Determinants of Delayed Presentation of Severe Childhood Illnesses at Tertiary Hospitals in Kaduna State, North West Nigeria

Delayed presentation of severely ill children to tertiary care facilities remains a critical determinant of preventable paediatric mortality in Nigeria. This hospital-based cross-sectional study examines the determinants of delayed presentation among caregivers of children with severe illness at two tertiary hospitals in Kaduna State, North West Nigeria. A total of 268 caregivers whose children were admitted with severe diagnoses were enrolled. Data were collected using structured questionnaires within 48 hours of admission, covering time elapsed from symptom onset to hospital arrival, prior treatment sought, reasons for delay, and sociodemographic characteristics. Overall, 58.6% of children presented more than 48 hours after symptom onset. Most caregivers (45.5%) had consulted a patent medicine vendor or traditional healer before presenting to the tertiary facility. Key reasons for delay included perceived symptom mildness in early stages, financial constraints, transportation difficulties, and preference for traditional medicine. Mothers with secondary or higher education were significantly less likely to present late (OR 0.41, 95% CI 0.22-0.76). Diagnoses most commonly associated with late presentation included meningitis, severe pneumonia, and severe malnutrition. The study recommends enhanced community awareness campaigns on childhood danger signs, subsidised emergency transport, and integration of referral support systems within primary healthcare facilities. Keywords: delayed presentation, severe childhood illness, Kaduna State, caregivers, North West Nigeria.