The spectrum of acute illness and mortality of children and adolescents presenting to emergency services in Sanghar district hospital, Pakistan: A prospective cohort study

Authors

Fiona Muttalib, BC Children's Hospital, Canada
Zahid Ali Memon, Aga Khan UniversityFollow
Shah Muhammad, Aga Khan UniversityFollow
Asif Soomro, Aga Khan UniversityFollow
Samia Khan, Aga Khan University
Shazia Bano, Aga Khan University
Muhammad Jawwad, Aga Khan UniversityFollow
Sajid Bashir Soofi, Aga Khan UniversityFollow
Bettina Hansen, University of Toronto, Canada.
Zulfiqar Ahmed Bhutta, Aga Khan UniversityFollow

Document Type

Article

Department

Paediatrics and Child Health; Centre of Excellence in Women and Child Health; Institute for Global Health and Development

Abstract

Objective: To describe presenting diagnoses and rates and causes of death by age category and sex among children with acute illness brought to a district headquarter hospital in Pakistan.
Design: Prospective cohort study.
Setting: Sanghar district headquarter hospital, Sindh, Pakistan between December 2019 and April 2020 and August 2020 and December 2020.
Participants: 3850 children 0-14 years presenting with acute illness to the emergency and outpatient departments and 1286 children admitted to the inpatient department.
Outcome measures: The primary outcome was Global Burden of Disease diagnosis category. Secondary outcomes were 28-day mortality rate, cause of death and healthcare delays, defined as delay in care-seeking, delay in reaching the healthcare facility and delay in appropriate treatment.
Results: Communicable diseases were the most common presenting diagnoses among outpatients and among inpatients aged 1 month to 9 years. Non-communicable diseases and nutritional disorders were more common with increasing age. Few children presented with injuries. Newborn period (age <28 >days) was associated with increased odds of death (OR 4.34 [95% CI 2.38 to 8.18], p.
Conclusion: This study adds to sparse literature surrounding the epidemiology of disease and hospital outcomes for children with acute illness seeking healthcare in rural Pakistan and, in particular, among children aged 5-14 years. Further studies should include public and private hospitals within a single region to comprehensively describe patterns of care-seeking and interfacility transfer in district health systems.

Comments

Pagination are not provided by the author/publisher.

Publication (Name of Journal)

BMJ Open

DOI

10.1136/bmjopen-2023-082255

Recommended Citation

Muttalib, F., Memon, Z. A., Muhammad, S., Soomro, A., Khan, S., Bano, S., Jawwad, M., Soofi, S., Hansen, B., Bhutta, Z. A. (2024). The spectrum of acute illness and mortality of children and adolescents presenting to emergency services in Sanghar district hospital, Pakistan: A prospective cohort study. BMJ Open, 14(8), e082255.
Available at: https://ecommons.aku.edu/coe-wch/107