Facility-based evaluation of under-fives with diarrhoea in Cross River State, Nigeria: a clinical audit

Ekong E. Udoh, Friday A. Odey, Emmanuel E. Effa, Ekpereonne B. Esu, Martin M. Meremikwu


Background:Diarrhoea is the second leading cause of under-five mortality globally. Proper evaluation of children with diarrhoea is important for making right diagnosis, instituting appropriate treatment and invariably reducing -related childhood deaths. This study was undertaken to determine the extent under five with diarrhoea diseases were evaluated by health workers prior to commencement of treatment.  

Methods: A clinical audit was conducted from May to June 2013 in 32 health facilities in the Southern region of Cross River State, Nigeria. Trained field workers extracted information related to patient evaluation from case records of under-fives treated diarrhoea diseases for using a validated audit tool.

Results:Case records of 370 under-five children treated for diarrhoea diseases were retrieved and audited. The duration of diarrhoea was reported in 242 (65.4%), stool consistency in 189 (51.1%) and vomiting in 177(47.8%). Other relevant information in the history was reported in less than 45%. Information on risk factors for diarrhoea was reported in less than 40%, assessment for skin turgor in 201 (54.3%) while other physical examination findings were reported in less than 25% of the case records. Request for laboratory investigations were recorded in about 10%.

Conclusions:The evaluation of under-five with diarrhoea by health workers prior to initiation of treatment was sub optimum. Patients’ evaluation declined steadily from the stage of history taking, to physical examination, and laboratory investigation.


Clinical audit, Diarrhoea, Evaluation, Health facilities, Under five

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