The Prevalence and Management of Dehydration amongst Neonatal Admissions to General Paediatric Wards in Kenya—A Clinical Audit. (9th January 2018)

• Record Type: Journal Article
• Authors: Akech, Samuel; Rotich, Beatrice; Chepkirui, Mercy; Ayieko, Philip; Irimu, Grace; English, Mike
• Is Part Of: Journal of tropical pediatrics. Volume 64:Number 6(2018:Dec.)
• Page Start: 516
• Page End: 522
• Publication Date: 2018-01-09
• Subjects: neonates -- dehydration -- Kenya -- Africa; Pediatrics -- Periodicals; Tropical medicine -- Periodicals; Pediatrics -- Periodicals; Tropical Medicine -- Periodicals; Environmental Health -- Periodicals; Infant; Child; 618.929883
• DOI: 10.1093/tropej/fmx108
• Languages: English
• ISSNs: 0142-6338

Abstract

Abstract: An audit of randomly selected case records of 810 patients admitted to 13 hospitals between December 2015 and November 2016 was done. Prevalence of dehydration was 19.7% (2293 of 11 636) [95% CI: 17.1–22.6%], range across hospitals was 9.4% to 27.0%. Most cases with dehydration were clinically diagnosed (82 of 153; 53.6%), followed by excessive weight loss (54 of 153; 35.3%) and abnormal urea/electrolytes/creatinine (23 of 153; 15.0%). Documentation of fluids prescribed was poor but, where data were available, Ringers lactate (30 of 153; 19.6%) and 10% dextrose (18 of 153; 11.8%) were mostly used. Only 17 of 153 (11.1%) children had bolus fluid prescription, and Ringer's lactate was most commonly used for bolus at a median volume per kilogram body weight of 20 ml/kg (interquartile range, 12–30 ml/kg). Neonatal dehydration is common, but current documentation may underestimate the burden. Heterogeneity in practice likely reflects the absence of guidelines that in turn reflects a lack of research informing practical treatment guidelines.