Profile of paediatric neurologic emergencies at the children emergency ward in a tertiary hospital in Port Harcourt, Nigeria
Keywords:Paediatric emergencies, Prevalence, Pattern, Outcome
Background: Neurologic emergencies are life-threatening in most cases with risks for acute or lifelong complications. Though a common presentation in the paediatric group, there is paucity of studies in our environment. The aim of this study is to describe the pattern, prevalence and outcome of paediatric neurologic emergencies in the university of Port Harcourt Teaching Hospital.
Methods: A retrospective cross-sectional study conducted at the University of Port Harcourt Teaching Hospital. Data was obtained from the registers in the children emergency ward over a one-year period.
Results: A total of 1125 children were admitted into the CHEW in 2022, 67 (6.0%) of them had neurologic emergencies. Their ages ranged from 3 months to 16 years with a mean age was 7.6±5.2 years. Thirty-seven (55.2%) were males with a male to female ratio of 1.2:1. The most frequent diagnosis were meningitis and meningoencephalitis in 21 (31.3%), epilepsy among 9 (13.4%) while febrile convulsion and cerebral malaria accounted for 4 (6.0%) respectively. The main neurologic emergencies at presentations were raised intracranial pressure 34.3%, convulsions (31.3%), unconsciousness (16.4%) and paralysis (9.0%). Majority (70.2%) of them were discharged, 9 (13.4%) died, 8 (11.9%) DAMA while 3 (4.5%) were referred. More than half of those that died presented late to the hospital.
Conclusions: Neurologic emergencies are prevalent and are common causes of morbidity and mortality in children with meningitis being the commonest cause. There is need to enhance preventive strategies against meningitis.
Ofovwe GE, Ibadin MO, Ofoegbu B. Pattern of emergency neurologic morbidities in children. J Natl Med Assoc. 2005;97(4):488-92
Akpan MU, Eno-ObongUtuk FE, Udeme Akpan M. Pattern of paediatric neurological emergencies in university of uyo teaching hospital, uyo, akwa-ibom state of nigeria. Ibom Med J. 2014;7(1):23-9.
Iloeje SO. Paediatric neurologic emergencies at the University of Nigeria Teaching Hospital, Enugu. West Afr J Med. 1997;16(2):80
Jackson M, Szczepaniak M, Wall J. Numbers and types of neurological emergencies in England and the influence of socioeconomic deprivation: a retrospective analysis of hospital episode statistics data. BMJ. 2022;12:e061843.
Ngoue JE, Um SSN, Nengom JT. Incidence and pattern of neurologic emergencies in children at the mother and child center of the chantalbiya foundation. Pediatric Oncal. 2022;19(4):47-53.
Tshimangani T, Pongo J, BodiMabiala J, Yotebieng M, O'Brien NF. Pediatric acute severe neurologic illness and injury in an urban and a rural hospital in the democratic republic of the Congo. Am J Trop Med Hyg. 2018;98(5):1534-40.
Uche EO, Shokunbi MT, Malomo AO, Akang EE, Lagunju I, Amanor-Boadu SD. Pediatric brain tumors in Nigeria: clinical profile, management strategies, and outcome. Childs Nerv Syst. 2013;29(7):1131-5.
George IO, Frank-Briggs AI. Stroke in Nigerian Children with Sickle Cell Anaemia. J Public Health Epidemiol 2011;3:407-9.
Ibraheem RM, Abdulkadir MB, Gobir AA. Johnson WBR. Socio-demographic and clinical factors predicting time to presentation for children with pneumonia in Ilorin, Nigeria. Alexandria J Med. 2017; 54:247-50.
Gabriel-Job N, Azubogu SU. Prevalence and pattern of pneumonia among children admitted into university of port harcourt teaching hospital: a two year review. International J Trop Dis Health. 2020;3:1-6.
Treleaven E, Toan PN, Le DN, Diamond-Smith N, Partridge JC, Le HT. Gender disparities in child health care seeking in northern Vietnam. Asian Population Stud J. 2016;12:312-30.
Oyibo W, Ntadom G, Uhomoibhi P, Oresanya O, Ogbulafor N, Ajumobi O, et al. Geographical and temporal variation in reduction of malaria infection among children under 5 years of age throughout Nigeria. BMJ Global Health 2021;6:e004250.