Patterns of paediatric emergency admissions and predictors of prolonged hospital stay at the children emergency room, University of Calabar Teaching Hospital, Calabar, Nigeria.

BACKGROUND: There is a high prevalence of paediatric emergency cases in less developed countries. However, prolonged hospital stay at emergency units may further overstretch the facilities. OBJECTIVE: To 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. METHODS: This 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). RESULT: The 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). CONCLUSION: Prevention 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.

Pregnancy Termination in Sub-Saharan Africa: The Need for Refined Data

Purpose: This study examines the levels and pattern of; as well as the factors associated with; pregnancy termination in seventeen Sub-Sahara African countries. Methods: The 2000 round of demographic and health survey (DHS) data sets for the countries are used. The study population are women aged 15-49 who have ever been exposed to the risk of pregnancy and interviewed during the surveys. Univariate analysis is done to examine the distribution of the women. Bivariate analysis of selected background; contraceptive; sexual behaviour and fertility variables by having ever had a terminated pregnancy are also carried out. Lastly; multivariate logistic regression models are fitted to examine the magnitude of associated variables while controlling for others. Results: the associated factors vary from country to country. However; age and marital status are associated with and are critical predictors of having ever had a terminated pregnancy in all the countries. For example; the odds of having ever had a terminated pregnancy is about 54 and 32 times (for currently and formerly married women; respectively) that of those that have never married in Rwanda. Conclusion: This study has come up with findings that provoke more thinking and research on the topic of pregnancy termination and to reproductive health in general. This is because `ever had a terminated pregnancy' as used in the DHS context made no distinction between the three different pathways through which a pregnancy may not result into a live birth