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莫桑比克四个省份腹泻儿童合并症研究:横断面研究(2015 年至 2019 年)。

Examining comorbidities in children with diarrhea across four provinces of Mozambique: A cross-sectional study (2015 to 2019).

机构信息

Instituto Nacional de Saúde (INS), Distrito de Marracuene, Província de Maputo, Mozambique.

Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal.

出版信息

PLoS One. 2023 Sep 26;18(9):e0292093. doi: 10.1371/journal.pone.0292093. eCollection 2023.

Abstract

Comorbidities are defined as the simultaneous occurrence of two or more diseases within the same individual. Comorbidities can delay a patient's recovery and increase the costs of treatment. Assessing comorbidities can provide local health care policy-makers with evidence of the most common multi-health impairments in children. This could aid in redirecting and integrating care and treatment services by increasing health facilities the awareness and readiness of health facilities. The present analysis aims to determine the frequency and associated factors of comorbidities in children with diarrhea in Mozambique. A cross-sectional hospital-based analysis was conducted between January 2015 and December 2019 in children up to 59 months of age who were admitted with diarrhea in six reference hospitals in Mozambique. These hospitals are distributed across the country's three regions, with at least one hospital in each province from each region. Sociodemographic and clinical data were obtained through semi-structured interviews and by reviewing the child clinical process. Descriptive statistics, and Mann-Whitney-U tests were used. Crude and adjusted logistics regression models were built. P-values < 0.05 were considered statistically significant. Comorbidities were observed in 55.5% of patients (389/701; 95%CI: 51.8-59.1). Wasting was the most common comorbidity (30.2%; 212/701) and pneumonia was the least common (1.7%; 12/701). Children born with a low birth weight were 2.420 times more likely to have comorbidities, adjusted odds ratio: 2.420 (95% CI: 1.339-4374). The median (interquartile range) duration of hospitalization was significantly higher in children with comorbidities than without comorbidities, 5 days (3-7) and 4 days (3-6), respectively (p-value < 0.001). One in every two children with diarrhea in Mozambique has an additional health impairment, and this increases the length of their hospital stay.

摘要

合并症是指同一患者同时发生两种或多种疾病。合并症会延迟患者的康复并增加治疗成本。评估合并症可以为当地卫生保健政策制定者提供儿童最常见的多种健康障碍的证据。这可以通过提高卫生设施的意识和准备程度,帮助重新引导和整合护理和治疗服务。本分析旨在确定莫桑比克腹泻儿童合并症的频率和相关因素。这是一项 2015 年 1 月至 2019 年 12 月期间在莫桑比克 6 家参考医院进行的基于医院的横断面分析,研究对象为年龄在 59 个月以下因腹泻住院的儿童。这些医院分布在该国的三个地区,每个地区的每个省至少有一家医院。通过半结构化访谈和回顾儿童临床过程获取社会人口学和临床数据。使用描述性统计和曼惠特尼 U 检验。建立了未调整和调整后的逻辑回归模型。P 值<0.05 被认为具有统计学意义。55.5%(389/701;95%CI:51.8-59.1)的患者存在合并症。消瘦是最常见的合并症(30.2%;212/701),肺炎是最不常见的合并症(1.7%;12/701)。出生体重低的儿童发生合并症的可能性是出生体重正常儿童的 2.420 倍,调整后的优势比:2.420(95%CI:1.339-4374)。有合并症的儿童住院时间中位数(四分位距)明显长于无合并症的儿童,分别为 5 天(3-7)和 4 天(3-6)(p 值<0.001)。莫桑比克每两个腹泻儿童中就有一个存在额外的健康障碍,这会延长他们的住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6917/10522033/107c79739034/pone.0292093.g001.jpg

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