Aetiological considerations in the febrile unconscious child in the rainforest and arid regions of Nigeria.
An analysis of hospital admissions in two areas of Nigeria indicates that the burden of coma/convulsions with fever and malaria is higher in the rainforest region whereas that of bacterial meningitis (BM) and focal extracranial infection (FEI), mainly acute respiratory infections, is higher in the arid region. The burden of malaria has increased and chloroquine-resistant malaria has become a problem in clinical practice. There is the need to revise the current policy of initiation of treatment with chloroquine in severe malaria being practised in some centres; quinine would be a suitable alternative based on current trends. Co-existing infections, especially the association of other infections with BM, are an important feature in both wet and arid regions of Nigeria and point to the need for "routine" diagnostic spinal taps in order to minimise the chances of a missed diagnosis of BM.
Akpede
G O
GO
Department of Paediatrics, University of Maiduguri, Nigeria.
Abiodun
P O
PO
Ambe
J P
JP
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000209:etiology*; D003889:Desert Climate; D005334:Fever / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007239:Infections / Q000150:complications* / Q000188:drug therapy; D008288:Malaria / Q000150:complications* / Q000188:drug therapy; D009549:Nigeria; D011446:Prospective Studies; D014329:Tropical Climate