Morbidity Pattern in Adolescents attending the Ambulatory Care Unit in Abakaliki

Abstract

Summary 

Background: Adolescents form a sizeable and vulnerable group whose special needs are increasingly being acknowledged. In order to address their health problems effectively, a determination of the size, baseline disorders and causes of death in this group is of strategic importance, particularly in developing countries.  

Objectives: To determine the number of adolescents attending our Institution over a defined period of time, as well as the morbidity pattern and outcome of various diseases among them.

Design: Retrospective analysis of hospital records.

Patients and Methods: The hospital attendance and admission registers of all patients aged 10 years to 24 years, seen at the various outpatient clinics of Ebonyi State University Teaching Hospital, Abakaliki, between January, 2001 and December, 2001 were reviewed and analyzed.

Results: Of the 16,684 patients seen during the study period, 4600 (27.6 percent) were aged 10-24 years with F: M ratio of 1.4:1. However, only 2813 patients (61.1 percent) of this number had complete data for analysis. While 16 percent of the 2813 patients were in the age group 10-15 years, a far greater proportion (84 percent) were aged 16 24 years with a peak at age group 19-21 years and a trough at 10-12 years. Malaria in 690 (24.5 percent) patients was the most common clinical condition for which the patients attended the clinic, followed by gastrointestinal disorders in 522 (18.6 percent), genitourinary tract disorders in 367 (13.0 percent), and trauma in 177 (6.3 percent) patients. Unwanted pregnancy was diagnosed in 105 patients (3.7 percent). Peptic ulcer disease was responsible for 54.9 percent of all gastrointestinal disorders. Sexually transmitted diseases including HIV infection were responsible for 63.8 percent of all genitourinary tract disorders. Road traffic accident and its complications formed the bulk (80.2 percent) of the trauma cases encountered. Psycho-somatization and drug abuse accounted for 46.1 percent and 22.7. percent respectively, of all neurological/psychosocial disorders, while acne vulgaris was predominant (57.4 percent) among the skin disorders. The following disorders were either unique to, or had their onset predominantly in adolescence: sexually transmitted diseases, unwanted pregnancy, peptic ulcer disease, trauma, psychosocial disorders, drug abuse and acne vulgaris. Six hundred and twenty-six patients (22.3 percent) out of whom 39 (6.2 percent) died, were admitted into various wards while 2187 patients (77.7 percent) were discharged home. The major causes of death were trauma with complications in nine cases (23.1 percent), malaria in seven cases (17.9 percent) and HIV/AIDS in six cases HIV(15.4 percent).

Conclusion: The present study has shown that adolescents are indeed a sizeable group with a unique morbidity and mortality pattern. We therefore advocate the establishment of an Adolescent Clinic at our institution so that health interventions specific to this age group and the identified disorders may be addressed effectively and in a timely manner.

Keywords: Adolescents, morbidity, mortality, outpatient visits