Bacterial isolates from blood cultures of children with suspected septicaemia in Calabar, Nigeria

BACKGROUND: Septicaemia is a common cause of morbidity and mortality among children in the developing world. This pattern has changed little in the past decade. Physical signs and symptoms, though useful in identifying possible cases have limited specificity. Definitive diagnosis is by bacteriologic culture of blood samples to identify organisms and establish antibiotic susceptibility. These results are usually not available promptly. Therefore a knowledge of epidemiologic and antimicribial susceptibility pattern of common pathogens is useful for prompt treatment of patients. This report highlights the pattern of bacterial isolates in our environment from a retrospective study of our patients' records. METHODS: One thousand, two hundred and one blood samples were analysed from children aged 0–15 years, admitted into the children's wards of the University of Calabar Teaching Hospital, Calabar, Nigeria with features suggesting septicaemia. Samples were collected under aseptic conditions and cultured for aerobic and anaerobic organisms. Isolates were identified using bacteriologic and biochemical methods and antibiotic sensitivity determined by agar diffusion method using standard antibiotic discs. RESULTS: Bacteria was isolated in 552 (48.9%) of samples with highest rates among newborns (271 : 50.8). The most frequent isolates were Staphylococcal aureus (48.7%) and Coliforms (23.4%). Results showed high susceptibilities to the Cephalosporins (Ceftriazone- 100%:83.2%, Cefuroxime-100%:76.5%) and Macrolides (Azithromycin-100%:92.9%) for S. aureus and coliforms respectively. This study underscores the importance of septicaemia as a common cause of febrile illness in children and provides information on common prevalent aetiologic agents and drug susceptibilities of the commonest pathogens. CONCLUSION: Staphylococcus aureus and coliforms were the leading causes of septicaemia in children in this locality, and the third generation cephalosporins and azithromycin were shown to be effective against these pathogens

Accidental childhood poisoning in Calabar at the turn of the 20th century

Background: Accidental poisoning is a preventable cause of childhood morbidity and mortality. Therefore, knowledge of the common causative agents is necessary in order to create awareness among caregivers towards its prevention. Objectives: To document the pattern of accidental childhood poisoning in Calabar from 1996 to 2000, and to compare the findings with those of a previous study from the same centre.Methods: A retrospective study of cases of poisoning seen at the University of Calabar Teaching Hospital over five years was undertaken. The data extracted from the case files included age, sex, date of admission, poison ingested, home address, social class of parents, duration of admission and outcome.Results: There were 45 cases of accidental childhood poisoning out of 20,539 patients seen; an incidence rate of 2.2 per 1000. Twenty-seven (60 percent) of the cases occurred in subjects aged one to two years. Thirty-three (73.3 percent) were males while 12 (26.7 percent) were females. All the cases were children whose parents were from socio-economic classes IV and V. The commonest poison was kerosene in 26 (57.8 percent) cases, followed by alcohol in 10 (22.2 percent), caustic soda in five (11.1 percent), drugs in three (6.7 percent), and bleach in one (2.2 percent). There was an overall mortality of 20 percent; the mortality rates following caustic soda, kerosene, and alcohol were 100 percent, 11.5 percent and 5.5 percent, respectively.Conclusion: The most common agent of accidental childhood poisoning in Calabar was kerosene, followed by alcohol, while the agent with the highest mortality rate was caustic soda. The most vulnerable age group was the under two-year old. The findings of this study call for intensified health education aimed at creating awareness of the need to store these agents away from the reach of children. Nigerian Journal of Paediatrics Vol. 31(3) 2004: 67-7

Heart Failure among Paediatric Emergencies in Calabar, South Eastern Nigeria

A study of heart failure among paediatric emergencies in the University of Calabar Teaching Hospital, Calabar, was prospectively carried out over a period of 9 months in the Children's Emergency Room (CHER). Two hundred & thirty four out of 1512 admissions presented with heart failure giving a prevalence of 15.5%. The main causes of heart failure among the 234 children were anaemia (73.1%), pneumonia (17.5%) and ventricular septal defect (3,8%). Pneumonia (61% of cases) and ventricular septal defect (78%) of cases) were largely encountered in infants. Majority (69%) of the patients with anaemic heart failure were aged between 1 and 5 years. The main diseases associated with anaemia were malaria (73.9%), sickle cell anaemia (12.5%) and septicaemia (6.3%). Heart failure constituted 1.7% (26 out of 1512) of total deaths in CHER during the period. The fatality rates for patients in whom heart failure complicated anaemia, pneumonia and ventricular septal defect were 9.9%, 12.2% and 44.4% respectively. Most of the deaths (77%) occurred within the first 24 hours of hospitalization. Anaemia and acute respiratory infections, which are the leading causes of heart failure in our children, must be promptly identified, treated and prevented. Key Words: Anaemia, heart failure, paediatric emergencies, pneumonia, prevalence. Mary Slessor Journal of Medicine Vol.4(1) 2004: 58-6

Maternal Exclusive Breast- Feeding Practice In Calabar, Nigeria: Some Related Social Characteristics

Objective: To determine the social characteristic of mother who practice exclusive breast –feeding in Calabar Subject and Methods: A prospective questionnaire based cross sectional survey of breast feeding practices among mother of children aged 0-24 months was carried out in Calabar in April 1998. Using WHO indicators for assessing breast feeding practices, the exclusive breast feeding rate was determined in mothers of children aged 0-6 months. This documents the social characteristics of those mothers who practiced exclusive breast feeding (EBF). Result: Of 1145 mother in the study, 4456 were mothers of children aged 0-6 months. Of this 102 (22.9%) practiced EBF. The maternal characteristics associated with a high EBF rate were being married (

Nutritional Status of Pre-School Children in Rural Nigeria: Relationships with Intestinal Helminthiasis

Objectives: To assess the nutritional status of pre-school children in a rural community in Nigeria and to evaluate the relationship between anthropometric status and intestinal helminthiasis Method: A prospective randomized cross-sectional survey of 195 children living in a farm community at the outskirts of Calabar. Main outcome measures: Anthropometric status, helminth infection rate. Results: Overall prevalence rates of underweight, stunting and wasting were 37.9%, 21.5% and 6.7% respectively while the corresponding rates in helminth infected children were 36.6%, 42.9% and 9.9%. The prevalence rates of underweight, wasting, and stunting were higher in infected than the non-infected children, but only the difference in the rate of stunting reached statistical significance (p = 0.052). Conclusion: Helminthiasis may contribute to the high prevalence of malnutrition in rural Nigerian children. Key Words: Nutritional Status, Intestinal Helminthiasis, Pre-School Children. Jnl of Medical Investigation and Practice Vol.1 2000: 18-2