Childhood acute glomerulonephritis in Port Harcourt, Rivers State, Nigeria.

BACKGROUND: Acute glomerulonephritis (AGN) is an important cause of renal morbidity and mortality in children. The incidence varies across the countries with lower rates in developed countries due to improved environmental hygiene and socio-economic status.

METHODS: A prospective study of patients admitted with the diagnosis of AGN was carried out in the Department of Paediatrics, University of Port Harcourt Teaching Hospital (UPTH) from June 2006 to June 2008. The patients' demographic data, presenting complaints; antecedent history of sore throat or skin infections, clinical findings including blood pressure; investigations, management and outcome were obtained. Data was compared with a previous study done in UPTH 14 years ago and in other countries.

RESULTS: A total of 31 patients aged 3 to 16 years had AGN, giving an annual incidence of 15.5 cases. They comprised 16 (51.6%) males and 15 (48.4%) females with a M:F ratio of 1.1:1. There is no significant change in the annual incidence of AGN when compared with the 14.5 cases per year reported in our centre 14 years ago. Fourteen (45.2%) of the patients were between 5-10 years. The highest incidence occurred during the dry cold windy (harmattan) season of October to February in 19 (61.3%) patients. Twenty-four (77.4%) of the patients were from low socio-economic classes (social class IV and V). Sore throat was the commonest infection preceeding AGN (66.6%). Hypertensive encephalopathy with seizure occurred in 5 (16.1%) patients. There were 4 (12.9.1%) patients with nephrotic range proteinuria, and 12 (38.7%) patients had renal failure. Urinary tract infection occurred in 7 (22.6%) patients; klebsiella being the commonest organism isolated. All patients received conservative treatment while dialysis was done in 5 patients; one peritoneal dialysis (PD) and 4 haemodialysis. The recovery rate was 83.9% and a hospital mortality of 3 (9.7%).

CONCLUSION: The annual incidence of AGN has remained almost the same in Port Harcourt despite the increased urbanization and overcrowding in this oil rich state of Nigeria.