Pediatric Residency Program, Department of Woman's and Child's Health, University of Padova, Padova, Italy.
Doctors with Africa CUAMM, Padova, Italy.
PLoS One. 2020 Nov 4;15(11):e0241209. doi: 10.1371/journal.pone.0241209. eCollection 2020.
An effective pediatric emergency care (PEC) system is key to reduce pediatric mortality in low-income countries. While data on pediatric emergencies from these countries can drive the development and adjustment of such a system, they are very scant, especially from Africa. We aimed to describe the characteristics and outcomes of presentations to a tertiary-care Pediatric Emergency Department (PED) in Mozambique.
We retrospectively reviewed PED presentations to the "Hospital Central da Beira" between April 2017 and March 2018. Multivariable logistic regression was used to identify predictors of hospitalization and death.
We retrieved 24,844 presentations. The median age was 3 years (IQR 1-7 years), and 92% lived in the urban area. Complaints were injury-related in 33% of cases and medical in 67%. Data on presenting complaints (retrieved from hospital paper-based registries) were available for 14,204 (57.2%) records. Of these, respiratory diseases (29.3%), fever (26.7%), and gastrointestinal disorders (14.2%) were the most common. Overall, 4,997 (20.1%) encounters resulted in hospitalization. Mortality in the PED was 1.6% (62% ≤4 hours from arrival) and was the highest in neonates (16%; 89% ≤4 hours from arrival). A younger age, especially younger than 28 days, living in the extra-urban area and being referred to the PED by a health care provider were all significantly associated with both hospitalization and death in the PED at the multivariable analysis.
Injuries were a common presentation to a referral PED in Mozambique. Hospitalization rate and mortality in the PED were high, with neonates being the most vulnerable. Optimization of data registration will be key to obtain more accurate data to learn from and guide the development of PEC in Mozambique. Our data can help build an effective PEC system tailored to the local needs.
有效的儿科急救医疗（PEC）系统是降低低收入国家儿童死亡率的关键。虽然来自这些国家的儿科急诊数据可以推动该系统的发展和调整，但这些数据非常匮乏，尤其是来自非洲的。我们旨在描述莫桑比克一家三级儿科急诊部（PED）的就诊特点和结局。
我们回顾性分析了 2017 年 4 月至 2018 年 3 月期间“贝拉中央医院”PED 的就诊情况。采用多变量逻辑回归来确定住院和死亡的预测因素。
我们共检索到 24844 例就诊记录。中位数年龄为 3 岁（IQR 1-7 岁），92%的患者居住在城市地区。33%的病例为损伤相关，67%为医疗相关。就诊时的主要症状（从医院纸质登记处获取）有记录的为 14204 例（57.2%）。其中，呼吸道疾病（29.3%）、发热（26.7%）和胃肠道疾病（14.2%）最为常见。总的来说，4997 例（20.1%）就诊需要住院治疗。PED 的死亡率为 1.6%（89%的死亡发生在到达后 4 小时内），新生儿的死亡率最高（16%；89%的死亡发生在到达后 4 小时内）。多变量分析显示，年龄较小（尤其是小于 28 天）、居住在城市以外地区和由医疗保健提供者转介至 PED，均与 PED 的住院和死亡显著相关。
在莫桑比克，受伤是转至 PED 的常见就诊原因。PED 的住院率和死亡率都很高，新生儿最为脆弱。优化数据登记将是获得更准确数据的关键，以便从中学习并指导莫桑比克 PEC 的发展。我们的数据可以帮助建立适合当地需求的有效的 PEC 系统。
