Pre-presentation management, metabolic state and outcome of children admitted for diarrhoea disease in Calabar, Nigeria

Abstract

Abstract:

Background: Much of the activities for the prevention and management of diarrhoea should occur or be initiated at home. In addition, management is guided by clinical and metabolic state. This work was designed to examine some pre- hospital management practices and the metabolic state of children with diarrhoea in Calabar, Nigeria.

Methodology: Prospective study of the pre-presentation management, clinical and metabolic states of children with diarrhoea presenting at University of Calabar Teaching Hospital, Calabar from April to November 2016. History was used to determine pre- presentation management while blood glucose and electrolytes were determined before initiation of treatment.

Results: Forty-four children aged 4 – 13years, mean 18.65 ± 17.37months were recruited into the study. Forty (90.91%) had acute watery diarrhoea and 4 (9.09%) had dysentery. Of these, 72.27%had oral electrolyte solutions at home and nine (20.45%) zinc. Twelve (27.27%) had mild, 26 (45.4%) moderate and 3 (6.82%) severe dehydration. Twenty (63.64%) had metabolic acidosis, 18(40.91%) hyponatraemia and 18(40.9%) azotaemia suggesting Acute Kidney Injury. Two (4.50%) had hypoglycaemia while 16(36.30%) had hypozincaemia.

Conclusion: A majority of children with diarrhoea have oral electrolytes solution before presentation in the hospital and all had continued feeding. There is a high proportion with hyponatremia and more than a third hadazotaemia. Modality of treatment at home did not seem to affect these parameters, perhaps because all subjects had continued feeding. Further studies on the appropriateness of low osmolarity ORS in this environment and renal function of children with diarrhoeaare recommended.

Keyword: Diarrhoea, Pre- hospital Management, electrolytes derangement