was significantly  associated with prolonged hospital stay and risk of mortality. Conclusion: Complication is common among children hospitalized for pneumonia in Osogbo. Heart failure was the most common complication. Presence of pneumonia complications and hypoxaemia are important contributors to mortality in this environment. Keywords: Pneumonia, complication, under-fives, Nigeria.&nbsp

Abnormal biochemical parameters among term neonates with perinatal asphyxia and their non-asphyxiated controls in Osogbo

Objective: This study aimed to determine the prevalence of abnormal biochemical parameters among neonates with perinatal asphyxia in comparison to their non-asphyxiated controls.Methodology: This is a prospective case - control study involving 54 asphyxiated term neonates and 54 non-asphyxiated term babies at LAUTECH teaching hospital, Osogbo. Serum levels of Sodium, Bicarbonate, Chloride, Calcium and Potassium were determined daily for 72 hours in both groups using standard methods. The results were compared.Results: The overall prevalence of abnormal biochemical parameters namely hyponatraemia, hypocalcaemia, metabolic acidosis, hypochloraemia and hypokalaemia among the asphyxiated versus non-asphyxiated babies in the first 72 hours of life were 30.9% vs 19.8% (p < 0.020); 28.4% vs 4.9% (p < 0.000); 30.9% vs 3.1% (p < 0.0001); 27.2% vs 25.9% (p < 0.200) and 24.7% vs 3.1% (p < 0.070) respectively.Conclusion: Babies with hypoxic ischaemic encephalopathy stage III significantly showed the worst biochemical parameters; early estimation of serum electrolytes in neonates with perinatal asphyxia may be appropriate for timely intervention. &nbsp