Management of children with cerebral malaria in Lagos - a medical audit.
Cerebral malaria, one of the severe forms of malaria, carries a very high fatality rate even when managed in the best of centres. This underpins the need for a medical audit to review patient management steps or procedures to improve the standard of patient care of children with cerebral malaria in the Lagos University Teaching Hospital.


METHODS
A retrospective audit of records of children with cerebral malaria who presented in the emergency room of the Lagos University Teaching Hospital in the last five years. Relevant clinical and patient management information of survivors were extracted from the records and analysed.


RESULTS
The records show that critical information useful in the management of these children was lacking in 50 - 60% of the records reviewed. The appropriate anti-malarial drug (intravenous quinine) in adequate doses was used in 54(94.7% ) of cases. A total of 12 patients (21.1% ) still had either mannitol or dexamethasone given to them. Blood transfusion was ordered in 60% of the children despite severe anaemia being present in only 30% of them.


CONCLUSIONS
This study highlights the sub-optimal level of knowledge and practice among doctors and the need for retraining of medical staff in maintaining proper records. The authors recommend the use of patient management guidelines.
Lesi
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Department of Paediatrics, Lagos University Teaching Hospital, Idi-Araba, Lagos.PMB 12003, Lagos. a.lesi@alpha.linkserve.com
Okoromah
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D002675:Child, Preschool; D005260:Female; D006801:Humans; D016779:Malaria, Cerebral / Q000188:drug therapy*; D008297:Male; D008485:Medical Audit; D009549:Nigeria; D012189:Retrospective Studies