Husain Amyna, Baker M Douglas, Bisanzo Mark C, Stevens Martha W
Johns Hopkins Children's Center, Johns Hopkins University, Baltimore, MD, USA.
University of Vermont Medical Center, University of Vermont, Burlington, VT, USA.
J Public Health Afr. 2017 Aug 24;8(1):582. doi: 10.4081/jphia.2017.582. eCollection 2017 Jun 23.
False tooth extraction (FTE), a cultural practice in East Africa used to treat fever and diarrhea in infants, has been thought to increase infant mortality. The mortality of clinically similar infants with and without false tooth extraction has not previously been examined. The objective of our retrospective cohort study was to examine the mortality, clinical presentation, and treatment of infants with and without false tooth extraction. We conducted a retrospective chart review of records of infants with diarrhea, sepsis, dehydration, and fever in a rural Ugandan emergency department. Univariate analysis was used to test statistical significance. We found the mortality of infants with false tooth extraction (FTE+) was 18% and without false tooth extraction (FTE-) was 14% (P=0.22). The FTE+ study group, and FTE- comparison group, had similar proportions of infants with abnormal heart rate and with hypoxia. There was a significant difference in the portion of infants that received antibiotics (P=0.001), and fluid bolus (P=0.002). Although FTE+ infants had clinically similar ED presentations to FTE- infants, the FTE+ infants were significantly more likely to receive emergency department interventions, and had a higher mortality than FTE- infants.
拔除乳牙(FTE)是东非一种用于治疗婴儿发热和腹泻的文化习俗,过去一直被认为会增加婴儿死亡率。此前尚未对有和没有进行拔除乳牙的临床症状相似的婴儿的死亡率进行过研究。我们这项回顾性队列研究的目的是调查有和没有进行拔除乳牙的婴儿的死亡率、临床表现及治疗情况。我们对乌干达农村一家急诊科中患有腹泻、败血症、脱水和发热的婴儿的病历进行了回顾性图表审查。采用单因素分析来检验统计学显著性。我们发现,进行了拔除乳牙的婴儿(FTE+)的死亡率为18%,未进行拔除乳牙的婴儿(FTE-)的死亡率为14%(P = 0.22)。FTE+研究组和FTE-对照组中,心率异常和缺氧的婴儿比例相似。接受抗生素治疗的婴儿比例(P = 0.001)和接受液体冲击治疗的婴儿比例(P = 0.002)存在显著差异。尽管FTE+婴儿在急诊科的临床表现与FTE-婴儿相似,但FTE+婴儿接受急诊科干预的可能性显著更高,且死亡率高于FTE-婴儿。