Post-Neonatal Hypoglycaemia and Paediatric Emergency Room Admissions: A Study In The University Of Port Harcourt Teaching Hospital

Authors

  • Tamunopriye Jaja Department of Paediatrics and Child Health, College of Health Sciences, University of Port Harcourt, Port Harcourt, Nigeria.
  • Alice Nte Department of Paediatrics and Child Health, College of Health Sciences, University of Port Harcourt, Port Harcourt, Nigeria.
  • Adetoun Ejilemele Department of Chemical Pathology, College of Health Sciences, University of Port Harcourt, Port Harcourt, Nigeria.

DOI:

https://doi.org/10.60787/tnhj.v11i1.43

Keywords:

Hypoglycaemia, Post-neonatal, Paediatric emergencies, Nigeria

Abstract

Background: Hypoglycaemia, a common complication of many childhood diseases, significantly increases disease-related morbidity and mortality. The objective of this study is to determine the prevalence, morbidity pattern and outcomes of hypoglycaemia at admission of post- neonatal children in the Children's Emergency Ward (CHEW) of the University of Port Harcourt Teaching (UPTH).

Methods: All post-neonatal children admitted into the UPTH CHEW from September 2007-January 2008 who met the inclusion criteria were prospectively studied using a pre-tested proforma which obtained their sociodemographic and clinical data. In all subjects, plasma glucose was determined on admission (using glucometer and glucose oxidase tests) before management. Data analysis was with EPI Info version 6.04 and statistical significance was set at 0.05.

Results: Three hundred and seventy children aged 1month-15 years (mean 36.7±40 months) with 272(78.9%) under-fives were studied. Their plasma glucose levels ranged from 1.0-12mmol/l with 19(5.1%) children among whom were 15(78.9%) under-fives being hypoglycaemic (plasma glucose-1.0-2.4mmol/l, mean 1.4 + 0.2mmol/l). All cases of hypoglycaemia were detected by both methods of estimation. The commonest diseases diagnosed in the study population, irrespective of the plasma glucose level, were malaria, anaemia and diarrhoea. Overall, 49 (13.2%) children of whom 7(14.3%) were hypoglycaemic died. Hypoglycaemia was associated with longer hospital stay and higher mortality rate (36.8%) (p=0.001).

Conclusion: Hypoglycaemia, detectable by bedside glucometer test, significantly increases morbidity and mortality associated with common childhood diseases. There is therefore a need for its prevention, early diagnosis and prompt management in all paediatric care settings, especially in resource-limited countries, as recommended in the Integrated Management of Childhood Illness algorithm.

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References

Mark AS. Hypoglycaemia. In: Nelson Textbook ofPaediatrics. Berhman RE, Kliegman RM, Jenson HB, eds. Philadelphia: Saunders 1996: 420-430.

Cornblath M, Schwartz R. In: Saunders WB, ed. Disorders of carbohydrate metabolism in infancy. Philadelphia: 1976: 3-27.

Elusiyan JBE, Adeyujigbe EA, Adeodu OO. Hypoglycaemia in a Nigerian paediatric emergency ward. J Trop Pediatr 2005: 2-6.

Osier FH, Berkley JA, Saunderson F, Mohammed S, Newton CRJC. Abnormal blood glucose concentration on admission to a rural Kenyan district hospital: Prevalence and outcome. Arch Dis Child 2003; 88:621-25.

Wharton B. Protein energy malnutrition. Problems and priorities. Acta Paediatr Scand Suppl 1991; 374: 5-14.

Grange AA. Hypoglycaemia in Nigerian children, Lagos State, Nigeria. FMCPaed Dissertation. Lagos; National Postgraduate Medical College of Nigeria, 1976; 1-62.

Akpede GO, Olomu SC, Shatima DR, Dawodu SO, Olu-Eddo AN, Adeolu OO. Hypoglycaemia in acute bacterial meningitis Nig J Paediatr 2002; 29(4): 88-89.

Soltesz G, Jenkins PA, Aynsley-Green A. Hyperinsulinaemic hypoglycaemia in infancy and childhood. A practical approach to diagnosis and medical treatment based on the experience of 18 cases. Acta Paediatr Hung 1984;25: 319-32.

Harworth JC, Coodin FJ. Idiopathic spontaneous hypoglycaemia in children. Reports of seven cases and review of literature. Paediatrics 1960; 25:748-65.

Robert E B, Saul S M, Jennifer B. Where and why are 10 million children dying every year? Lancet 2003; 361: 2226-34

Ezeaka VC, Grange AO, Ogunbase AO, Awogbemi I. Childhood morbidity and mortality in the Lagos University Teaching Hospital, Lagos. Nig J. Paediatr 2002; 29:91

George I O, Alex-Hart B A, Frank-Briggs A I. Mortality Pattern in Childhood, A Hospital based Study in Nigeria. International Journal of Biomedical Science 5(4), 369-372, Dec. 15, 2009

Goove S. Integrated management of childhood illness by outpatient health workers: technical basis and overview. The WHO Working Group on Guidelines for Integrated Management of the Sick Child. Bull World Health Oregon 1997;75 Suppl 1:7-24

Sauerwen H. Marsh K. Hypoglycaemia on and after admission in Kenyan children with severe malaria. QJM 1998; 91:191-7

WHO. Department of Child and Adolescent Health and Development; Prevention and treatment ofhypoglycaemia In: Integrated Management ofChildhood illness. Geneva 2001;147

Ruiz Magro P, Aparicio Lo ́pez C, Lo ́pez-Herce Cid J, Marti ́nez Campos M,Sancho Pe ́rez L. Metabolic changes in critically ill children. An Esp Pediatr 1999; 51:143-8.

Kawo NG, Msengi AE, Swai AB. Specificity ofhypoglycaemia for cerebral malaria in children. Lancet 1990; 336: 454-7

Marsh K, Foster D, Waruiru C. Indicators of life threatening malaria in African children. N Engl J Med 1995; 332: 1399-404

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Published

2015-12-02

How to Cite

Jaja, T., Nte, A., & Ejilemele, A. (2015). Post-Neonatal Hypoglycaemia and Paediatric Emergency Room Admissions: A Study In The University Of Port Harcourt Teaching Hospital. The Nigerian Health Journal, 11(1), 19. https://doi.org/10.60787/tnhj.v11i1.43
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