Dataset Information

Predicting mortality among hospitalized children with respiratory illness in Western Kenya, 2009-2012.

ABSTRACT:

Background

Pediatric respiratory disease is a major cause of morbidity and mortality in the developing world. We evaluated a modified respiratory index of severity in children (mRISC) scoring system as a standard tool to identify children at greater risk of death from respiratory illness in Kenya.

Materials and methods

We analyzed data from children <5 years old who were hospitalized with respiratory illness at Siaya District Hospital from 2009-2012. We used a multivariable logistic regression model to identify patient characteristics predictive for in-hospital mortality. Model discrimination was evaluated using the concordance statistic. Using bootstrap samples, we re-estimated the coefficients and the optimism of the model. The mRISC score for each child was developed by adding up the points assigned to each factor associated with mortality based on the coefficients in the multivariable model.

Results

We analyzed data from 3,581 children hospitalized with respiratory illness; including 218 (6%) who died. Low weight-for-age [adjusted odds ratio (aOR)?= 2.1; 95% CI 1.3-3.2], very low weight-for-age (aOR?= 3.8; 95% CI 2.7-5.4), caretaker-reported history of unconsciousness (aOR?= 2.3; 95% CI 1.6-3.4), inability to drink or breastfeed (aOR?= 1.8; 95% CI 1.2-2.8), chest wall in-drawing (aOR?= 2.2; 95% CI 1.5-3.1), and being not fully conscious on physical exam (aOR?= 8.0; 95% CI 5.1-12.6) were independently associated with mortality. The positive predictive value for mortality increased with increasing mRISC scores.

Conclusions

A modified RISC scoring system based on a set of easily measurable clinical features at admission was able to identify children at greater risk of death from respiratory illness in Kenya.

SUBMITTER: Emukule GO

PROVIDER: S-EPMC3965502 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

Predicting mortality among hospitalized children with respiratory illness in Western Kenya, 2009-2012.

Emukule Gideon O GO McMorrow Meredith M Ulloa Chulie C Khagayi Sammy S Njuguna Henry N HN Burton Deron D Montgomery Joel M JM Muthoka Philip P Katz Mark A MA Breiman Robert F RF Mott Joshua A JA

PloS one 20140325 3

<h4>Background</h4>Pediatric respiratory disease is a major cause of morbidity and mortality in the developing world. We evaluated a modified respiratory index of severity in children (mRISC) scoring system as a standard tool to identify children at greater risk of death from respiratory illness in Kenya.<h4>Materials and methods</h4>We analyzed data from children <5 years old who were hospitalized with respiratory illness at Siaya District Hospital from 2009-2012. We used a multivariable logist ...[more]

PMID: 24667695

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Project description:The epidemiology of pediatric COVID-19 in sub-Saharan Africa and the role of fecal-oral transmission in SARS-CoV-2 are poorly understood. Among children and adolescents in Kenya, we identify correlates of COVID-19 infection, document the clinical outcomes of infection, and evaluate the prevalence and viability of SARS-CoV-2 in stool. We recruited a prospective cohort of hospitalized children aged two months to 15 years in western Kenya between March 1 and June 30 2021. Children with SARS-CoV-2 were followed monthly for 180-days after hospital discharge. Bivariable logistic regression analysis was used to identify the clinical and sociodemographics correlates of SARS-CoV-2 infection. We also calculated the prevalence of SARS-CoV-2 detection in stool of confirmed cases. Of 355 systematically tested children, 55 (15.5%) were positive and were included in the cohort. The commonest clinical features among COVID-19 cases were fever (42/55, 76%), cough (19/55, 35%), nausea and vomiting (19/55, 35%), and lethargy (19/55, 35%). There were no statistically significant difference in baseline sociodemographic and clinical characteristics between SARS-CoV-2 positive and negative participants. Among positive participants, 8/55 (14.5%, 95%CI: 5.3%-23.9%) died; seven during the inpatient period. Forty-nine children with COVID-19 had stool samples or rectal swabs available at baseline, 9 (17%) had PCR-positive stool or rectal swabs, but none had SARS-CoV-2 detected by culture. Syndromic identification of COVID-19 is particularly challenging among children as the presenting symptoms and signs mirror other common pediatric diseases. Mortality among children hospitalized with COVID-19 was high in this cohort but was comparable to mortality seen with other common illnesses in this setting. Among this small set of children with COVID-19 we detected SARS-CoV-2 DNA, but were not able to culture viable SARs-CoV-2 virus, in stool. This suggests that fecal transmission may not be a substantial risk in children recently diagnosed and hospitalized with COVID-19 infection.

Dataset Information

Predicting mortality among hospitalized children with respiratory illness in Western Kenya, 2009-2012.

Background

Materials and methods

Results

Conclusions

Publications

Predicting mortality among hospitalized children with respiratory illness in Western Kenya, 2009-2012.

Similar Datasets

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