Acute Post Streptococcal Glomerulonephritis among Children from Sokoto, North-Western Nigeria
Fatima Bello Jiya *
Department of Paediatrics, Usmanu Danfodiyo University Sokoto, Usmanu Danfodiyo University Teaching Hospital, Sokoto Nigeria.
Paul Kehinde Ibitoye
Department of Paediatrics, Usmanu Danfodiyo University Sokoto, Usmanu Danfodiyo University Teaching Hospital, Sokoto Nigeria.
Nma Muhammed Jiya
Department of Paediatrics, Usmanu Danfodiyo University Sokoto, Usmanu Danfodiyo University Teaching Hospital, Sokoto Nigeria.
Mohammed Hassan Abba
Department of Paediatrics, Usmanu Danfodiyo University Sokoto, Usmanu Danfodiyo University Teaching Hospital, Sokoto Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Aims: To determine the clinical and laboratory profile of children with acute post streptococcal glomerulonephritis (APSGN) admitted into Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, the outcome, and factors associated with in-hospital mortality.
Study Design: A 5- year retrospective study.
Place of Study: Emergency Paediatric Unit (EPU) and Paediatric Medical Ward (PMW) of the Department of Paediatrics, UDUTH Sokoto.
Methodology: The records of children aged 4 to 14 years with the diagnosis of APSGN were reviewed. Relevant history, physical examination findings, laboratory and radiologic investigation findings were extracted from their case folders and recorded into a proforma sheet. Data was analyzed using SPSS version 23. (IBM SPSS Inc., USA). The level of statistical significance was set at 5%, which is p-value < 0.05.
Results: Fifty-four (0.9%) of the 6128 children were managed for APSGN giving a prevalence of 10.8 APSGN cases per 1000 children. Forty-one folders were utilized for the study. There were 21(51.2%) females and 20(48.8%) males, with F:M ratio of 1.1:1. Mean age at presentation was 9.1± 3.1 years. Majority (92.6%) were ≥5 years and mainly 22(53.7%) of low socio-economic status. The main features were body swelling 40(97.6%), fever 25(61.0%), oliguria 24(58.5%), systemic hypertension 37(90.2%), proteinuria 41(100.0%), and haematuria 41(100.0%). Acute kidney injury was the commonest 25(61.0%) complication. Thirty (73.2%) cases were discharged, 5 (12.2%) died, 6(14.6%) left against medical advice. Low social status (0.03), requirement for dialysis (p=0.003), congestive cardiac failure (p=0.01), and pulmonary oedema (p=0.04) were significantly associated with in-hospital mortality. Requirement for dialysis (p=0.005) was the independent predictor of in-hospital mortality. At three months post discharge, 20(48.8%) of the 31 cases had achieved complete resolution of APSGN.
Conclusion: APSGN is common in Sokoto and similar in pattern to other reports from Nigeria. The presence of complications at presentation increases the risk of in-hospital mortality.
Keywords: Acute post streptococcal glomerulonephritis, children, pattern, outcome, Sokoto