Abstract
Background There is a dire need for paediatric critical care (PCC) services, but their availability in tertiary hospitals in Nigeria is not well defined. Objective We evaluated self-reported PCC practice, resources, and perceived challenges in various zones of the country, using paediatric residents' perspective. Methods This is a descriptive cross-sectional survey, carried out at an Intensive Course in Paediatrics at the University of Benin Teaching Hospital, Nigeria. Participants' PCC practice and perceived adequacy of PCC resources and services were assessed using a 100 mm uncalibrated visual analogue scale (VAS). A comparison between northern and southern zones was done. A 2-sided p value < 0.05 was considered significant. Results A total of 143 residents participated in the study, 37.1% of them were male, and 62.9% were female. Their mean age was 34.6 ± 3.2 years. They were mainly (86.7%) from federal institutions across the country. Less than a half (46.7%) of the trainees attended to critically ill children daily, but only 4 out of every 10 respondents stated that such severely ill children survived till hospital discharge; 12.1% of the trainees had PICUs in their institutions. Financial constraints hindered PICU admissions. PCC staff were relatively fewer in northern zones than southern zones (p < 0.05). Their perceived adequacy of PCC equipment and services were low (VAS scores 32.7 ± 2.6 and 30.9 ± 2.8, respectively) with a strong positive correlation between the two measurements (r = 0.839; p < 0.001). Conclusion There is an unmet need for PCC practice in Nigerian tertiary hospitals with a resultant low survival rate of critically ill children. PCC training curricula and improved critical care resources are desirable in the setting.
Highlights
Paediatric critical care (PCC) or intensive care is a relatively new medical specialty, especially in low- and middle-income countries [1]
Recovery from childhood critical illnesses is dependent on clinical-laboratory monitoring, prompt escalation of clinical care, effective team dynamics, and multidisciplinary care as well as adequate communication with caregivers [1, 2]
A Critical Care Research and Practice recent single-centre study in southern Nigeria showed that 33.3% of children admitted into the Emergency Unit required critical care but only 2.8% of these critically ill children were transferred to the hospital’s general ICU due to limited relevant resources and financial constraints [3]
Summary
Paediatric critical care (PCC) or intensive care is a relatively new medical specialty, especially in low- and middle-income countries [1]. A national audit of critical care resources in South Africa by Bhagwanjee and Scribante [5] found that, regarding the public sector ICU bed, the population ratio ranged from less than 1 : 20,000 to 1 : 80,000 but less than one-fifth of beds are dedicated to paediatric and neonatal patients. Touray et al [6] in Gambia reported in 2018 that only one hospital among seven surveyed public hospitals (treating more than 50 critically ill patients a month) had a dedicated intensive care unit, resulting in an estimated 0.4 ICU beds/100,000 population in the country, while Siaw-Frimpong et al [7] in Ghana reported 0.5 ICU beds/100,000 people in 2020. Atumanya et al [8] in Uganda reported 1.3 ICU beds per million population in a recent survey, showing limited accessibility to critical care services in the country. A Critical Care Research and Practice recent single-centre study in southern Nigeria showed that 33.3% of children admitted into the Emergency Unit required critical care but only 2.8% of these critically ill children were transferred to the hospital’s general ICU due to limited relevant resources and financial constraints [3]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
