Pattern of childhood morbidities and outcome of childhood admissions in a Nigerian public secondary healthcare facility

Keywords: Childhood morbidities, Infectious diseases, Childhood deaths


Background: Patterns of morbidity and mortality in hospital populations are indicative of community health needs and can be useful in planning improved medical services.

Objectives: To determine the morbidity, mortality and outcome patterns, and the average duration of hospital stay of admitted children in the public secondary healthcare facility.

Methods: Available hospital records of children aged one month to 15years, admitted during a one year period (October 1, 2010, to September 30, 2011) were reviewed for relevant data such as age, gender, final diagnosis, outcomes and dates of admissions and discharges.

Results: Of the 1,266 records reviewed, 57.6% children were males, 42.4% females (Z= -10.9458; p=0.0001) and 82.5% were aged under-five years. Infections accounted for 81.6% of the morbidities, with malaria (39.2%), gastroenteritis (15.2%), pneumonia (10.9%), severe anaemia (4.2%) and septicaemia (3.0%) being the top five conditions. The duration of admission ranged from less than 24hours to 30 days, with a mean of 3.2 (2.8) days.

Nine hundred and ninety-eight (78.8%) children were discharged while 64 (5.1%) died; 85.9% of the deaths occurred among under-five children. Thirty-four (6.3%) out of 537 females and 30 (4.1%) out 729 males died (Z= 7.7374; p= 0.0001). The top three causes of mortality included malaria 26.6%, septicaemia 12.5% and pneumonia 10.9%. Fifty out of 59 deaths (84.7%) occurred within 72 hours and 7 (11.9%) in<24hours of admission.

Conclusions: Male children were more vulnerable to diseases while mortality was significantly higher among females. Infections dominated the causes of childhood morbidity and mortality in the public secondary healthcare facility, with under-five children bearing the brunt.


1. Fajolu IB, Egri-Okwaji MTC. Childhood mortality in children emergency centre of the Lagos University Teaching hospital. Niger J Paediatr 2011; 38(3):131–5.

2. George IO, Alex-Hart BA and Frank-Briggs AI. Mortality pattern in children: A Hospital-Based study in Nigeria. Int J Biomed Sci 2009; 5(4): 369-72.

3. Okechukwu AA. Morbidity pattern in paediatric outpatient unit of the University of Abuja Teaching Hospital, Gwagwalada, Nigeria. Niger J Clin Pract 2010; 13(1): 1-6.

4. Tette EMA, Neizer M, Nyarko MY, Sifah EK, Nartey ET, Donkor ES. Changing patterns of disease and mortality at the Children’s Hospital, Accra: Are infections rising? PLoS ONE 2016; 1194). E0150387. DOI:10.1371/journal.pone.0150387.

5. Fagbule D, Joiner KT. Pattern of childhood mortality at the University of Ilorin Teaching Hospital. Niger J Paediatr 1987; 14: 1–5.

6. Adeyokunnu AA, Taiwo O, Antia AU. Childhood mortality among 22255 consecutive admissions in the University College of Hospital, Ibadan. Niger J Paediatr 1980; 7: 7–15.

7. Fetuga B, Ogunlesi T, Adekanbi F, Olanrewaju D, Olowu A. Comparative analyses of childhood deaths in Sagamu, Nigeria: implications for the fourth MDG. South Afr J Child Health 2007; 1: 106-11.

8. Onyiriuka AN. Morbidity and mortality patterns of post-neonatal paediatric medical admissions in a large mission hospital in Benin City, Nigeria. J Biomed Sci 2005; 4(1): 49-58.

9. Eke PO, Onafalujo AK. Effects of climate change on health risks in Nigeria. Asian J Bus Manage Sci 2011; 1(1): 204-15.

10. Idowu AA, Ayoola SO, Opele AI, Ikenweiwe NB. Impact of climate change in Nigeria. Iranica J Energy Environ 2011; 2(2): 145-52.

11. Ebele NE, Emodi NV. Climate Change and Its Impact on Nigerian Economy. J Sci Res Rep 2016; 10(6): 1-13.

12. Adams H, Geefhuysen J, Hansen JDL. A survey of admissions and deaths in a black Paediatric Department. S Afr Med J 1978; 53: 703-5.

13. IkefunaAN, Emodi IJ. Some characteristics of Paediatric admission at the University of Nigeria Teaching Hospital Enugu Nigeria. Niger J Clin Pract 2007; 10(3): 216-9.

14. Roy RN, Nandy S, Shrivastava P, Chakraborty A, Dasgupta M, Kundu TK. Mortality pattern of hospitalized children in a tertiary care hospital of Kolkata. Indian J Community Med 2008; 33: 187-9.

15. Adepoju AO. Differential pattern in child mortality rate in rural Nigeria. Ann Res Rev Bio 2015; 7(5): 309-17.

16. UN Inter-agency Group for Child Mortality Estimation. Levels and Trends in child mortality: Report 2017. UNICEF 2017 [Internet] Available from [accessed on September 1, 2018].

17. Okoronkwo NC, Onyearugha CN, Ohanenye CA. Pattern and outcomes of paediatric medical admissions at the Living Word Mission Hospital, Aba, South East Nigeria. Pan Afr Med J 2018; 30(202). doi:10.11604/pamj.2018.30.202.15966.

18. Aigbe O, Zannu AE. Differentials in Infant and Child Mortality Rates in Nigeria: Evidence from the Six Geopolitical Zones. Inter J Human Soc Sci 2012; 2(16): 206-14.

19. Edelu BO, Eze JN, Oguonu T, Ndu IK. Morbidity and mortality pattern in the Children Emergency Unit of the University of Nigeria Teaching Hospital Enugu. Orient J Med 2014; 26 (3-4): 73-8.

20. Ndukwu CI, Onah S K. Pattern and outcome of post-neonatal pediatric emergencies in Nnamdi Azikiwe University Teaching Hospital, Nnewi, South East Nigeria. Niger J Clin Pract 2015; 18: 348-53.

21. Ighogboja IS, Angyo I, Okolo AA, Szlachetka B. Morbidity and mortality Pattern in Jos, Nigeria. Niger Med Pract 1995; 30:15-8.

22. Adeboye MA, Ojuawo A, Ernest SK, Fadeyi A, Salisu OT. Mortality pattern within twenty-four hours of emergency paediatric admissions in a resource-poor nation health facility. West Afr J Med. 2010; 29(4): 249-52.

23. George IO and Tabansi PN. An audit of cases admitted in the children emergency ward in a Nigerian tertiary hospital. Pak J Med Sci 2010; 26(3): 740-43.

24. Mouneke UV, Ibekwe RC, Eke CB, Ibekwe MU and Chinawa JM. Mortality among paediatric inpatients in Mile 4 Mission hospital, Abakaliki, south-eastern Nigeria: a retrospective study. Niger J Paed 2013; 40(3): 259–63.

25. Toma BO, Gyang M, Abdu1 H, Shwe D, Ekere IA, Ihekaike M. Paediatric morbidity and mortality in a Sub-urban Hospital in Jos, North -Central Nigeria. Int J Trop Dis Health 2015; 5(2): 156-64. DOI: 10.9734/IJTDH/2015/12683.

26. Erdmann AL, Andrade SR, Mello ALSF, Drago LC. Secondary Health Care: best practices in the health services network. Rev. Latino-Am. Enfermagem 2013; 21(Spec): 131-139.

27. National Population Commission, Nigeria. State Population. [Internet] Available from: [Accessed on June 12, 2017].

28. Eck C, Pierre RB, Hambleton IR. Medical paediatric admission patterns at the University Hospital of the West Indies: issues for future planning. West Indian Med J2006; 55(5): 340-45.

29. Khan HI, Khaliq N, Afzal MF. Pediatric intensive care unit: Pattern of admissions. Professional Med J 2006; 13(3): 358-61.

30. Eko JE. Implication of economic recession on the health care delivery system in Nigeria. Soc Sci 2017; 6(1): 14-8. doi: 10.11648/

31. Ekeopara CA, UgohaAM. The contributions of African traditional medicine to Nigeria’s health care delivery system. Int Org Sci Res-J Human Soc Sci 2017; 22(5): 32-43.

32. Adefolaju T. Traditional and orthodox medical systems in Nigeria: The imperative of a synthesis. Am J Health Res 2014; 2(4): 118-24. doi: 10.11648/j.ajhr.20140204.13

33. Lawal OM, Temiye EO. Pattern of preschool children’s admission and mortality in a private health facility in Lagos, Nigeria. Niger Med Pract 1998; 35(3/4): 42–6.

34. Chawla V, Haufton B. Pattern of childhood mortality at Harare central hospital, Zimbabwe. East Afr Med J 1988; 65: 238-45.

35. Menge I, Esamai F, Van Reken D, Anabwani G. Paediatric morbidity and mortality at the Eldoret District Hospital, Kenya. East Afr Med J 1995; 72: 165–69.

36. Trape JF. The public health impact of chloroquine resistance in Africa. Am J Trop Med Hyg 2001; 64 (Suppl): 12–7.

37. Whitty CJM, Allan R, Wiseman V, Ochola S, Nakyanzi-Mugisha MV, Vonhm B, et al. Averting a malaria disaster in Africa – where does the buck stop? Bull World Health Org 2004; 82(5): 381- 4.

38. Oyedeji GA. A comparative study of post-neonatal childhood admissions in Nigeria and Saudi-Arabia. Niger Med Pract 1996; 32: 71–4.

39. Abhulimhen-Iyoha BI, Okolo AA. Morbidity and mortality of childhood illnesses at the emergency paediatric unit of the University of Benin Teaching Hospital, Benin City. Niger J Paed 2012; 39: 71-4.

40. Ayoola OO, Orimadegun AE, Akinsola AK, Osinusi K. A five year review of childhood mortality at the University College Hospital, Ibadan. West Afr J Med 2005; 24: 175—9.

41. Ganatra B, Hirve S. Male bias in health care utilization for under-fives in rural community in Western India. Bull World Health Org 1994; 72(1): 101–04.

42. Onyiriuka AN. Discharge of hospitalized under-fives against medical advice in Benin City, Nigeria. Niger J Clin Pract 2007; 10(3): 200-4.

43. Ibekwe RC, Muoneke VU, Nnebe-Agumadu UH, Amadife MA. Factors influencing discharge against medical advice among paediatric patients in Abakaliki, Southeastern Nigeria. J Trop Pediatr 2009; 55(1): 39-41. doi: 10.1093/tropej/fmn100.

44. Okoromah CN, Egri-Okwaji MT. Profile of and control measures for paediatric discharges against medical advice. Niger Postgrad Med J 2004; 11(1): 21-5.
Original Research