COMMUNITY ACQUIRED PNEUMONIA AMONG CHILDREN ADMITTED IN A TERTIARY HOSPITAL: THE BURDEN AND RELATED FACTORS.

OBJECTIVE: To find out the hospital burden of pneumonia and preventable factors associated with the disease. DESIGN: Prospective cross sectional study. SETTING: The paediatric ward of Moi Teaching and Referral Hospital in Western Kenya. SUBJECTS: All the children admitted to the paediatric wards and found to have clinical features consistent with pneumonia. RESULTS: One thousand eight hundred and eighty two children were included in the study out of whom pneumonia was responsible for 13.23% and 5.5% of all deaths. Degree of severity was used to classify patients into mild pneumonia, severe pneumonia and very severe pneumonia each group comprised 12%, 70% and 18% respectively. Parents in age group 21 to 25 years (OR 2, CI 1.07 - 3.63) and use of firewood /charcoal (OR 4.23, CI 3.9 - 4.6) were risk factors for mild pneumonia. Unemployment (OR 2.7, CI 2 - 3.2), age group 21 to 25 years (OR 4, CI 1.2 - 6.4) and use of firewood/charcoal (OR 1.1, CI 1.02 - 1.26) were risk factors for severe pneumonia. CONCLUSION: Pneumonia accounted for less number of admitted children compared to previous study. Use of firewood or charcoal as source of fuel and mothers in age group 21 - 25 years were independent risk factors for mild pneumonia and severe pneumonia.

Diagnostic potential of serum vitamin E tocopherol and cholesterol levels in children with protein energy malnutrition in western Kenya.

OBJECTIVE: To determine the levels and diagnostic potential of vitamin E (alpha-tocopherol) in protein energy malnutrition (PEM) in western Kenya. DESIGN: Passive Hospital based study conducted on inpatients and outpatients. SETTING: Webuye sub-District and Moi Teaching and referral Hospitals, Western Kenya. SUBJECTS AND METHODS: Serum levels for vitamin E and cholesterol concentrations in children < 5 years of age (n=56) admitted to Webuye District Hospital, Bungoma, Western Kenya and some (n=3) admitted to Moi teaching and referral Hospital, Eldoret Kenya suffering from Kwashiorkor, Marasmus or PEM and malaria plus there controls, for a period of one year (January-December, 2001) were examined. High Performance Liquid Chromatography (HPLC) and Spectrophotometry were used for the analysis. RESULTS: The serum vitamin E levels were higher in Kwashiorkor (0.078 mg/ml, SD 0.034) than marasmus (0.075 mg/ml; SD 0.069) and controls (0.057 mg/ml; SD 0.022). The mean serum cholesterol levels were higher in marasmus (204.6 mg/dl; SD 104.8) than Kwashiorkor (186.0 mg/dl; SD 119.3) and controls (154.3; SD 33.3). There was a significant correlation in vitamin E concentrations between Kwashiorkor and controls only at P<0.01 as compared to Marasmus and Marasmic/Kwashiorkor. Vitamin E levels did not show significant correlation to cholesterol in malnourished children from Webuye, Bungoma in western Kenya at P<0.01. CONCLUSION: Vitamin E could be a useful diagnostic tool for PEM in this area.