Patterns and outcomes of Emergency Pediatric Unit admissions in Usmanu Danfodiyo University Teaching Hospital in Sokoto State, Nigeria: a five-year review

Submitted: 15 April 2024
Accepted: 23 June 2024
Published: 26 August 2024
Abstract Views: 252
PDF: 94
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Children are susceptible to illnesses that often require urgent medical attention, with attendant high mortality rates, especially in resource-constrained settings. Periodic audits in tertiary care facilities can guide preventive and therapeutic policies. The aim was to determine the admissions pattern and outcome over five years in the Emergency Paediatric Unit (EPU) of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, a major tertiary facility in North Western Nigeria. This was a retrospective study between January 2017 and December 2021. The admission records of children aged >1 month to 15 years were retrieved, relevant information extracted, and entered into a study proforma. Data was analyzed using SPSS version 23. There were 6088 admissions. Under-fives constituted 4448 (73.1%), and males were 3558 (58.4%). The median age was 24.0 months (Interquartile Range, IQR, 12, 60). Top admissions were severe malaria (1100; 18.1%), acute diarrhoeal disease (631; 10.4%), Sickle Cell Disease (SCD) (624; 10.2%), pneumonia (547;9.0%), Severe Acute Malnutrition (SAM) (438;7.2%), febrile convulsions (421;6.9%), pharyngotonsillitis (402;6.6%) and sepsis (398;6.5%). Total discharges were 2483 (40.8%), 2635 (43.3%) were transferred, and mortalities were 679 (11.2%). Case fatality rates of the top admissions were sepsis (19.6%), SAM (19.4%), severe malaria (13.7%), pneumonia (10.6%), febrile convulsions (5.0%), acute diarrhoeal disease (4.9%), pharyngotonsillitis (2.5%) and SCD (2.1%). SCD was the most common non-infectious morbidity and responsible for most re-admissions. Malaria was the top cause of mortality in all age groups except infancy, where sepsis and pneumonia predominated. In conclusion, malaria and other infectious diseases accounted for most admissions. Non-communicable diseases, like SCD, also constitute significant morbidity. Hence, policymakers need to scale up targeted preventive measures.

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References
Perin J, Mulick A, Yeung D, et al. Global, regional, and national causes of under-5 mortality in 2000-19: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet Child Adolesc Health. 2022;6:106-15. DOI: https://doi.org/10.1016/S2352-4642(21)00311-4
Bigna JJ, Noubiap JJ. The rising burden of non-communicable diseases in sub-Saharan Africa. The Lancet Global Health. 2019;7:e1295-e6. DOI: https://doi.org/10.1016/S2214-109X(19)30370-5
United Nations Children's Fund (UNICEF). Under five mortality. 2024. Available from: https://data.unicef.org/topic/child-survival/under-five-mortality/.
Statista. Countries with the highest mortality rate among children aged under 5 as of 2021 (per 1,000 live births). 2021. Available from: https://www.statista.com/statistics/281580/countries-with-highest-mortality-rate-among-children-aged-under-five/
Onubogu U, West B. Pattern and outcome of diseases among children presenting in the emergency room of a tertiary hospital in Port Harcourt, Nigeria. Open Journal of Pediatrics, 2022;12:538-53. DOI: https://doi.org/10.4236/ojped.2022.123057
Isezuo KO, Onankpa BO, Adamu A, et al. Socio-demographic factors associated with late presentation and outcome of febrile children admitted in a tertiary facility in North-Western Nigeria: A Comparative Study. Int J Pediatr Res. 2020;6:063. DOI: https://doi.org/10.23937/2469-5769/1510063
Enyuma CO, Anah MU, Pousson A, et al. Patterns of paediatric emergency admissions and predictors of prolonged hospital stay at the children emergency room, University of Calabar Teaching Hospital, Calabar, Nigeria. Afr Health Sci. 2019;19:1910-23. DOI: https://doi.org/10.4314/ahs.v19i2.14
Ibeziako SN, Ibekwe RC. Pattern and outcome of admissions in the children’s emergency room of the University of Nigeria Teaching Hospital, Enugu. Nigerian Journal of Paediatrics. 2002;29:103-7. DOI: https://doi.org/10.4314/njp.v29i4.12018
Adeyemi EO, Oladele A, Ajigbotosho SO, et al. A review of post neonatal paediatric admission pattern and outcome in a public tertiary health facility in Nigeria. Niger Med J 2023;64:604-11.
Okoronkwo NC, Chapp-jumbo AUN. Pattern of morbidity and mortality of childhood illnesses at the emergency paediatric unit of Abia State University Teaching Hospital, Aba, Nigeria. East Cent Afr Med J. 2015;2:70-3.
Sa’ad YM, Hayatu A, Al-Mustapha II, et al. Morbidity and mortality of childhood illnesses at the emergency pediatric unit of a tertiary hospital, North-Eastern Nigeria. Sahel Medical Journal. 2015;18:1-3. DOI: https://doi.org/10.4103/1118-8561.152150
Anyanwu, O.U., Ezeanosike, O.B. and Ezeonu, T.C. Pattern and Outcome of Admissions at the Children Emergency Room at the Federal Teaching Hospital Abakaliki. African Journal of Medical and Health Sciences, 2014;12:6-10. DOI: https://doi.org/10.4103/2384-5589.139435
Bilkisu GI, Aminu MS, Sunday OO, et al. Pattern of medical childhood morbidity and mortality in a new specialist hospital in Gusau, Nigeria. Annals of Nigerian Medicine. 2014;8:15-9 DOI: https://doi.org/10.4103/0331-3131.141024
Ayetoto T. Short-lived futures: 32 states hold back Nigeria’s progress on under-5 survival. 2024. Available from: https://businessday.ng/backpage/article/short-lived-futures-32-states-hold-back-nigerias-progress-on-under-5-survival/
National Population Commission (NPC). Nigeria Demographic and Health Survey 2018. 2019. Available from: https://dhsprogram.com/pubs/pdf/FR359/FR359.pdf
Wikipedia. Sokoto State. 2024. Available from: https://en.wikipedia.org/w/index.php?title=Sokoto_State&oldid=1217063971
Jiya NM, Sani UM, Jiya F, Ameh B. Prevalence of uncomplicated malaria in a paediatrics outpatient department of a tertiary health institution in Sokoto, Nigeria. Sahel Med J. 2010;13:29-34. DOI: https://doi.org/10.4103/1118-8561.145630
National Population Commission. 2006 National Census. Federal Republic of Nigeria Official Gazette. 2007;94:196.
World Health Organization (WHO). ICD-10 : international statistical classification of diseases and related health problems : tenth revision. 2019. Available from: https://icd.who.int/browse10/2019/en
Duru C, Peterside O, Akinbami F. Pattern and outcome of admissions as seen in the Niger Delta University Teaching Hospital, Bayelsa State, Nigeria. Nigerian Journal of Paediatrics. 2013;40:232-7.
Agbesanwa TA, Babatola AO, Fatunla OA, et al. Pattern of admissions and outcome in the children emergency department of a tertiary health institution in Southwestern Nigeria: a four-year review. Afr J Emerg Med 2023;13:45-51. DOI: https://doi.org/10.1016/j.afjem.2023.02.001
Okoronkwo NC, Onyearugha CN. Pattern and outcomes of paediatric medical admissions at the Living Word Mission Hospital, Aba, South East Nigeria. Pan African Medical Journal. 2018;30:202. DOI: https://doi.org/10.11604/pamj.2018.30.202.15966
Abhulimhen-Iyoha B, Okolo AA. Morbidity and mortality of childhood illnesses at the emergency paediatric unit of the University of Benin Teaching Hospital, Benin City. Niger J Paed. 2012;39:71-4. DOI: https://doi.org/10.4314/njp.v39i2.7
Ahmed MAA, Musa IR, Mahgoub HM, et al. Patterns, outcomes and predictors of pediatric medical admissions at Gadarif Hospital in Eastern Sudan. Frontiers in Pediatrics. 2022;10:764028. DOI: https://doi.org/10.3389/fped.2022.764028
Roy RN, Shrivastava P, Das DK, et al. Burden of hospitalized pediatric morbidity and utilization of beds in a tertiary care hospital of Kolkata, India. Indian Journal of Community Medicine. 2012;37:252-5. DOI: https://doi.org/10.4103/0970-0218.103474
Schneuer FJ, Demetriou E, Bond D, et al. Child characteristics and health conditions associated with paediatric hospitalisations and length of stay: a population-based study. The Lancet Regional Health Western Pacific. 2023;32:100706. DOI: https://doi.org/10.1016/j.lanwpc.2023.100706
Borghesi A, Marzollo A, Michev A, Fellay J. Susceptibility to infection in early life: a growing role for human genetics. Human Genetics. 2020;139:733-43. DOI: https://doi.org/10.1007/s00439-019-02109-2
Isezuo K, Adamu A. Impact of COVID pandemic on pattern and outcome of admissions in a paediatric emergency unit in Sokoto, Nigeria Asian Journal of Paediatric Research. 2024;14:59-68 DOI: https://doi.org/10.9734/ajpr/2024/v14i7366
Isezuo KO, Sani UM, Waziri UM, et al. Pattern and outcome of heart failure amongst children admitted in an emergency pediatric unit of a tertiary hospital in Sokoto State, North-Western Nigeria. Nigerian Journal of Basic and Clinical Sciences 2022;19:126-31. DOI: https://doi.org/10.4103/njbcs.njbcs_17_22
Nyango D, Mutihir J. Trend of health worker’s strike at a Tertiary Health Institution in North Central Nigeria. Annals of Medical Research and Practice. 2021;2:1-5. DOI: https://doi.org/10.25259/ANMRP_9_2020
Jiya NM, Sani UM, Isezuo KO, et al. Severe malaria anaemia in Sokoto. Nigeria Acta Sci Paediatr. 2020;3.4:24-9. DOI: https://doi.org/10.31080/ASPE.2020.03.0235
Jiya NM, Isezuo KO, Ahmad MM, Jiya FB. Bacterial meningitis in children: clinical presentation, causative organism and outcome. Caliphate Medical Journal. 2017;5:428-33. DOI: https://doi.org/10.47837/CMJ.19770126.NMA.20175347124
Isezuo KO, Yusuf T, Ibitoye PK, et al. A 5-year review of measles cases admitted into the emergency paediatric unit of a tertiary hospital in Sokoto, North-Western Nigeria. Sahel Med J 2018;21:122-7. DOI: https://doi.org/10.4103/smj.smj_38_17
Umar UI, Muhammed IL, Gwarzo GD. Pattern and outcome of admissions at the emergency pediatric unit of Federal Medical Centre Nguru, Yobe State, Nigeria. Pyramid Journal of Medicine. 2018;1:1. DOI: https://doi.org/10.4081/pjm.2018.1
Aygun B, Odame I. A global perspective on sickle cell disease. Pediatr Blood Cancer. 2012;59:386-90. DOI: https://doi.org/10.1002/pbc.24175
Edelu BO, Igbokwe OO, Iloh ON. A review of pediatric mortalities in the emergency units of Nigerian tertiary hospitals. Int J Med Health Dev 2020;25:1-5. DOI: https://doi.org/10.4103/ijmh.IJMH_37_19
Ibrahim M, Udoma M, Abdulwahab I. Infant mortality at Usmanu Danfodiyo University Teaching Hospital, Sokoto. Nig J Paed. 1993;20:17-20.
Ugege MO, Garba BI. A two-year retrospective review of paediatric mortality in a tertiary facility in North-western Nigeria. Journal of Advances in Medicine and Medical Research, 2020;32:119-28. DOI: https://doi.org/10.9734/jammr/2020/v32i2430759

How to Cite

Isezuo, Khadijat O., Usman M. Sani, Usman M. Waziri, Bilkisu I. Garba, Asma’u Adamu, Fatima B. Jiya, Baba Jibrin, et al. 2024. “Patterns and Outcomes of Emergency Pediatric Unit Admissions in Usmanu Danfodiyo University Teaching Hospital in Sokoto State, Nigeria: A Five-Year Review”. Pyramid Journal of Medicine 7 (1). https://doi.org/10.4081/pjm.2024.498.