Browsing by Author "Johnson, 'WBR"
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Item Hypoxaemia as a measure of disease severity in young hospitalized Nigerian children with pneumonia: A cross-sectional study.(South African Medical Association., 2015-01) Abdulkadir, Mohammed Baba; Ibraheem, Rasheedat; Johnson, 'WBR; Abdulkarim, A.ABackground. Pneumonia remains a common cause of mortality among children in developing countries. Hypoxaemia is a common consequence of pneumonia in children. Objectives. To define the relationship between Hb oxygen saturation (SpO2) and parameters of outcome, duration of supplemental oxygen and duration of hospitalisation among children with pneumonia. Methods. A cross-sectional study was carried out at the paediatric wards of a tertiary hospital in North-Central Nigeria. Two hundred children aged between 2 and 59 months with pneumonia seen at the University of Ilorin Teaching Hospital were recruited consecutively. Sociodemographic and clinical information regarding the illness was obtained. Hb SpO2 of subjects was recorded with a pulse oximeter at presentation. The primary outcome was the SpO2 of the children with pneumonia. Secondary outcome measures were disease outcome, duration of supplemental oxygen and duration of hospitalisation among children with pneumonia. Results. The prevalence of hypoxaemia among the children was 41.5% and their mean SpO2 was 90.4% (standard deviation (SD) 8.9%). Surviving children with hypoxaemia had a longer mean (SD) duration of hospitalisation of 6.9 (6.4) days compared with those without hypoxaemia (4.9 (2.7) days; p=0.001). Children with hypoxaemia spent a longer duration receiving supplemental oxygen compared with those without hypoxaemia (p=0.001). The case fatality rate from pneumonia was 8.5% (17 deaths). The risk of death among children with hypoxaemia was 48 times higher than among the non-hypoxaemic children. Conclusion. Hypoxaemia with increasing severity significantly predicts a longer duration of hospitalisation, duration on supplemental oxygen and poorer outcome in children with pneumonia.Item Relationship between some risk factors of pneumonia and hypoxaemia in hospitalized Nigerian children.(Pan African Thoracic Society (PATS), 2014-09) Ibraheem, Rasheedat; Johnson, 'WBR; Abdulkarim, A.AThere is a current body of knowledge linking various risk factors with the frequency of pneumonia and a fatal outcome. Despite this, there is a dearth of published data assessing the association between these risk factors of pneumonia and the occurrence of hypoxaemia. Thus, the current study was carried out to determine the relationship between the risk factors of pneumonia and hypoxaemia in hospitalised under-5 children at the University of Ilorin Teaching Hospital, Nigeria. This is a descriptive study involving 200 children aged between 2 months and 5 years with pneumonia. Sociodemographic, anthropometric, clinical, and laboratory data were obtained. The pulse oximetry measurement was recorded after a stable reading for at least 1 minute while the child was breathing room air. Hypoxaemia was defined as an arterial oxygen saturation of less than 90%. Data were analysed using the SPSS 20.0 software package. There were 119 males and 81 females. Bronchopneumonia was identified in 168 (84.0%) of the children while lobar pneumonia was diagnosed in 32 (16.0%) children. After a multivariate logistic regression, low social status of the child was significantly associated with hypoxaemia, p=0.023. There was a negative correlation between the socio-economic status of the child, maternal age (years), maternal literacy level, birth order of the child, and of immunisation status with the presence of hypoxaemia (r= -0.191, -0.151, -0.162, -0.154, -0.148; p=0.007, 0.032, 0.022, 0.030, and 0.036, respectively). The study concluded that socio-economic class of the child was a risk factor of pneumonia associated with the presence of hypoxaemia.Item Validity and accuracy of maternal tactile assessment for fever in under-five children in North Central Nigeria: a cross-sectional study.(British Medical Association, 2014-10) Abdulkadir, Mohammed Baba; Johnson, 'WBR; Ibraheem, R.MObjectives This study seeks to determine not only the reliability of parental touch in detecting fever as compared to rectal thermometry in under-five children, but also the sociodemographic factors that may predict its reliability. Setting The study was carried out in the Emergency Paediatric Unit of a tertiary hospital in North Central Nigeria. Participants 409 children aged less than 5 years with a history of fever in the 48 h prior to presentation and their mothers were recruited consecutively. All the children recruited completed the study. Children with clinical parameters suggestive of shock, and those who were too ill, were excluded from the study. Primary and secondary outcome measures The primary outcome was the proportion of mothers who could accurately predict if their child was febrile or not (defined by rectal temperature) using tactile assessment only. Secondary outcomes were the validity and accuracy of touch in detecting fever and factors related to its accuracy. Results About 85% of the children were febrile using rectal thermometry. The sensitivity, specificity, positive predictive and negative predictive values for touch as a screening tool were 63%, 54%, 88.3% and 21%, respectively. High maternal socioeconomic status and low maternal age influenced positively the accuracy of touch in correctly determining the presence or absence of fever. Conclusions This study has shown that tactile assessment of temperature is not reliable and that absence of fever in a previously febrile child should be confirmed by objective methods of temperature measurement.