ABSTRACT
OBJECTIVES: To evaluate the effect of late diagnosis and other factors on outcome of paediatric bacterial meningitis (BM) and recommend appropriate intervention. DESIGN: Case series. SETTING: University of Calabar Teaching Hospital, Calabar, Nigeria. SUBJECTS: 62 consecutive BM patients aged two months to 16 years admitted between 1991 and 1994. MAIN OUTCOME MEASURES: Mortality rate. RESULTS: Diagnostic difficulties experienced in 58% of cases and other factors resulted in delayed diagnosis and high mortality (20 to 47%). CONCLUSION: Only elimination of the identified inadequacies in management can significantly reduce the BM-related high mortality in developing countries.
Subject(s)
Developing Countries , Meningitis, Bacterial/diagnosis , Meningitis, Bacterial/mortality , Acute Disease , Adolescent , Child , Child, Preschool , Female , Hospital Mortality , Hospitals, University , Humans , Infant , Male , Nigeria , Prognosis , Retrospective Studies , Time FactorsABSTRACT
A total of 225 pre-school Nigerians were studied to evaluate the effect of anaemia on the respiratory rate of febrile children, and the influence of this on the reliability of the WHO criteria for the clinical diagnosis of pneumonia in the primary health care setting. Malaria was the commonest cause of febrile illness (63.1 pc). The prevalence of severe anaemia was 28.0 pc. The mean respiratory rate of anaemic children (53.9 +/- 12.8/min) was significantly higher than that of the non-anaemic (48.4 +/- 12.7/min; p = 0.011). Mean body temperature was not significantly different in both groups. Haematocrit was negatively correlated with respiratory rate. The positive correlation observed between temperature and respiratory rate was enhanced by decreasing haematocrit. More of the severely anaemic children (68.6 pc) exceeded the WHO respiratory rate threshold for diagnosis of pneumonia than the moderately anaemic (55.4 pc) or non-anaemic (36.1 pc). The specificity of the WHO criteria for clinical diagnosis of pneumonia decreased with decreasing haematocrit.
Subject(s)
Anemia/complications , Fever/complications , Hyperventilation/etiology , Anemia/blood , Child, Preschool , Fever/diagnosis , Follow-Up Studies , Hematocrit , Humans , Infant , Malaria/complications , Nigeria , Pneumonia/complications , Pneumonia/diagnosis , Prevalence , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
For the general practitioner it is extremely difficult to make the diagnosis of the thalamic pain syndrome of Dejerine-Roussy which may develop in patients who have suffered a cerebrovascular accident. Because of this inability, the syndrome is considered rare in Africa. At the Teaching Hospital of the University of Calabar, Calabar, Nigeria two cases were seen recently however. We hereby present those two cases and discuss the aetiology, clinical presentation, diagnosis and treatment. This is intended to help the general practitioner to overcome the difficulties usually experienced in diagnosis and treatment of such cases.