Objective. This study investigated the treatment outcomes and determinant factors likely to be associated with recovery rate. Methods. A retrospective chart review (RCR) was performed on 348 patients who were enrolled in the outpatient care (OPC) during the study period. Results. Of the 348 cases, 33.6% recovered (having MUAC ≥125 mm), 49.1% defaulted, and 11.5% transferred to other OPC units to continue with treatment. There were 187 (53.7%) males and 161 (46.3%) females with severe malnutrition. The average weight gain rate was 28 g/kg/day. Controlling for other factors, patients who completed the treatment plan had 3.2 times higher probability of recovery from severe acute malnutrition (SAM) as compared to patients who defaulted (adjusted odds ratio (AOR) = 3.2, 95% CI = 1.9, 5.3, and p < 0.001). The children aged 24–59 months had 5.8 times higher probability of recovery from SAM as compared to children aged 6–11 months (AOR = 5.8, 95% CI = 2.5, 10.6, and p < 0.001). Conclusions. Cure rate was low and the default rate was quite high. Children who were diagnosed as having marasmus on admission stayed longer before recovery than their kwashiorkor counterparts. Younger children were of greater risk of nonrecovery.

BackgroundBloodstream infections in neonates and infants are life-threatening emergencies. Identification of the common bacteria causing such infections and their susceptibility patterns will provide necessary information for timely intervention. This study is aimed at determining the susceptibilities of bacterial etiological agents to commonly-used antimicrobial agents for empirical treatment of suspected bacterial septicaemia in children.MethodsThis is a hospital based retrospective analysis of blood cultures from infants to children up to 14 years of age with preliminary diagnosis of sepsis and admitted to the Neonatal Intensive Care Unit (NICU) and Paediatric Wards of the Teaching Hospital Tamale from July 2011 to January 2012.ResultsOut of 331 blood specimens cultured, the prevalence of confirmed bacterial sepsis was 25.9% (86/331). Point prevalence for confirmed cases from NICU was 44.4% (28/63) and 21.6% (58/268) from the Paediatric ward. Gram positive cocci (GPC) were the predominant isolates with Coagulase positive (32.2%) and Coagulase-negative (28.7%) Staphylococci accounting for 60.9% of the total isolates. Gram negative rods (GNR) comprised 39.1% of all isolates with Klebsiella, E.coli and Salmonella being the most common organisms isolated. Klebsiella was the most frequent GNR from the NICU and Salmonella typhi was predominantly isolated from the paediatric ward. Acinetobacter showed 100.0% susceptibility to Ceftriaxone and Cefotaxime but was resistant (100.0%) to Ampicillin, Tetracycline and Cotrimoxazole. Escherichia coli and Klebsiella were 80.0% and 91.0% susceptible to Ceftriaxone and Cefotaxime respectively. Klebsiella species showed 8.3% susceptibility to Tetracycline but was resistant to Ampicillin and Cotrimoxazole. Escherichia coli showed 40.0% susceptibility to Ampicillin, Chloramphenicol and Cotrimoxazole; 20.0% susceptibility to Tetracycline and 80.0% susceptible to Gentamicin and Cefuroxime. Coagulase negative Staphylococci was susceptible to Gentamicin (72.0%) but Coagulase positive Staphylococci showed intermediate sensitivity to Gentamicin (42.9%).ConclusionCoagulase Negative, Coagulase Positive Staphylococci, Salmonella and Klebsiella were the aetiological agents of bloodstream infection among children at TTH. While gram-positive and gram-negative bacteria showed low susceptibility to Ampicillin, Tetracycline and Cotrimoxazole, the GNR were susceptible to Gentamicin and third-generation cephalosporins.

Background: Though treatment of severe acute malnutrition cases in both the in-patient care and the outpatient care has been going on since 2011 at the Tamale Teaching Hospital, little is known about the clinical treatment outcomes and factors that may be associated with the recovery rate in the in-patient setting. This study investigated the clinical treatment outcomes and determinant factors likely to be associated with recovery rates at the Hospital. Methods: We performed a retrospective chart review (RCR) of all pediatric patients aged (0-11 years of age) who were diagnosed of severe acute malnutrition between March 2011 and December 2013. Logistic regression modeling was used to determine the risk factors of severe malnutrition. Results: Of the 630 cases that were reviewed, only 19.5 % recovered (having mid-upper-arm-circumference measure 125 mm, or oedema resolved, or gained 5g/kg/body weight for 2 consecutive days at the time of discharge), 1.7 % defaulted, and 65.2 % were referred to outpatient care units for continued treatment. The observed case fatality rate was 13.5 %. Marasmic cases had more chronic co-morbid conditions at admission compared to kwashiorkor patients (81.7% vs. 69.3%, p=0.01). Conclusions: Case fatality rate in this population was quite high. Case referral to outpatient care unit was appropriately high. Malaria was the most common co-morbid condition diagnosed among the cases reviewed. Younger age, 15% or more increase in weight, and type of malnutrition were the main predictors of recovery from severe acute malnutrition in the in-patient care setting.