Morbidity and mortality patterns of post-neonatal paediatric medical admissions in a large mission hospital in Benin City, Nigeria

This study was conducted to determine the morbidity and mortality pattern in children admitted into a mission hospital and to compare the results with those obtained from public hospitals. It was a retrospective study that reviewed the admission and outpatient attendance registers as well as the case records of all children aged between one month and 14 years admitted into St. Philomena Catholic Hospital (SPCH), Benin City, from 1st January 2000 to 31st December 2001. Out of the 8172 children seen at the paediatric outpatient clinic, 1210 (14.8%) were admitted; comprising of 646 (53.4%) males and 564 (46.6%) females. Under-fives accounted for 84.0% of these admissions. Slightly more cases were admitted during the wet season 632 (52.3%) than the dry season 578 (47.7%). Malaria and its complications (61.1%), gastroenteritis (16.6%) and acute lower respiratory tract infection (ALRTI) (8.7%) were the three commonest causes of childhood hospitalisation. Other causes include anaemia (3.7%), measles (3.6%) and febrile convulsion (3.3%). Overall, mortality rate was 4.1%, with under-fives accounting for 92.0% of these deaths. Mortality rate in under-fives was 18.0%, while mortality rate was 1.7 times higher in girls than boys. The commonest causes of death were malaria and its complications (52.0%), anaemia (18.0%), gastroenteritis (14.0%), measles (8.0%) and ALRTI (6.0%). High case fatality rates were found in cerebral malaria (27.8%), anaemia (20.0%), meningitis (20.0%) and measles (9.1%). The commonest cause of death among infants (excluding neonates) was gastroenteritis, while malaria-induced anaemia was the commonest cause of death among children aged 1-4 years. Malaria and its complications, gastroenteritis, ALRTI and severe anaemia are the most important causes of childhood morbidity and mortality in Benin City. Health interventions aimed at controlling these diseases should be strengthened if childhood morbidity and mortality are to be significantly reduced. Greater resources should be allocated to the health care needs of under-fives especially during the wet season.