Lugangira Kristina, Kazaura Method, Kalokola Festus
Department of Case Management, Tibu Homa Project, URC, P. O. Box 1403, Mwanza, Tanzania.
Department of Epidemiology/Biostatistics, Muhimbili University of Health and Allied Sciences, P. O. Box 65015, Dar es Salaam, Tanzania.
BMC Res Notes. 2017 Oct 10;10(1):502. doi: 10.1186/s13104-017-2818-z.
There is a growing concern about child mortality especially in developing countries. The Government of Tanzania and non-governmental organizations are fighting against diseases like malaria, anaemia, diarrhoea and pneumonia that contribute extensively to child mortality. This was a hospital-based, retrospective cohort study involving 1130 under-fives (excluding neonates) being either discharged from or died in public hospitals of the Lake Zone in Tanzania. We extracted information on symptoms and signs at admission, major diagnoses and causes of death from the medical records. We applied binary logistic regression models to assess risk factors associated with in-patient under-five death.
The major leading morbidities include malaria (49%), anemia (37%), diarrhea (27%), pneumonia (22%) and severe acute malnutrition (21%). We found the case fatality of 74 deaths per 1000 under-five admissions. Major underlying causes of deaths were severe anaemia, severe malaria and severe pneumonia. Factors associated with in-patient death were female sex (AOR 1.7; 95% CI 1.0, 2.8) and the odds significantly decreased with increasing level of maternal education.
Malaria remains a leading cause of admissions in hospitals among under-fives. Although the case fatality among children aged between 2 and 59 months admitted in hospitals in Lake Zone is decreasing, efforts are needed to address major causes of deaths (severe anaemia, severe malaria and severe pneumonia).
人们越来越关注儿童死亡率,尤其是在发展中国家。坦桑尼亚政府和非政府组织正在与疟疾、贫血、腹泻和肺炎等疾病作斗争,这些疾病在很大程度上导致了儿童死亡。这是一项基于医院的回顾性队列研究,涉及1130名五岁以下儿童(不包括新生儿),他们要么从坦桑尼亚湖区的公立医院出院,要么在那里死亡。我们从医疗记录中提取了入院时的症状和体征、主要诊断和死亡原因的信息。我们应用二元逻辑回归模型来评估与五岁以下住院儿童死亡相关的风险因素。
主要的发病情况包括疟疾(49%)、贫血(37%)、腹泻(27%)、肺炎(22%)和重度急性营养不良(21%)。我们发现每1000例五岁以下儿童入院中有74例死亡的病死率。主要的潜在死亡原因是重度贫血、重度疟疾和重度肺炎。与住院死亡相关的因素是女性(比值比1.7;95%置信区间1.0,2.8),且随着母亲教育水平的提高,死亡几率显著降低。
疟疾仍然是五岁以下儿童住院的主要原因。尽管湖区医院收治的2至59个月大儿童的病死率在下降,但仍需努力解决主要的死亡原因(重度贫血、重度疟疾和重度肺炎)。