南非西开普农村地区严重腹泻性脱水的相关因素。

Factors Associated with Severe Dehydrating Diarrhoea in the Rural Western Cape, South Africa.

机构信息

Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.

Department of Paediatrics and Child Health, Ukwanda Centre for Rural Health, Stellenbosch University, Cape Town, South Africa.

出版信息

J Trop Pediatr. 2019 Feb 1;65(1):1-8. doi: 10.1093/tropej/fmy002.

DOI:10.1093/tropej/fmy002

PMID:29415224

Abstract

BACKGROUND

Acute diarrhoea (AD) remains a leading cause of childhood death. We evaluated whether delayed healthcare seeking was associated with severe dehydration in rural South Africa.

METHODS

In a prospective cohort study of children with AD admitted to a secondary-level hospital, data were collected through structured caregiver interviews and hospital record review. The primary outcome was severe dehydration/death, and the primary determinant was delay >12 h between AD symptom onset and healthcare facility presentation.

RESULTS

Total 68% (71 of 104) of children experienced a delay, and 51% (54 of 104) had severe dehydration with no in-hospital deaths. There was no difference in children with (35 of 71) or without (19 of 33) delay for severe dehydration. Mothers of children with severe dehydration tended to be younger [median (interquartile range) 24 (21-28) vs. 27 (23-30) years, p = 0.07] and used less oral rehydration solution (63 vs. 80%, p = 0.08).

CONCLUSION

Delay of >12 h in seeking healthcare for AD was not associated with severe dehydration.

摘要

背景

急性腹泻（AD）仍然是导致儿童死亡的主要原因。我们评估了在南非农村地区，延迟寻求医疗保健是否与严重脱水有关。

方法

在对因 AD 而住院的二级医院儿童进行的前瞻性队列研究中，通过对照顾者进行结构化访谈和医院病历回顾收集数据。主要结局是严重脱水/死亡，主要决定因素是 AD 症状出现和到医疗机构就诊之间的时间延迟>12 小时。

结果

共有 68%（71/104）的儿童出现了延迟，51%（54/104）的儿童出现严重脱水，无院内死亡。有（71/104）和无（33/104）延迟的儿童中，严重脱水的比例没有差异。严重脱水儿童的母亲往往更年轻[中位数（四分位距）24（21-28）岁比 27（23-30）岁，p=0.07]，使用口服补液盐的比例更低（63%比 80%，p=0.08）。