Potentially modifiable factors associated with death of infants and children with severe pneumonia routinely managed in district hospitals in Malawi

dc.contributor.authorEnarson, Penelope M.en_ZA
dc.contributor.authorGie, Robert P.en_ZA
dc.contributor.authorMwansambo, Charles C.en_ZA
dc.contributor.authorChalira, Alfred E.en_ZA
dc.contributor.authorLufesi, Norman N.en_ZA
dc.contributor.authorMaganga, Ellubey R.en_ZA
dc.contributor.authorEnarson, Donald A.en_ZA
dc.contributor.authorCameron, Neil A.en_ZA
dc.contributor.authorGraham, Stephen M.en_ZA
dc.date.accessioned2016-08-26T10:06:33Z
dc.date.available2016-08-26T10:06:33Z
dc.date.issued2015
dc.descriptionCITATION: Enarson, P. M., et al. 2015. Potentially modifiable factors associated with death of infants and children with severe pneumonia routinely managed in district hospitals in Malawi. PLoS ONE, 10(8):1-13, doi:10.1371/journal.pone.0133365.
dc.descriptionThe original publication is available at http://journals.plos.org/plosone
dc.description.abstractObjective: To investigate recognised co-morbidities and clinical management associated with inpatient pneumonia mortality in Malawian district hospitals. Methods: Prospective cohort study, of patient records, carried out in Malawi between 1st October 2000 and 30th June 2003. The study included all children aged 0-59 months admitted to the paediatric wards in sixteen district hospitals throughout Malawi with severe and very severe pneumonia. We compared individual factors between those that survived (n = 14 076) and those that died (n = 1 633). Results: From logistic regression analysis, predictors of death in hospital, adjusted for age, sex and severity grade included comorbid conditions of meningitis (OR =2.49, 95% CI 1.50-4.15), malnutrition (OR =2.37, 95% CI 1.94-2.88) and severe anaemia (OR =1.41, 95% CI 1.03-1.92). Requiring supplementary oxygen (OR =2.16, 95% CI 1.85-2.51) and intravenous fluids (OR =3.02, 95% CI 2.13-4.28) were associated with death while blood transfusion was no longer significant (OR =1.10, 95% CI 0.77-1.57) when the model included severe anaemia. Conclusions: This study identified a number of challenges to improve outcome for Malawian infants and children hospitalised with pneumonia. These included improved assessment of co-morbidities and more rigorous application of standard case management.en_ZA
dc.description.urihttp://journals.plos.org/plosone/article?id=10.1371/journal.pone.0133365
dc.description.versionPublisher's version
dc.format.extent13 pages
dc.identifier.citationEnarson, P. M., et al. 2015. Potentially modifiable factors associated with death of infants and children with severe pneumonia routinely managed in district hospitals in Malawi. PLoS ONE, 10(8):1-13, doi:10.1371/journal.pone.0133365
dc.identifier.issn1932-6203 (online)
dc.identifier.otherdoi:10.1371/journal.pone.0133365
dc.identifier.urihttp://hdl.handle.net/10019.1/99482
dc.language.isoen_ZAen_ZA
dc.publisherPublic Library of Science
dc.rights.holderAuthors retain copyright
dc.subjectPneumonia in children -- Malawien_ZA
dc.subjectHospitals -- Malawien_ZA
dc.titlePotentially modifiable factors associated with death of infants and children with severe pneumonia routinely managed in district hospitals in Malawien_ZA
dc.typeArticleen_ZA
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