Pre-presentation management, metabolic state and outcome of children admitted for diarrhoea disease in Calabar, Nigeria

Uka, VG; Samson‐Akpan, Patience E.; Okpara, Henry Chima; Ekanem, Emmanuel

doi:10.4314/njp.v45i3.2

Cited by 3 publications

(8 citation statements)

References 16 publications

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“…Our study found that the most common home remedy offered by caregivers was mainly ORS (79.4%) which is in keeping with the 47-72.3% rate within the country, [25,26] and the most common source of drinking water was sachet/bottled water (47.8%). This finding is reassuring and in line with the WHO/UNICEF [1] recommendation.…”

Section: Discussionsupporting

confidence: 83%

“…Our findings were lower than the reported prevalence of acidosis in Nigeria. [25,26] In contrast, hypernatremia (37.9%) was the most common electrolyte derangement as reported by researchers from Tanzania. [32] Our study revealed that none of the babies managed for diarrhea had hypoglycemia.…”

Section: Discussionmentioning

confidence: 95%

“…[8] The majority of the children (72.1%) had mild-to-moderate dehydration which is similar to the reports by other authors. [24][25][26] The majority of our cohort of babies had moderate dehydration, at presentation, possibly because more than four-fifth of them had ORS before the presentation. Thus, public health interventions that promoted ORS administration at home should be enhanced to reduce the sequelae of severe dehydration.…”

Section: Discussionmentioning

confidence: 99%

“…A similar low prevalence of hypoglycemia was previously reported. [6,26] Although hypoglycemia may not occur commonly in children with diarrheal disease, it could significantly contribute to diarrhea mortality when it occurred. [6] The sociodemographic characteristics did not seem to have an association with the dehydration status of patients in this study.…”

Section: Discussionmentioning

confidence: 99%

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Pattern of bacteriological and biochemical profile and determinants of metabolic acidosis among under-fives with diarrheal diseases at the diarrhea treatment and training unit of the University of Calabar Teaching Hospital, Calabar, Nigeria

Enyuma

Ikpeme

Olorunfemi

et al. 2022

CJHS

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Objectives: Dehydration and electrolyte derangements are major causes of morbidity and mortality in diarrhea disease. We aimed to evaluate the pattern and determinants of electrolyte derangements and isolates in a stool sample of under-fives with diarrhea at a tertiary hospital in Nigeria. Materials and Methods: This was a prospective and cross-sectional study of 136 under-fives admitted into the diarrheal training and treatment unit who were consecutively recruited. Patients were tested for association using Pearson’s Chi-square, Kruskal–Wallis’ test, and logistic regression modeling. Results: A total of 136 babies were recruited. Three of the stool sample were culture positive for non-specified Escherichia coli, another two grew Entamoeba histolytica. Almost half (n = 56/136, 41.2%) of the children had metabolic acidosis. Predictors of acidosis included severe dehydration (adjOR: 5.76, 95%CI: 1.54–21.50, P = 0.009), ≤3 months breastfeeding (AdjOR 0.39, 95%CI: 0.153–0.997, P = 0.049), and fever (adjOR 6.30, 95%CI: 1.74–22.83, P = 0.005). Conclusion: Metabolic acidosis was common with diarrhea for which exclusive breastfeeding was protective in this study. Although few, the growth of E. histolytica implicates sanitary conditions and suggests the viral origin of diarrhea, hence strongly supports the introduction of rotavirus vaccine in our national routine immunization schedule while proper use of ORS may impact positively on the metabolic complication of diarrheal disease in the tropics.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pattern of bacteriological and biochemical profile and determinants of metabolic acidosis among under-fives with diarrheal diseases at the diarrhea treatment and training unit of the University of Calabar Teaching Hospital, Calabar, Nigeria

Enyuma

Ikpeme

Olorunfemi

et al. 2022

CJHS

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“…18 In contrast however, it was lower than the prevalence of 44.5% and 44.3% described by Dhyani et al in India and Okposio et al in Benin, Nigeria respectively. 13,28 A lower prevalence of 13.64% was however documented in Calabar, South-south Nigeria by Uka et al 30 These differences may possibly be due to the differences in clinical characteristics of the subjects, and the study population. The preponderance of hypokalaemia in patients with SAM and in the intensive care unit has been documented.…”

Section: Discussionmentioning

confidence: 82%

Dyselectrolytemia in under-five children with acute diarrhoea-induced dehydration: a cross-sectional study in a South-East Nigerian hospital

Ezuruike

Ibeneme

Uwaezuoke

2022

Int J Contemp Pediatr

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Background: Diarrhoeal disease contributes significantly to preventable deaths among under-fives globally. Associated dyselectrolytemia is a major contributor to morbidity and mortality in these children. The aim of the study was to determine the prevalence and pattern of serum electrolyte derangement among under-fives with dehydration due to acute diarrhoea.Methods: It was a hospital-based descriptive cross-sectional study conducted at the Federal Medical Centre, Umuahia involving 150 under-five children with dehydration due to acute diarrhoea from October 2018 to January, 2020. Clinical detail and degree of dehydration were recorded. The serum electrolytes were estimated using Ion selective electrode method.Results: The overall prevalence of electrolyte derangement was 62.6%. Hyponatraemia was the commonest electrolyte derangement, accounting for 31.3% of cases. Hypokalaemia and metabolic acidosis occurred in 24% and 12.7% of cases respectively. Across the different degrees of dehydration hyponatremia was 5 times more likely to develop in the severely dehydrated (OR 5.25, p=0.001) compared to the mildly dehydrated. The odds of developing hypokalaemia were 17 times more likely in the moderately dehydrated (OR 17.21, p=0.007) and 38 times more likely in the severely dehydrated Subjects (OR 38.50, p≤0.001).Conclusions: The frequency of electrolyte derangements was high and increased with the increasing severity of dehydration. Routine estimation of serum electrolytes is advocated for under-five children with acute diarrhoea, especially with moderate and severe dehydration. Also, the use of sodium and potassium-containing fluids can be instituted as choice fluids in resource-poor settings without laboratory support.Background: Diarrhoeal disease contributes significantly to preventable deaths among under-fives globally. Associated dyselectrolytemia is a major contributor to morbidity and mortality in these children. The aim of the study was to determine the prevalence and pattern of serum electrolyte derangement among under-fives with dehydration due to acute diarrhoea.Methods: It was a hospital-based descriptive cross-sectional study conducted at the Federal Medical Centre, Umuahia involving 150 under-five children with dehydration due to acute diarrhoea from October 2018 to January, 2020. Clinical detail and degree of dehydration were recorded. The serum electrolytes were estimated using Ion selective electrode method.Results: The overall prevalence of electrolyte derangement was 62.6%. Hyponatraemia was the commonest electrolyte derangement, accounting for 31.3% of cases. Hypokalaemia and metabolic acidosis occurred in 24% and 12.7% of cases respectively. Across the different degrees of dehydration hyponatremia was 5 times more likely to develop in the severely dehydrated (OR 5.25, p=0.001) compared to the mildly dehydrated. The odds of developing hypokalaemia were 17 times more likely in the moderately dehydrated (OR 17.21, p=0.007) and 38 times more likely in the severely dehydrated Subjects (OR 38.50, p≤0.001).Conclusions: The frequency of electrolyte derangements was high and increased with the increasing severity of dehydration. Routine estimation of serum electrolytes is advocated for under-five children with acute diarrhoea, especially with moderate and severe dehydration. Also, the use of sodium and potassium-containing fluids can be instituted as choice fluids in resource-poor settings without laboratory support.

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Burden and severity of deranged electrolytes and kidney function in children seen in a tertiary hospital in Kano, northern Nigeria

et al. 2023

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Introduction Derangement in serum electrolytes and kidney function is often overlooked, especially in resource-constrained settings, and associated with increased risk of morbidity and mortality. This study aimed to describe the burden of derangements in serum electrolytes and kidney function in children presenting to a tertiary hospital in Nigeria. Methods The laboratory records of all children who had serum electrolytes urea and creatinine ordered on their first presentation to hospital between January 1 and June 30, 2017 were retrospectively reviewed. Basic demographic data including admission status (inpatient or outpatient) were recordedandserum levels of sodium, potassium, chloride and bicarbonate were assessed for derangements usingnormal values from established reference ranges. Results of repeat samples were excluded. Kidney function was classified based on the serum creatinine relative to normal values for age and sex. Results During the study period, 1909 children (60.3% male); median (IQR) age 42 (11.9) months had serum chemistry and 1248 (65.4%) were admitted. Results of their first samples were analyzed. Electrolyte derangements were present in 78.6% of the samples most commonly hyponatraemia (41.1%), low bicarbonate(37.2%), hypochloraemia (33.5%) and hypokalemia(18.9%). Azotaemia was found in 20.1% of the results. Elevated serum creatinine levels were found in 399 children (24.7%), 24.1% of those being in the severe category. Children aged 5 years and younger accounted for 76.4% of those with derangement in kidney function. One hundred and eight outpatients (17.8%) had deranged kidney function. Conclusion Deranged serum electrolytes and kidney function were common in this cohort.

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Pre-presentation management, metabolic state and outcome of children admitted for diarrhoea disease in Calabar, Nigeria

Cited by 3 publications

References 16 publications

Pattern of bacteriological and biochemical profile and determinants of metabolic acidosis among under-fives with diarrheal diseases at the diarrhea treatment and training unit of the University of Calabar Teaching Hospital, Calabar, Nigeria

Pattern of bacteriological and biochemical profile and determinants of metabolic acidosis among under-fives with diarrheal diseases at the diarrhea treatment and training unit of the University of Calabar Teaching Hospital, Calabar, Nigeria

Dyselectrolytemia in under-five children with acute diarrhoea-induced dehydration: a cross-sectional study in a South-East Nigerian hospital

Burden and severity of deranged electrolytes and kidney function in children seen in a tertiary hospital in Kano, northern Nigeria

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