Ochora Moses, Kyoyagala Stella, Kyasimire Lydia, Akambasisa Mercy, Twine Margaret, Ahmed Muna, Lutasingwa Dan, Nampijja Dorah, Kumbakumba Elias
Department of Paediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda.
PLoS One. 2025 Jan 2;20(1):e0312316. doi: 10.1371/journal.pone.0312316. eCollection 2025.
Most deaths among children under 5 years occur within the first 24 hours of hospital admission from preventable causes such as diarrhea, pneumonia, malaria, and HIV/AIDS. The predictors of these deaths are not yet well documented in our setting. This study aimed to describe the patterns and predictors of these mortalities among children aged 1-59 months at a regional hospital in South Western Uganda. We conducted a prospective cohort study among 208 children aged 1-59 months admitted to Mbarara Regional Referral Hospital. The mortality rate within the first 24 hours was 7.7% (95% CI 4-12) and the median time to death was 7.3(2.62-8.75) hours. Most deaths occurred in infants, with severe pneumonia, severe acute malnutrition, and malaria as leading causes. Factors predicting mortality included admission during the night (AHR: 3.7, 95% CI 1.02-13.53, p-value 0.047) and abnormal neutrophil count(AHR: 3.5, 95% CI 1.10-11.31, p-value 0.034). The study highlights the importance of timely interventions, particularly for infants, and suggests extra monitoring for those admitted at night or with abnormal neutrophil counts.
5岁以下儿童的大多数死亡发生在入院后的头24小时内，死因包括腹泻、肺炎、疟疾和艾滋病毒/艾滋病等可预防的原因。在我们的研究环境中，这些死亡的预测因素尚未得到充分记录。本研究旨在描述乌干达西南部一家地区医院1至59个月大儿童的这些死亡模式和预测因素。我们对姆巴拉拉地区转诊医院收治的208名1至59个月大的儿童进行了一项前瞻性队列研究。头24小时内的死亡率为7.7%（95%置信区间4-12），死亡的中位时间为7.3（2.62-8.75）小时。大多数死亡发生在婴儿中，主要原因是重症肺炎、重度急性营养不良和疟疾。预测死亡的因素包括夜间入院（风险比：3.7，95%置信区间1.02-13.53，p值0.047）和中性粒细胞计数异常（风险比：3.5，95%置信区间1.10-11.31，p值0.034）。该研究强调了及时干预的重要性，特别是对婴儿而言，并建议对夜间入院或中性粒细胞计数异常的患者进行额外监测。
