Is the Broselow Tape and APLS formula applicable to Nigerian children? The Kano experience

Abstract

Background: Weight estimation is useful in pediatric practice; it is used in drug dosage calculation and for nutritional assessment. However, in comatose children actual weight measurement may not be possible therefore weight estimation becomes imperative. The Advanced Pediatric Life Support (APLS) formula and the Broselow Tape have been validated in most developed countries, but not in Nigerian children. Objective: To determine the performance of APLS formula and Broselow Tape in Nigerian children. Materials and Methods: The actual weight of 300 children in the Pediatric Emergency Unit and the Outpatient Department of Aminu Kano Teaching Hospital were taken using weighing scales and their length was also taken; these were compared with values estimated from their ages using the APLS formula and the Broselow Tape. Results: Both methods had similar pattern of performance, underestimating weight (39.7%) in the 1-year age group, and overestimation in the older age groups; however, these were within 95% limit of agreement. The overall average percentage difference was 5.3% and 5.4% for the Broselow Tape and APLS formula, respectively. The proportion of agreement within 10% of the actual weight were 36.8%, 48.8%, 64.3%, 48.1%, and 54.1% for 1, 2, 3, 4, and 5-year age groups, respectively. Conclusion: Both methods are of benefit in Nigerian children, although they underestimated weight in children within the 1-year-age-group.