Blood transfusion in an emergency paediatric unit in Owerri, Nigeria: pattern and outcome.

The increasing number of patients presenting with severe anaemia and who invariably receive blood transfusion is of concern. This retrospective study reports the pattern of presentation and the outcome of management of patients who were transfused in the Emergency Paediatric Unit of Federal Medical Centre, Owerri, between September 2002 and August 2004.

Prescribing practices of doctors attending to under fives in a children's outpatient clinic in Owerri, Nigeria.

Prescribing practices of doctors in different clinical settings have been documented but there is a dearth of information on prescribing practices with regards to children especially the under fives. This study set to describe the prescribing practices of doctors attending to under fives in a children's outpatient clinic. The information obtained is expected to aid in designing appropriate interventions. Between January and April 2004 the age, sex and drugs prescribed for under fives seen at the children's outpatient clinic of Federal medical centre, Owerri in South eastern Nigeria were extracted at the end of each day's consultations from their cards and entered into a spread sheet. Patients who had no prescriptions were excluded. A total of 2471 medications were prescribed for 790 patients who met the criteria for inclusion in the study. Antimalarials, Analgesics, Antibiotics, Vitamin C, Antihistamines and Multivitamin preparations were the commonest drugs prescribed. The prescription rate per patient was 3.13. While three different antimalarials were prescribed a total of twelve different antibiotics were. Prescription rate for injections was 1.9 per cent. Only 13.3 per cent of the patients had all their drugs prescribed in generic names. The others had at least two drugs prescribed in brand names. The difference in cost between same drugs prescribed in brand names as against in generic names were between 41.7 per cent and 60 per cent. All the antimalarials and analgesics prescribed were in the Nigerian National essential drug list while only 16.7 per cent of antibiotics prescribed were not. This study has documented significant flaws in the prescribing practices of these doctors, particularly the low rate of prescription in generic names, high rate of antibiotics prescription, inappropriate prescription of multivitamin preparations and Vitamin C and a relatively high rate of poly pharmacy. Suggested interventions include developing and circulating easy to use treatment guidelines for diseases commonly seen in our centre and a regular audit of the application of these guidelines. Continuing medical education of doctors on rational drug use and evidence based medicine should also be instituted.

Pattern of morbidity among pre-school children attending the children's outpatient clinic of Federal Medical Centre Owerri, Nigeria.

BACKGROUND: Several interventional programmes which sought broadly to promote the health of the child and also prevent diseases were introduced globally in the latter period of the last century. This study set to describe the pattern of morbidity among pre-school children attending the children's outpatient clinic of the Federal Medical Centre, Owerri. METHOD: The case records of pre-school children who presented at the clinic between January and April 2004 were collected and entered into a spread sheet. The age, sex and diagnosis made were extracted from the records. In cases where more than two diagnoses were made, the most likely two following a review of presenting complaints and findings on examination were chosen. RESULT: Eight hundred and twenty nine patients consisting of 468 (56.2%) males and 361 (43.5%) females met the inclusion criteria. Patients aged 0-11 months constituted 47.8% while those between 48 and 59 months accounted for 1%. The five commonest causes of morbidity were malaria (60.7%), acute respiratory infection (35.8%), diarrhoeal disease (7.4%), skin infection (6.8%) and urinary tract infection (3.6%). The prevalence of malaria and acute respiratory disease were highest in patients aged between 12-23 months while diarrhoea was highest in the group 0-11 months. The prevalence of vaccine preventable diseases such as measles and tuberculosis were low accounting for 1.1% and 1% of morbidity respectively. CONCLUSION: This study shows that morbidity from vaccine preventable diseases is low, which is likely a reflection of the increased emphasis on immunization programmes. The major causes of morbidity in pre-school children in Owerri are still common diseases that have been around for a while and are basically preventable.