Burden and spectrum of paediatric respiratory diseases at a referral hospital in North-Central Nigeria - A five year review

Introduction: Globally respiratory diseases, comprising a broad range of disease conditions due to infectious and non-infectious causes, are a major cause of childhood morbidity and mortality. Thus, identification of the burden of respiratory illness will ensure appropriate interventions towards reducing its attendant morbidity and mortality. The study was conducted to identify the burden, spectrum and outcome of respiratory diseases in hospitalized children at University of Ilorin Teaching Hospital, North-Central Nigeria. Methods: A retrospective descriptive cross-sectional study involving children admitted through the emergency paediatric unit over five years (January 2013-December 2017) was conducted. Data on demography, diagnosis, comorbidities and complications, duration of admission, and outcome were collected and analyzed using SPSS 20. Results: Of the total 7012 children admitted, 1939(27.7%) were due to respiratory diseases with a median age of 16 (interquartile range {IQR} 7-36) months. Males were 994(51.3%) and 945(48.7%) females. Infectious diseases were the most common cause of admission. Pneumonia (50.1%) and aspiration pneumonitis (5.1%) accounted for the highest admissions due to infective and non-infective respiratory diseases respectively. Overall, respiratory diseases accounted for 20.7% (119/574) of the overall mortality among all admissions while the all respiratory disease mortality was 6.1% (119/1939). The major contributors to mortality were pneumonia, aspiration pneumonitis and tuberculosis accounting for 81(68.1%), 12(10.1%) and nine (7.6%) deaths respectively. The median duration of hospital stay was four days [IQR: 2 to 6 days]. A significantly higher proportion of the deaths occurred with four days of admission and 82.4% of the deaths occurred among those aged less than five years. A higher number of females (70, 58.8%) died compared to males (49, 41.2%), p=0.05. Conclusion: Pneumonia and aspiration pneumonitis are major contributors to morbidity and mortality due to respiratory diseases for which interventions towards improving childhood health indices should be prioritized

Prevalence of chronic respiratory disease in urban and rural Uganda

Objective To determine the prevalence of chronic respiratory diseases in urban and rural Uganda and to identify risk factors for these diseases. Methods The according to standard guidelines and completed questionnaires on respiratory symptoms, functional status and demographic characteristics.The presence of four chronic respiratory conditions was monitored: chronic obstructive pulmonary disease (COPD), asthma, chronic bronchitis and a restrictive spirometry pattern. Findings In total, 1502 participants (average age: 46.9 years) had acceptable, reproducible spirometry results: 837 (56%) in rural Nakaseke and 665 (44%) in urban Kampala. Overall, 46.5% (698/1502) were male. The age-adjusted prevalence of any chronic respiratory condition was 20.2%. The age-adjusted prevalence of COPD was significantly greater in rural than urban participants (6.1 versus 1.5%, respectively; P<0.001), whereas asthma was significantly more prevalent in urban participants: 9.7% versus 4.4% in rural participants (P<0.001). The age-adjusted prevalence of chronic bronchitis was similar in rural and urban participants (3.5 versus 2.2%, respectively; P=0.62), as was that of a restrictive spirometry pattern (10.9 versus 9.4%; P=0.82). For COPD, the population attributable risk was 51.5% for rural residence, 19.5% for tobacco smoking, 16.0% for a body mass index <18.5 kg/m2 and 13.0% for a history of treatment for pulmonary tuberculosis.Conclusion The prevalence of chronic respiratory disease was high in both rural and urban Uganda. Place of residence was the most important risk factor for COPD and asthma

Determinants of antibiotic prescription in paediatric patients: The case of two hospitals in Maputo, Mozambique

Background. The need for healthcare in paediatric patients is often due to respiratory diseases, acute diarrhoea and viral fever, which suggests a limited need for the use of antibiotics.Objectives. To identify the determinants of antibiotic prescription in hospitalised paediatric patients in Mozambique.Methods. A cross-sectional study was conducted between January and June 2015. A total of 454 medical prescriptions and clinical records of children aged 0 - 14 years from Hospital Central de Maputo (HCM) and Hospital Geral de Mavalane (HGM) were analysed.Results. Antibiotics were used in 97.6% of the patients, with no significant differences (p>0.05) in the prescription rates of the hospitals. The most commonly used antibiotics were beta-lactams (57.3%), aminoglycosides (28.3%) and co-trimoxazole(9.4%). Antibiotics were prescribed in all cases of bronchopneumonia, fever, sepsis and acute gastroenteritis. For malaria and undefined diagnoses, antibiotics were prescribed 97.8% and 99.3% of cases, respectively. It was clear that most severe clinical conditions (odds ratio (OR) 9.06; 1.13 - 12.14) and age <5 years (OR 5.47;1.54 - 7.60) were treated with antibiotics.Conclusion. The prescription of antibiotics for paediatric patients at both HCM and HGM was largely influenced by patients' clinical condition and age. It showed that physicians used an empirical approach, in the absence of laboratory tests, often leading to unnecessary antibiotic treatments with negative causative effects. Physicians should be encouraged to use an evidence-based approach for managing the cases correctly

Modulation in airway smooth muscle reactivity and improvement in lung function of cigarette smokers and passive non-smokers following garcinia kola treatment

Inhalation of tobacco smoke is a major risk factor for the development of airway hyperreactivity (AHR) in non-cigarette smokers and increase respiratory distress in smokers. Garcinia kola has been linked to smooth muscle relaxation and may ameliorate obstruction and resistance to airflow. This study examined the effect of Garcinia kola on airflow and reactivity of the airway smooth muscles (ASM) of asymptomatic regular cigarette smokers (CS) and passive non-smokers (PNS) following 10 minutes cigarette smoking and exposure to cigarette smoke. Sixty apparently healthy male undergraduates comprising cigarette smokers and non-smokers volunteered as subjects. Changes in peak expiratory flow rate (PEFR) in L/min in CS and PNS was measured with Spirometer before and after 10 minutes of smoking and/or exposure to cigarette smoke. Thereafter, half the population of CS and PNS were given G. kola (200 mg/kg body weight) and PEFR measured at intervals of 30 minutes for a maximum of 90 minutes. Peak expiratory flow rate significantly decreased (p < 0.05) following 10 minutes of smoking and exposure to smoke in both CS and PNS, however, G. kola ingestion marginally increased PEFR values significantly at 30, 60 and 90 minutes intervals. Comparatively, increase in PEFR was greater in PNS than in CS (P < 0.05) treated with G. kola and climaxed at 60 minutes. Conclusively, cigarette smoking and exposure to cigarette smoke compromise lung function with a decrease in peak expiratory flow rate. G. kola treatment significantly reversed this trend, cleared the airways, enhanced airflow and improved lung function

Profil épidémiologique des pathologies respiratoires chez l'enfant à l'Hôpital d'Enfants de Rabat, Maroc

Introduction: les pathologies respiratoires représentent un motif fréquent d'hospitalisation en pédiatrie. L'objectif de cette étude était d'évaluer le profil épidémiologique des pathologies respiratoires chez l'enfant à l'hôpital d'enfants de Rabat, Maroc.Méthodes: il s'agit d'une étude observationnelle transversale qui a concerné tous les cas d'enfants âgés de 3 mois à 15 ans hospitalisés pour une pathologie respiratoire au service de pneumoallergologie et infectiologie pédiatriques de l'hôpital d'enfants de Rabat sur une période d'une année, du 1 janvier 2014 au 31 décembre 2014.Résultats: sur 3537 patients hospitalisés, 2493 (70,5%) l'ont été pour une pathologie respiratoire. Les hospitalisations pour exacerbation d'asthme (p < 0,001), bronchiolite aigüe (p < 0,001) et dyspnée laryngée (p = 0,004) étaient plus fréquentes chez le garçon alors que les hospitalisations pour pneumopathie aigüe (p = 0,005), pour inhalation de corps étranger (p = 0,007) et pour coqueluche (p = 0,020) étaient plus fréquentes chez la fille. Les hospitalisations pour pneumopathie aigüe (p < 0,001), exacerbation de séquelles graves de virose (p < 0,001) et pour coqueluche (p < 0,001) étaient plus fréquentes chez le nourrisson. Les hospitalisations pour pneumopathie aigüe (p < 0,001) et pour coqueluche (p = 0,015) étaient plus fréquentes en période automnohivernale.Conclusion: les motifs d'hospitalisation étaient dominés par les exacerbations d'asthme et la bronchiolite aigüe, lesquelles étaient plus fréquentes chez le garçon. Les infections respiratoires, représentées par les pneumopathies aigües et la coqueluche, étaient plus fréquentes en période automnohivernale et touchaient plus le nourrisson

Chronic Obstructive Pulmonary Disease (COPD): A Review of the Clinical Management

Chronic Obstructive Pulmonary disease (COPD) is one of the most common chronic respiratory diseases which contribute significantly to the burden of non-communicable diseases(NCDs). With the increasing prevalence of COPD in developing countries a good knowledge of the diagnosis and adequate management are important tools for both primary care and specialist physicians to ensure appropriate treatment.Methods: Review of the available literature on the subject was done through Medline and Google search utilizing the following keywords COPD; epidemiology; pathogenesis and management.Result: Spirometry is an important tool in the diagnosis and staging of COPD. Various treatment targets aimed at improving breathing and the quality of life in patients are available.Conclusion: New therapies that have the potential to improve disease outcome are urgently needed

An Overview of Chronic Obstructive Pulmonary Disease (COPD): Epidemiology and Pathogenesis

Chronic Obstructive Pulmonary Disease (COPD) is one of the most common chronic respiratory diseases which contribute significantly to the burden of non-communicable diseases. With the increasing prevalence of COPD in developing countries a good knowledge of disease burden and process is essential.Methods: Review of the available literature on the subject was done through Medline and Google search utilising the following keywords COPD; epidemiology; pathogenesis and management.Result: COPD which is increasing in prevalence has varied pathogenetic mechanisms which are influenced by both intrinsic and extrinsic environmental promoters.Conclusion: The prevalence of COPD is increasing especially in developing countries. The pathogenesis is multifactorial and current understanding provides insights that are expected to improve on treatment and outcome

Childhood Asthma

Asthma is the most common chronic disease of South African children; affecting growth and development and quality of life. Features supporting the diagnosis are a family or personal history of atopy; night cough; exercise-induced cough and/or wheeze and seasonal variation in symptoms. Asthma is on the increase in both developed and developing countries; in both rural and urban communities. The first part of this series aims to give a brief overview of the epidemiology; pathophysiology and diagnosis of childhood asthma

The prevalence of occupational asthma and rhinitis among woodworkers in south-eastern Nigeria

Wood dusts are known to cause respiratory disorders like rhinitis and asthma. This study was therefore done to determine the magnitude of the problem among woodworkers in south-eastern Nigeria exposed to high level of wood dust.Five hundred and ninety one woodworkers were selected using a stratified random sampling. The prevalence of woodworkrelated rhinitis and asthma were then observed in the study population. Also the peak expiratory flow rate (PEFR) of each woodworker was obtained. The prevalence of occupational rhinitis was 78%, while that of asthma was 6.5%. As period of woodwork increased the prevalence of rhinitis and asthma increased (rhinitis: χ2 trend = 53.015, df = 1, P = 0.000). For asthma, χ2 trend =19.721, df = 1, P = 0.000). Also the PEFR significantly became low with increasing years of exposure to woodwork (χ2 trend = 75.965, df = 1, P= 0.000). In conclusion the prevalence of rhinitis and asthma in woodworkers was high and significantly increased with years of working as a woodworker