Faculty of medicine and biomedical sciences of the University of Yaoundé I, Yaoundé, Cameroon; Mother and Child Centre of the Chantal Biya Foundation of Yaoundé, Yaoundé, Cameroon.
Faculty of medicine and biomedical sciences of the University of Yaoundé I, Yaoundé, Cameroon.
Arch Pediatr. 2020 Jul;27(5):257-260. doi: 10.1016/j.arcped.2020.05.006. Epub 2020 May 12.
Although sub-Saharan Africa accounts for only 21% of the global population of children and adolescents aged 5-15 years, 55% of deaths among children in this age group occur in this region. This seems to be related to infectious diseases. We hypothesized that besides infectious diseases, in our context, a chronic underlying condition increases mortality. Our goal was to describe the leading causes of mortality among this age group.
We conducted a retrospective study in a tertiary care center in Yaoundé. We included the medical files of children who died between January 2013 and December 2017.
The in-hospital mortality rate was 10.3 per 1000. Coma and/or convulsion was the main cause of death (70.6%), followed by severe anemia (64.7%) and respiratory distress (56.8%). We identified a chronic illness in 62.2% of cases: HIV infection (39.2%) and sickle cell disease (24.5%) were the most prevalent. The main diagnoses were severe malaria, severe sepsis, and meningitis (Cryptococcus sp. included) in 25 (n=35), 16.4 (n=27), and 10.3% (n=17) of cases, respectively.
HIV infection and sickle cell disease are the most prevalent chronic diseases related to the patients' death in the age group studied. Specific interventions focusing on this age group are recommended including intensification of impregnated bednet usage as well as HIV and sickle cell disease management.
尽管撒哈拉以南非洲仅占全球 5-15 岁儿童和青少年人口的 21%，但该年龄段儿童的 55%死亡发生在该地区。这似乎与传染病有关。我们假设，除了传染病之外，在我们的背景下，慢性潜在疾病会增加死亡率。我们的目标是描述该年龄段的主要死亡原因。
我们在雅温得的一家三级护理中心进行了一项回顾性研究。我们纳入了 2013 年 1 月至 2017 年 12 月期间在医院死亡的儿童的病历。
院内死亡率为每 1000 人中有 10.3 人。昏迷和/或抽搐是主要死因（70.6%），其次是严重贫血（64.7%）和呼吸窘迫（56.8%）。我们在 62.2%的病例中发现了慢性疾病：艾滋病毒感染（39.2%）和镰状细胞病（24.5%）最为常见。主要诊断分别为严重疟疾、严重败血症和脑膜炎（包括新型隐球菌），在 25 例（n=35）、16.4 例（n=27）和 10.3%（n=17）的病例中。
艾滋病毒感染和镰状细胞病是与研究年龄组患者死亡相关的最常见慢性疾病。建议针对该年龄组采取具体干预措施，包括加强使用浸渍蚊帐以及艾滋病毒和镰状细胞病的管理。
