Post-hospital mortality in children aged 2-12 years in Tanzania: A prospective cohort study

Autor: Adolfine Hokororo, Neema Chami, Luke R. Smart, Neema Kayange, Duncan K. Hau, Robert N. Peck, Aynsley Duncan
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Time Factors
Physiology
lcsh:Medicine
Urine
Tanzania
Pediatrics
Biochemistry
Families
0302 clinical medicine
Risk Factors
Medicine and Health Sciences
Public and Occupational Health
030212 general & internal medicine
Hospital Mortality
Prospective Studies
Prospective cohort study
Child
lcsh:Science
Children
2. Zero hunger
Multidisciplinary
Mortality rate
Hazard ratio
Age Factors
Child Health
Hematology
Patient Discharge
3. Good health
Body Fluids
Genetic Diseases
Child
Preschool

Child Mortality
Female
Anatomy
Research Article
medicine.medical_specialty
Death Rates
030231 tropical medicine
03 medical and health sciences
Population Metrics
Autosomal Recessive Diseases
Internal medicine
medicine
Humans
Hemoglobin
Nutrition
Clinical Genetics
Sickle Cell Disease
Population Biology
business.industry
Septic shock
Proportional hazards model
Hospitals
Public

Malnutrition
lcsh:R
Glasgow Coma Scale
Biology and Life Sciences
Proteins
medicine.disease
Child mortality
Hemoglobinopathies
Age Groups
People and Places
Population Groupings
lcsh:Q
business
Follow-Up Studies
Zdroj: PLoS ONE, Vol 13, Iss 8, p e0202334 (2018)
PLoS ONE
ISSN: 1932-6203
Popis: Background Sub-Saharan Africa has the highest rates of child mortality worldwide. Little is known about post-hospital outcomes after an index hospitalization for older children. We determined 12-month post-hospital mortality rate and identified factors associated with higher mortality. Methods In this prospective cohort study, we enrolled children 2–12 years of age admitted to the pediatric wards of two public hospitals in northwestern Tanzania. Participants or proxies were contacted at 3, 6 and 12 months post-hospitalization. The primary outcome measured was mortality. Factors associated with mortality were determined using Cox regression analysis. Results A total of 506 participants were enrolled. In-hospital mortality rate was 7.7% (39/506). Of the 467 participants discharged, the post-hospital mortality rate was 10.1% (47/467). Sickle cell disease (Hazard Ratio (HR) 3.32, 95% CI 1.44–7.68), severe malnutrition (HR 3.19, 95% CI 1.18–8.57), neurologic diseases (HR 3.51, 95% CI 1.35–9.11), heart disease (HR 7.11, 95% CI, 2.89–17.51), cancer (HR 11.79, 95% CI 4.95–28.03), and septic shock (HR 4.64, 95% CI 1.42–15.08) had higher association with mortality compared to other diagnoses. The risk factors significantly associated with mortality included older age (HR 1.01, 95% CI 1.00–1.08), lower hemoglobin level (HR 0.83, 95% CI 0.76–0.90), lower Glasgow Coma Scale (HR 0.66, 95% CI 0.59–0.74), history of decreased urine output (HR 2.87, 95% CI 1.49–5.53), higher respiratory rate (HR 1.02, 95% CI 1.00–1.03), estimated glomerular filtration rate less than 60 ml/min/1.73m2 (binary) (HR 1.84, 95% CI 1.10–3.10), and lower oxygen saturation (HR 0.96, 95% CI 0.92–0.99). Conclusions Post-hospital mortality is disturbingly high among children 2–12 years of age in Tanzania. Post-hospital interventions are urgently needed especially for older children with chronic illnesses.
Databáze: OpenAIRE
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