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喀麦隆北部一家医院中严重急性营养不良住院儿童的死亡率及其预测因素。

Prevalence and predictors of mortality among hospitalized children with severe acute malnutrition in a hospital in North Cameroon.

机构信息

Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Littoral Region 24157, Cameroon.

Deido District Hospital, Douala, Littoral Region 8037, Cameroon.

出版信息

J Trop Pediatr. 2023 Oct 5;69(6). doi: 10.1093/tropej/fmad042.

Abstract

BACKGROUND

Severe acute malnutrition (SAM) is a major public health concern responsible for paediatric hospitalizations and more than one-third of deaths across the world. In 2013, SAM caused ≥20% of deaths in severely malnourished infants in Douala, the economic capital of Cameroon. There is little data on SAM in economically, sanitary and socially disadvantaged Cameroonian regions including the North region.

OBJECTIVES

To determine the prevalence and potential predictors of mortality among children with SAM in a reference health facility in Garoua, North region, Cameroon.

METHODS

A cross-sectional analytical study was conducted from November 2021 to May 2022 at the paediatric ward of Garoua Regional hospital. Data collected on sociodemographic, clinical and therapeutic characteristics in this study were questionnaire based.

RESULTS

A total of 6769 children were admitted for hospitalization during the study period, among them 701 SAM cases, giving a hospital prevalence of 10.4%. Of the 347 children included, 51% of the study population were males and 87.6% were children aged 6-23 months. Seven predictors of mortality were identified: orphan status [adjusted odds ratios (AOR) = 8.70, p = 0.021], vomiting (AOR = 3.40, p < 0.0001), marasmus-kwashiorkor (AOR = 7.30, p = 0.005), lack of appetite (AOR = 56.10, p < 0.0001), cutaneous lesions (AOR = 5.50, p = 0.014), lethargy (AOR = 4.50, p = 0.001) and nasogastric rehydration (AOR = 6.50, p = 0.004).

CONCLUSION

Practitioners in the northern region of Cameroon should address these locally identified mortality factors to intervene with, and hopefully prevent and adequately manage malnutrition and SAM in this and similar contexts.

摘要

背景

严重急性营养不良(SAM)是一个主要的公共卫生问题,在全球范围内导致儿科住院和超过三分之一的死亡。2013 年,在喀麦隆经济首都杜阿拉,SAM 导致严重营养不良婴儿死亡人数超过 20%。在经济、卫生和社会条件不利的喀麦隆地区,包括北部地区,关于 SAM 的数据很少。

目的

在喀麦隆北部加鲁阿地区医院儿科病房,确定加鲁阿参考医疗机构中 SAM 儿童的患病率和死亡的潜在预测因素。

方法

这是一项横断面分析研究,于 2021 年 11 月至 2022 年 5 月在加鲁阿地区医院儿科病房进行。本研究收集的社会人口学、临床和治疗特征数据基于问卷调查。

结果

在研究期间,共有 6769 名儿童住院治疗,其中 701 例 SAM 病例,住院患病率为 10.4%。在纳入的 347 名儿童中,51%为男性,87.6%为 6-23 个月大的儿童。确定了 7 个死亡预测因素:孤儿身份[调整后的优势比(AOR)=8.70,p=0.021]、呕吐(AOR=3.40,p<0.0001)、消瘦型营养不良-夸希奥科(AOR=7.30,p=0.005)、食欲不振(AOR=56.10,p<0.0001)、皮肤损伤(AOR=5.50,p=0.014)、昏睡(AOR=4.50,p=0.001)和鼻胃补液(AOR=6.50,p=0.004)。

结论

喀麦隆北部地区的从业者应针对这些当地确定的死亡因素进行干预,希望能预防和充分管理营养不良和 SAM,并在类似情况下进行管理。

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