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Childhood coma in Ibadan. Relationship to socio-economic factors
1Department of Paediatrics, University College Hospital, Ibadan, Nigeria.
Insights
Socio-economic factors significantly impact childhood coma causes and outcomes in tropical regions. Cerebral malaria is the leading cause, with high mortality and neurological deficits observed in survivors.
Area of Science:
- Pediatrics
- Neurology
- Public Health
Background:
- Geographic variations in childhood coma aetiology and prognosis may be influenced by socio-economic factors.
- Previous research has not fully recognized the extent of this socio-economic contribution.
Purpose of the Study:
- To investigate the aetiology and prognosis of childhood coma in Ibadan.
- To explore the role of socio-economic factors in the observed patterns of childhood coma.
Main Methods:
- A prospective study was conducted on 118 children with strictly defined coma.
- Data collected included aetiology, clinical presentation, and outcomes.
Main Results:
- Cerebral malaria (55%) was the most common cause of coma, followed by meningitis (13%) and encephalitis (10%).
- Mortality was high (36%), with 64% of survivors experiencing neurological deficits.
- Poor prognostic indicators included aetiology, severe anaemia, hypoglycaemia, and pneumonia.
Conclusions:
- Childhood coma in this tropical setting has a poor prognosis.
- Aetiology, specific co-morbidities, and underlying socio-economic conditions are critical factors influencing outcomes.
Abstract:
According to the literature, socio-economic factors may contribute more to geographic variations in the aetiology and prognosis of childhood coma than has previously been recognised. This prospective study involving 118 children with strictly defined coma demonstrated that the commonest causes of coma in Ibadan were cerebral malaria (55%), meningitis (13%) and encephalitis (10%). The prognosis was poor. Forty-three (36%) of 118 cases died and 75 (64%) survived, including 23 who showed neurologic deficits. Noteworthy prognostic indices of coma were the aetiology of the condition, the presence of severe anaemia, hypoglycaemia and pneumonia. The findings are discussed in the context of the socio-economic background of children in the tropics.