CHRONICLES OF LIFE IN A CAMEROONIAN HOSPITAL: EPISODE 7
By Doctor in Training Vanessa Fozao
Source: Silverdale Natural therapy
One sunny Friday afternoon, as we prepared to close for the day, a man came into the hospital with his son. When asked what was wrong, he complained that his son had not been eating, and his body was swollen. Noticing his son’s swollen face, I asked him when he noticed these symptoms from his son. He responded by saying that one day his son woke up, and he noticed that his son had a swollen face. As days passed, the swelling became more prominent, as his body swelled as well, and it even affected his swallowing about 2 weeks back.
To remedy the situation, the father bought Amoxicillin from the pharmacy and gave it to his son, and his son was supposedly okay after he took the medication. It is important to note that Amoxicillin is a very common medication that many people use as the treatment for a lot of ailments. With the information we had obtained from the father, we decided to question him about the colour of his son’s urine, which he said was red in colour (like the drink grenadine). This was alarming. With this in mind, we hypothesized that it could be poststreptococcal Glomerulonephritis. To confirm this hypothesis, we did a urine dipstick test, which confirmed the presence of red blood cells and proteins.
With these new findings, we informed the dad that more tests were required. He declined the request for more tests and confessed that he was unable to pay for more tests. When we insisted and explained the condition to him, he said he was going to call someone from the village to bring money. Due to this agreement, we admitted his son and commenced treatment. The next day, the money from the village arrived and he went to pay for the additional tests. When he asked what the cost of the test was, the price was more than he expected. He hastily returned stating that he had so many children and if he spent such a huge sum of money on one child, then what becomes of his other children? He added that he was going to take the child back to the village because he had a ‘njangi’ to attend.
Well, his priorities definitely seemed misplaced, I must say. I must say I was perplexed that this man seemed more pressed about his ‘njangi’ than the health of his son.
As doctors, we persistently insisted that he continue the care of his son, but against our advice, he took his son to the village as soon as we left the hospital for the day. Only God knows what happened to that child and whether he is alive today or not. This encounter inspired me to educate the masses on poststreptococcal Glomerulonephritis.
Poststreptococcal Glomerulonephritis is an acute Glomerulonephritis that follows a streptococcal infection. Glomerulonephritis is an inflammation of the glomerulus, which is a part of the kidney that is important for filtration. Poststreptococcal Glomerulonephritis is characterized by a sudden appearance of hematuria, proteinuria, red blood cells in urine, edema, hypertension with or without oliguria. This ailment is more common in Africa because of a higher probability of acquiring skin infections. The disease may emerge after a skin or throat infection. It is also more common among children between 2 and 12 years old, and males are more likely than females to acquire it.
Symptoms include
- Poor urine output
- Swelling of the feet ankle, face, abdomen etc
- Visible blood in urine
- Joint pain, stiffness and swelling
Several tests can be performed including an Antistreptolysin O(ASO) , urinalysis test, Anti-DNASE B test, serum compliment level, and a kidney biopsy when necessary. The treatment of this disease is mostly symptomatic, and some measures such as reducing salt intake can help reduce the edema (swelling) as well as blood pressure. The prognosis in children is good as it usually goes away on its own within weeks to months. However, in adults, it can progress to Chronic kidney disease and subsequently, end stage renal disease, which is not a fun ordeal.
Complication of this condition include Acute kidney injury, Chronic Glomerulonephritis, Hypertension, Chronic kidney disease, End stage kidney disease, Congestive heart failure, Pulmonary edema, Hyperkalemia, Nephrotic syndrome.
As we always preach, prevention is ALWAYS better than cure. Therefore, to prevent this disease, always treat streptococcal infections properly and completely. Stop shying away behind common over the counter purchases of drug. Take the time, go to a doctor, consult with him or her, get good prescriptions and get medications from a reputable pharmacy or drug retail store. Another thing I will emphasize is that parents prioritize the well being of their children, no matter how many children one has.