What factors are associated with paediatric admissions and their outcomes in a rural hospital in northern Sierra Leone? Insights from a pilot observational study
What factors are associated with paediatric admissions and their outcomes in a rural hospital in northern Sierra Leone? Insights from a pilot observational study
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哪些因素与塞拉利昂北部乡村医院的儿科入院及其结果相关？
DOI：
10.1136/bmjph-2023-000545
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Afolabi M
中科院分区：
文献类型：
--
作者：
Afolabi M
关于入院模式和儿童死亡原因的数据对于告知改善儿童生存的优先事项至关重要。在撒哈拉以南非洲的许多卫生设施，了解儿科入院及其结果的模式是限制了这些重要feature.MethodsWe开发和试点文件的基本，标准化的病人水平的信息，入院原因，诊断，治疗和结果在塞拉利昂的农村医院收治的儿童一个简单的基于纸张的工具。该工具包含的部分涵盖了患者的基本社会人口学信息、主要医疗投诉、入院时进行的临床检查和测试结果、随后的临床和实验室调查结果、工作/明确诊断、管理和治疗结果。结果从2019年8月1日至2021年7月31日，我们使用该工具记录了入院，对塞拉利昂北方坎比亚地区医院收治的1663名儿童的治疗和临床结果进行了研究。大多数儿童（1 015名，62%）年龄在12-59个月，是男孩（942名，57%），消瘦（516名，31%），发育不良（238名，14%）或体重不足（537名，32%）。一半以上的儿童居住在距离医院1公里以上的地方（876/1410，62%）。录取人数最高的是2019年11月，最低的是2020年4月。严重疟疾是入院的主要原因。超过80%的儿童成功治疗并出院回家（1356/1663，81.5%），而122/1663（7.3%）死亡。5岁以下体重不足的儿童和有危险迹象的儿童（例如，呼吸困难、脱水、头部受伤或严重感染的迹象）比没有这些特征的儿童死亡风险更高（p<0.01; p=0.03; p=0.011和p=0.009，）结论使用一个简单的工具可以克服缺乏系统的病历记录和住院和结果的不良记录。持续使用该工具并定期审计，可以改善资源有限环境下的儿科护理服务。
IntroductionData on the pattern of admissions and causes of child death are crucial in informing priorities for improving child survival. In many health facilities in sub-Saharan Africa, understanding the pattern of paediatric admissions and their outcomes is constrained by poor documentation of these important features.MethodsWe developed and piloted a simple paper-based tool for documentation of basic, standardised patient-level information on causes of admissions, diagnoses, treatments and outcomes in children admitted to a rural hospital in Sierra Leone. The tool contained sections covering basic sociodemographic information about a patient, chief medical complaints, findings from clinical examinations and tests conducted at admission, results from subsequent clinical and laboratory investigations, working/definitive diagnoses, management and treatment outcomes.ResultsFrom 1 August 2019 to 31 July 2021, we used this tool to document the admissions, treatments and clinical outcomes of 1663 children admitted to Kambia district hospital in northern Sierra Leone. The majority of the children (1015, 62%) were aged 12–59 months, were boys (942, 57%), were wasted (516, 31%), stunted (238, 14%) or underweight (537, 32%). Above a half of the children lived more than 1 km distance from the hospital (876/1410, 62%). The highest number of admissions occurred in November 2019 and the lowest in April 2020. Severe malaria was the leading cause of admission. More than 80% of the children were successfully treated and discharged home (1356/1663, 81.5%) while 122/1663 (7.3%) died. Children aged under 5 years who were underweight, and those who presented with danger signs (eg, signs of breathing difficulty, dehydration, head injury or severe infections) had a higher risk of death than children without these features (p<0.01; p=0.03; p=0.011 and p=0.009, respectively).ConclusionLack of systematic documentation of medical histories and poor record keeping of hospital admissions and outcomes can be overcome by using a simple tool. Continuous use of the tool with regular audits could improve delivery of paediatric care in resource-limited settings.
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影响因子：
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作者：
Yusupha Sanyang
通讯作者：
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DOI：
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发表时间：
2015
期刊：
影响因子：
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作者：
B. Toma;M. Gyang;H. Abdu;D. Shwe;I. Ekere;M. Ihekaike
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DOI：
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发表时间：
2017
期刊：
Children
影响因子：
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作者：
Carmelle Tsai;C. Walters;J. Sampson;F. Kateh;Mary P. Chang
通讯作者：
Mary P. Chang
DOI：
10.1186/1748-5908-8-39
发表时间：
2013-03-28
期刊：
Implementation science : IS
影响因子：
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作者：
English M
通讯作者：
English M