Delayed Presentation and Outcome of Febrile Children Admitted in a Tertiary Facility in Sokoto, North-Western Nigeria: A Case-Control Study

Objective: Delay in seeking appropriate health care by caregivers is an important modifiable factor which contributes to childhood morbidity and mortality in developing countries. This study was carried out to assess the socio-demographic factors associated with late hospital presentation and outcome of acute febrile illnesses among children aged < 15 years in an emergency unit. Design: Prospective case control study. Setting: Hospital based study in the Emergency Paediatric Unit of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Subjects: Children admitted with acute febrile illnessesfrom October 2017 to March 2018. Cases were children with fever ≥ 3 days to 7 days, controls were those with fever < 3 days before presentation. Socio-demographic and outcome data were obtained. Analysiswas with SPSS version 23 and p < 0.05 was significant. Main outcome measures: Outcome (alive or dead) and duration of admission in days. Results: 124 of 494 admissions were sampled. Cases were more likely to have 3 or more siblings (OR 2.3; CI: 0.975.5), fathers and mothers who lacked formal education (OR 1.9; CI: 1.4-2.6, OR 2.2; CI: 1.6-3.0), and more likely visited patent medicine vendors (OR 1.3; CI: 0.95-1.9). They also had longer duration of admission (OR 8.3; CI: 3.7-18.5) and were more likely to die (OR 3.1; CI: 0.3-30.7). Three of the 4 mortalities had presented late and all were of low social class families. Conclusion: Late presentation was more with the uneducated parents with attendant longer duration of illness and higher mortality probably due to illness severity and lack of amelioration with prior treatment.