Pattern and Outcome of Admissions in the Children's Emergency Room of the University of Nigeria Teaching Hospital, Enugu

Abstract

Summary:  A five-year review of the pattern and outcome of paediatric admissions in the Children Emergency Room (CHER) of the University of Nigeria Teaching Hospital (UNTH) Enugu, showed a total of 10,267 admissions, a discharge rate of 50.4 percent, a transfer out rate of 44.3 percent, and a mortality of 5.1 percent. The commonest causes of admission were febrile convulsions (21.5 percent), severe malaria with anaemic heart failure (18.4 percent), acute lower respiratory tract infections (ALRTI) in 16.1 percent, diarrhoeal diseases (12.3 percent), complications of sickle cell anaemia (7.6 percent), acute neurological conditions (7.6 percent), acute asthma (5.2 percent) and neonatal conditions (4.8 percent). Surgical emergencies constituted 6.1 percent of all admissions while chronic medical conditions were only 0.4 percent. Among those that died, neonatal deaths involving mainly out-born babies accounted for 10.4 percent, while the leading causes of mortality beyond the neonatal period were severe malaria with severe anaemia in 30.0 percent, ALRTI in 19.3 percent and severe dehydration with shock in 10.9 percent. The majority of deaths (73.5 percent) in children under five years of age occurred in those aged two years and below with a peak in the age group, 7- 12 months. The vulnerability of our children to communicable but preventable diseases is highlighted. The provision of Children's Emergency Units is recommended where they do not exist. A cleaner environment, sustained health education and disease surveillance among the under-five for early detection of ill health and appropriate intervention will most likely reduce the burden of paediatric emergencies. At the appropriate level of care, facilities to ensure prompt response by blood transfusion services should be ensured.