RESUMEN
Introduction: Childhood illnesses cause significant number of admissions in different level hospitals. This retrospective study was undertaken to analyze the morbidity pattern in the Paediatric ward at a Zonal Hospital with aim that the results obtained will help in planning, prioritizing and implementing preventive, promotive and curative health care activities of the children in resource poor community. Materials and Methods: This study was carried out retrospectively for one year from July/Aug 2010 – June/July 2011. Age, sex, diagnosis, month of admission, duration of admission and the frequency of diseases were evaluated. Results: A total number of 977 patients were admitted during the study period. There were 579(59%) male and 398(41%) female children. Less than five years age group accounted for 569(58%) excluding the neonates. In the study period, respiratory tract infections were the commonest cause of admission 309(31.6%), gastrointestinal including diarrhoeal diseases were 278(28.5%), enteric fever comprised of 69(7%), and other diseases comprised of about 390(39.5%). Of the total admissions, CNS diseases comprised of 128(13%) of which 29(3%) were meningitis and meningoencephalitis. Sixty seven (52%) of the total CNS cases were due to febrile convulsion. Renal and cardiovascular diseases were 8.5% and 1.5% respectively. Conclusion: Children under five years of age being the most common age group amongst all, with respiratory and gastrointestinal diseases still being the most predominant cause of paediatric morbidity; community level interventions including IMCI should be strengthened for reducing hospital admissions, along with allocation of hospital beds and supplies as per morbidity pattern.
RESUMEN
Introduction: Snake bite poisoning in children is an emergency condition with significant mortality. It is more prevalent in Terai and Inner Terai regions of Nepal especially during monsoon season. There is no study on snake bite poisoning in this part of the country after the introduction of national snake bite management guideline in 2003. This retrospective study was conducted to evaluate the clinicoepidemiological profile, amount of anti-snake venom used and outcome of snake bites. Materials and Methods: Two hundred and forty six cases of snake bite poisoning admitted in emergency department of the hospital up to the age of 14 years, over a period of 6 years from 2004/2005 to 2009/2010 were evaluated retrospectively. Results: The study showed male predominance (57.3%) in snake bites with higher incidence of children above ten years of age (58%). The most of the poisonings (71.9%) was seen during June, July and August months which correspond to the monsoon season in Nepal. Majority of the victims had been bitten by unidentified snakes (52 %), mostly on the fingers & hands (64.6 %). Ptosis was observed in all cases of snake bite poisoning. Slightly less than 1/3rd of the children had respiratory distress needing respiratory support. Average ASV used was 18.2 vials. Case fatality rate (CFR) was quite high (28.2%) with more fatality on those with respiratory distress. Conclusion: As mortality due to snakebite poisoning and consumption of antisnake venom is not reduced by the use of the national protocol 2003, further study to evaluate alternate protocol is recommended.