A three-year survey of neonatal septicaemia (363 bacteriologically proven cases) in the University of Calabar Teaching Hospital, Calabar, has demonstrated that the dominant blood isolate was Staphylococcus aureus (53%) followed by unclassified Coliforms (20%), an unexpected Chromobacterium violaceum (5%). The incidence of neonatal septicaemia was 54.9 per 1000 live births for inborn infants. The predominant organisms were largely susceptible to gentamicin, ceftriazone and cefuroxime with a mortality rate of 19% with most (60.9%) of the fatalities being due to Gram-negative organisms.

BackgroundThere is a high prevalence of paediatric emergency cases in less developed countries. However, prolonged hospital stay at emergency units may further overstretch the facilities.ObjectiveTo assess the patterns of presentations, services offered and predictors of a prolonged stay at the Children Emergency Room of a tertiary hospital in Southern Nigeria.MethodsThis prospective cross-sectional, study was conducted at the University of Calabar Teaching Hospital, Nigeria from 1st January–31st December 2014. Socio-demographic and clinical characteristics of consecutively recruited children (n=633) were recorded in a proforma. Binary logistic regression was conducted to determine predictors of prolonged stay (>72 hours)ResultThe median age of participants was 2 (1 – 4.6) years. Three-fifths of children were admitted at off-hours and the commonest symptom was fever (73.9%). About 16.4% (95%CI:13.6% – 19.4%, n= 103/633) of the children had prolonged stay while those with sepsis had the longest mean stay (65.5±72.1 hours). Children admitted on account of Sickle cell disease (OR:11.2, 95%CI:1.3–95.1, P-value = 0.03), Malaria (OR:10.7, 95%CI:1.4–82.5, P-value = 0.02) or sepsis (OR:10.5, 95%CI:1.3 – 82.7, P-value = 0.03) had higher odds of prolonged hospital stay. There was no significant difference in hospital stay among children admitted by the consultant as compared to other health personnel (P-value = 0.08).ConclusionPrevention and proper management of Sickle cell disease and malaria reduces paediatric hospital stay in our environment. Paediatric emergency medicine should be re-organized to cater for high volume of off-hour admissions.

We studied the prevalence of congenital malaria among neonates with suspected sepsis and its outcome at the University of Calabar Teaching Hospital, Calabar, Nigeria. All in-born neonates admitted to the newborn unit with clinical features suggestive of sepsis were recruited. They were screened for bacterial sepsis and malaria. The mothers of the neonates that had parasitaemia were further screened for malaria and anaemia. A total of 546 in-born neonates were admitted to the neonatal unit and 202 (37%) presented with clinical signs suggested of sepsis. Of these, 71 babies (35% of 202 or 13% of the total in-born nursery admissions) had congenital malaria and 14 also had sepsis. Sixty-three (88.7%) of the parasitaemic babies were delivered by mothers who received antenatal care at our centre. Eighty-six percent of the mothers of the 71 babies also had the malaria parasite in their blood. The majority (67%) of the 71 mothers were gravidae 2 and below. Thirty (42.3%) of the affected neonates were anaemic and 5 (7%) of them required a blood transfusion. Congenital malarial is not uncommon in Calabar among babies with suspected sepsis. It appears that the antenatal chemoprophylaxis with pyrimethamine (25 mg weekly) currently used for malaria in our centre no longer protects the mother and fetus. An alternative is needed in order to stem maternal, fetal and neonatal morbidity and wastage. Babies with features of sepsis should be routinely screened for malaria.

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Summary:A retrospective study of children with acute glomerulonephritis (AGN) over a 10-year period (January 1997-December 2006 was carried out with the aim to establish the prevalence, the population at risk, and the predisposing factors. Out of a total of 6,026 admissions during the study period, 76 (1.3%) had acute glomerulonephritis. Forty of the 76 were males while 28 were females with a male to female ratio of 1.4:1. The mean age for males was 7.2±4.3 years and that of females was 6.5±3.2 years. The overall age range was 3-13 years with a modal age of 5 years for both sexes. The annual prevalence showed two peaks, May-July and October-January. Eighty two percent of patients were of the low while 11.8% were of the middle socioeconomic classes. Haematuria, oedema, proteinuria and hypertension were the major presenting features. Hypertensive encephalopathy and acute renal failure were the complications recorded and also emerged as the causes of death. Childhood AGN is common in Calabar compared to other centres in Nigeria, afflicting largely those of low socio-economic status and displays a peak in the middle of both dry and rainy seasons of the year. The outcome is good but could be better if facilities are provided for dialysis.