Determinants of Outcome among Under-Five Children Hospitalized with Pneumonia at a Tertiary Health Facility in South-West Nigeria.

BACKGROUND: Pneumonia contributes largely to mortality among children particularly in developing countries. In 2018, about 15% of all deaths in children aged less than 5 years were attributed to pneumonia globally. This study aimed to identify factors at presentation that determine mortality among children less than 5 years of age hospitalized with pneumonia. METHODS: This was a prospective observational study conducted at the Children emergency unit of Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria. Subjects were consecutive children aged between 1-60 months with clinical and radiological pneumonia. Treatment outcome and determinants of mortality were studied. RESULTS: A total of 129 subjects were studied with a male to female ratio of 1.5: 1. Thirteen subjects died, giving a case fatality rate of 10.1%. Mortality was associated with age <24 months (p= 0.001), severe wasting (p< 0.001), temperature >38.30C (p= 0.001), grunting (p< 0.001), central cyanosis (p < 0.001), hypoxaemia (p < 0.001), loss of consciousness (p = 0.007), severe anaemia (p < 0.001), and leucopaenia (p = 0.001). Among the significant variables, temperature >38.30C [adjusted odds ratio (OR) 34.241, 95% confidence interval (CI) 2.496 - 469.815], grunting (OR 19.444, 95% CI 1.744 - 216.725), central cyanosis (OR 43.984, 95% CI 2.001- 966.729), hypoxaemia (OR 41.883, 95% CI 1.918 - 914.495) and severe anaemia (OR 48.201, 95% CI 3.351 - 693.432) were the independent determinants of mortality. CONCLUSION: Children hospitalized for pneumonia with temperature >38.30C, grunting, cyanosis, hypoxaemia, and severe anaemia are more likely to die. Hence, they must be treated intensively.

Fatal scorpion sting in a child.

Fatal scorpion stings are rare in Nigeria. Hitherto, there has been no report from Nigeria of death following scorpion stings. This report is that of a 2-year-old boy who was stung by a scorpion while playing outside his home environment in Osogbo, South West Nigeria. He subsequently presented to the Children Emergency Unit of Ladoke Akintola University of Technology Teaching Hospital, Osogbo, in pain and with features of shock. He died within 2 h of admission despite all treatment given to relieve pain and manage shock. The case is reported in order to share the important lessons learned.