Anaemia in Critically Ill Children- A Case Study from Nigeria

Abstract

Background and Aim: Anaemia is a common cause of morbidity and mortality in the tropics. World Health Organization estimated that anaemia affects one-quarter of the world's population and is concentrated within preschool age children and in resource-poor countries like ours. The aim of this study was to evaluate the prevalence and severity of anaemia in critically ill children presenting at the Children Emergency Ward of the University of Port Harcourt Teaching Hospital (UPTH), Nigeria. Materials and Methods: This was a retrospective study of anaemic children (1 month to 16 years) admitted into the Children Emergency Ward of the UPTH from January to December 2010. Medical case notes of the patients were reviewed. Information obtained included age, gender, presenting complaints, diagnosis, packed cell volume (PCV), blood transfusion and outcome. The PCV was determined by microhaemtocrit method. Data generated were analysed using SPSS for widow, version 12.0 (SPSS Inc, Chicago Illinois, USA). Descriptive statistics in the form of the frequency and percentage were used. Results: There were a total of 1581 children admitted into the Children Emergency Ward of the UPTH during the period of study. Four hundred and twenty three were confirmed to have anaemia of varying degree giving a prevalence of 26.8%. Most 295(69.7%) of the mothers were poorly educated and live in the urban slums. There were more males 418(67.1%) than females 205(32.9%). Fever, vomiting and weakness were the main presenting features. Ninety two patients (6.3%) had mild anaemia, 102 patients (6.5%) had moderate anaemia and 229 patients (14.5%) had severe anaemia. Two hundred and twelve of the critically ill children (50.1%) were transfused on account of severe anaemia. Malaria and septiicaemia were the commonest associated morbid conditions. Twenty five deaths were recorded. Severe anaemia accounted for 13(52.0%) of the total deaths.  Conclusion: Anaemia is prevalent among Nigerian children in critical condition. Severe anemia is common and associated with increased risk of clinically relevant outcomes such as hospitalization and mortality.