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BackgroundChildhood mortality in sub-Saharan Africa still remains high despite a reduction in global trends. Although several strategies have been instituted to help reduce this, the progress is slow which can affect the achievement of the Sustainable Development Goal 3 (SDG). Majority of these deaths occur within the first twenty-four hours of admission due to delay in seeking medical care and inability to identify and adequately resuscitate the critically ill patients. The aim of the study was to describe the pattern of mortality within the first twenty-four hours in children presenting to the Paediatric Emergency Unit (PEU) of Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. Methods This was a retrospective review of mortalities in children aged 2 months to 13 years admitted to PEU from January to December 2020. The bio-data, duration of illness, diagnoses, duration of hospital stay and admission outcome were extracted from their health records and analysed. Results There were 2,145 admissions during the study period of which 59.3% (n=1272) were males, and 38.5% (n=825) were under-five years of age. Out of the 171 (7.9%) that died, 31.5% (n=54) occurred during the first 24 hours with 51.8% (n=28) being males and 77.7% (n=42) under-five years of age. The months with the highest recorded mortality occurring within 24 hours were January 16.6% (n=9), March 14.8% (n=8), and February 12.9% (n=7) with sepsis/septic shock 18.5% (n=10), Pneumonia 12.9% (n=7), surgical conditions 9% (n=5), Severe acute malnutrition 7% (n=4), and diarrhoea diseases 7% (n=4) being the leading causes of death. Conclusion Sepsis/septic shock and pneumonia are top two causes of mortality within 24-hours of admission with the highest mortality occurring in the first quarter. In order to end preventable deaths in under-fives and achieve the SDG 3.2, early health care seeking behaviour, quality and timely interventions for critically ill children as well as appropriate development and deployment of disease commodity packages will be key.

BackgroundAlthough there has been a decrease in mother to child transmission (MTCT) of HIV, new pediatric infections still occur especially during the postnatal period. Prevention of vertical transmission is a key strategy in reducing the incidence which is 15-30% during pregnancy and delivery and 5-20% during breastfeeding. Early infant diagnosis and prompt initiation of antiretroviral are among some of the interventions that help to reduce the risk of transmission.ObjectivesThe purpose of the study is to assess the prevalence of HIV infection and the socio-demographic characteristics of HIV exposed infants presenting to KATH infectious disease clinic. MethodsA retrospective review of folders of exposed infants presenting to the infectious disease clinic from September 2019 to September 2021 was done. Data was entered onto excel sheet and exported to SPSS version 20 for analysis. Descriptive statistics were used. ResultsA total of 245 HIV exposed infants were seen within study period of which 54.35 (133/245) were males. The mean (SD) of birth weight was 3.07 (0.50). The median (IQR) age in months were 2.3 (1.5-3.3) at first visit to the HIV exposed clinic. Mode of delivery was by spontaneous vaginal delivery for 50.6% (124/245) and by caesarian section for 36.3% (89/245). Exclusive breastfeeding was initiated in 72.7% (178/245), formula feeding in 6.1% (15/245), and mixed feeding in 4.1% (10/245). Antiretroviral were initiated at birth for 95.9% (235/245) of infants. Septrin prophylaxis was initiated at 6 weeks for 60% (147/245). A major limitation of this records review was high level of data missingness. Most of the early infant diagnosis results were missing. The very few recorded were negative making it impossible to evaluate the true status of the exposed infants.ConclusionEven though infants exposed to mothers with HIV are seen regularly at KATH, the quality of the data collections must improve to estimate accurately the prevalence and determinants of HIV infection in exposed infants.

Background Parapneumonic effusions (PPE) and Empyema are serious complications of pneumonia in children that are associated with higher morbidity and prolonged hospital stay. The introduction of the pneumococcal conjugate vaccines (PCV 13) have led to a reported decline in the episodes of complicated pneumonia in children. The organisms commonly associated with PPE and Empyema are Streptococcus pneumoniae and Staphylococcus aureus though Mycobacterium tuberculosis has also been reported. There is paucity of data on children with PPE and Empyema in Ghana. We aimed to describe the profile, mode of presentation and outcomes in children admitted with PPE and Empyema to the Komfo Anokye Teaching Hospital. Methods A retrospective review of medical records (folders) and electronic data on children with PPE and Empyema admitted to the pulmonology unit from January 2018 to December 2020 were retrieved. Demographic records, immunization status, clinical presentation, length of hospital stay and outcome of admission were extracted using a Microsoft Excel. Data was then analysed with STATA version 16. Results Records were available for 51 children; the median age was 42 months IQR (22.5-96) and 68.6% (n=35) were males. In all 84.2% (n=38), had received all immunisations up to date for age. At presentation, 9.5% (n=4/42) had oxygen saturation 38oC. The median respiratory rate was 47.5 IQR (32.8-57). The Median white cell count was 15.84 X10 9/l IQR (11.9-24.73) and median hemoglobin was 9.6 g/dl IQR (8.6-11.7). Pleural aspirate culture isolated Staphylococcus aureus for 6 patients. The rest were either not available or had no bacterial growth. Amoxicillin clavulanic acid and ceftriaxone were the most commonly used antibiotics. The median length of hospital stay was 9 days IQR (7-12) while the median length of chest tube insertion was 7 days IQR (5.5-9). In all 7.8 (n-4/51) patients died. Conclusion Both young and older children are affected with PPE/empyema. There is a good uptake of vaccines among children admitted for PPE/empyema, Staphylococcus aureus is the most common bacterial isolated from pleural aspirate culture. Most children admitted with complicated PPE/Empyema survived.

Background Pediatric heart diseases (PHDs), comprising congenital heart diseases (CHDs) and acquired heart diseases (AHDs) are significant contributors to non-communicable diseases in children. CHDs alone occur in 0.8-1.0% live births globally. Data on echocardiogram diagnosed PHDs in Ghana however is lacking. We set out to describe the echocardiogram diagnosed prevalence of the various PHDs, their age profile and change in trends over an eleven-year period in children less than sixteen years seen in Kumasi. MethodsWe retrieved archived first echocardiogram scan reports from January 2010 through December 2020, and extracted the diagnosis, scan date and sex of the patients. PHDs were categorized into CHDs and AHDs and proportions of the top five reported respectively. Observed trends in proportion of types of PHDs and age at first diagnosis were computed. Data was collected using Microsoft® Excel and analyzed with R statistical software. ResultsPHDs were present in 49.9% (2474/4962) of the scans done with 51.5% (95%CI: 49.5-53.5) being males and 93.3% CHDs. The number of different diagnoses were 3344 as some of the patients had multiple diagnosis. Of these, the top five CHDs were Ventricular Septal Defect (699, 20.9%), Atrial Septal Defect (634, 19.0%), Patent Ductus Arteriosus (576, 17.2%), Tetralogy of Fallot (318, 9.5%) and Atrio-Ventricular Canal Defect (222, 6.6%). That for AHDs were Rheumatic Heart Disease (61, 1.8%), Dilated Cardiomyopathy (46, 1.4%), pericardial effusion (29, 0.9%), Hypertrophic Cardiomyopathy (26, 0.9%) and Infective Endocarditis (14, 0.4%). Proportion of various PHDs stayed constant over the years (p=0.129). The median (IQR) age in months for acyanotic CHDs (6, 1.5-18), cyanotic CHDs (15.0, 4.0-36.0) and AHDs (72.0, 19.0-120) were significantly different (p