The Presenting Symptoms, Clinical Diagnosis and Shock Index Value of Children with Sepsis at the University College Hospital Ibadan: A Cross Sectional Study

Background: Sepsis is a global health concern accounting for a mortality rate of 25-30% with about 50-85% due to septic shock. The majority of sepsis cases (up to 85%) occur in Low and Middle- income countries. There were 48.9 million cases of sepsis worldwide, with children accounting for more than half of those cases. Nigeria is the second highest contributor to under-five mortality in the world, with majority of these deaths attributed to sepsis. The aim of this study is to determine the common presenting symptoms, clinical diagnosis and shock index value of children with sepsis at a tertiary Hospital.

Material and Method: This cross sectional study enrolled 102 children with sepsis. Their bio-demographic details were collected using a structured interviewer administered questionnaire. Their presenting symptoms and pathologic diagnosis weres gotten, also the shock index values were calculated using the properly measured blood pressure and heart rate. The data was analysed using spss version 23.0 for windows. P < or = 0.05 set as point of statistical significance.

Results: The study showed that, 68(66.7%) were males and 34(33.3%) were females. While 26(25.5%) were under one year, 39(38.2%) aged 1-5 years, 12(11.8) were 5-10 years and 25(24.5%) were 10-15 years. All the participants had symptom of fever. While breathlessness was the second commonest symptom. The commonest clinical diagnosis among the study participants was pneumonia. The shock index value of the study population ranged from 0.7 to 5.50 with median of 1.6(IQR 1.3- 1.9) the logistic regression showed that children with elevated shock index were 10.9 times more likely to develop septic shock when compared to those with normal shock index.(p=0.034, aOR = 10.899, CI = 1.20 – 98.79.

Conclusion: The higher the shock index, the more likely for the child to develop septic shock and its sequelae.