Late presentation of paediatric patients to clinics: a major barrier to uptake of laboratory services in nigeria

Introduction

In Nigeria, paediatric patients present to health clinics at critical states that leave the medical doctors with no other choice but to blindly prescribe drugs without proper diagnostic tests.

Objectives

This study was aimed at determining effect of late-presentation of paediatric malaria cases to the hospital on uptake of laboratory services.

Methods

Conducted study at the Medical Centre, University of Nigeria, Enugu Campus. Reviewed medical records contents of fifty-six paediatric patients from January 22 to March 23, 2014. Records were taken during clinic days at the OPD section. Malaria parasite test showing 3+++ and PCV below 39% of the patients involved were used as a major basis for sampling. The following inclusion criteria were used: age bracket of 1-12years, late presentation, very weak with severe fever, malaria test of 3+++ and PCV below 39% while exclusion criteria included adults, early presenters and patients presenting symptoms not related to malaria. The following were the main instruments used; structured questionnaires, medical records and Micro-haematocrit centrifuge.

Results

55% the patients admitted did not use laboratory services until their first line of anti-malaria therapy ended; their PCV reading was recorded as 39%. 45% of the patients presented to the medical centre during the weekend when the Lab Scientist was not on duty; they recorded lower PCV reading of 38% during the week day when the Lab scientist had resumed.

Conclusion

Late presentation which comes either in the form of:

• Patients presenting late to the clinic with severe malaria symptoms. This leads to anti-malaria therapy for the paediatric patients without the necessary diagnostic tests in a bid to save their lives, or

• Patients presenting to the medical centre during the weekend when the only Lab Scientist working at the medical centre is off-duty.

All these act as barriers to uptake of laboratory services.

Disclosure of interest

None declared.