Dataset Information

Neurodevelopmental performance among pre-schoolers treated for severe anaemia at Lira Regional Referral Hospital, Uganda.

ABSTRACT:

Background

Severe anaemia is a common clinical problem among young children in sub-Saharan Africa. However, the effect of severe anaemia on neurodevelopment of these children is not well described. Therefore, we assessed the neurodevelopmental performance of preschool children diagnosed with severe anaemia in Northern Uganda.

Methods

We conducted a prospective cohort study among children < 5 years of age 14 days post discharge after an episode of severe anaemia (Hb < 5.0 g/dl; n = 171; mean Hb = 3.9g/dl) at Lira Regional Referral Hospital, Uganda. Neurodevelopmental outcomes (cognitive, language and motor) were assessed using Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III). Age-adjusted z-scores for each domain were calculated using scores from healthy community control children (n = 88) recruited from the same environment for each age category. Multiple linear regression was used to compare z-scores in the cognitive, language and motor scales between the two groups after adjusting for weight-for-age z-score, socioeconomic status, mother's education, and father's employment on all the scales.

Results

The prevalence of neurodevelopmental impairment was 2.3% (95% CI: 0.8-6.1) for cognition, 1.7% (95%: 0.6-5.3) for language and 3.5% (95% CI: 1.6-7.6) for motor scales and 4.6% (95% CI: 2.3-9.1) for deficits in ?1 area of neurodevelopment. Significant differences were observed between the two groups with the SA group performing worse on cognition [adjusted mean score, (Standard error, SE), P-value] [-0.20, (0.01) vs. 0.00, (0.01), P = 0.02]; language [-0.25, (0.01) vs. 0.00, (0.01), P< 0.001]; and motor [-0.17, (0.01) vs. 0.00, (0.01), P = 0.05] scales.

Conclusion

In children < 5 years of age, severe anaemia was associated with neurocognitive (cognition, language and motor) deficits in the immediate period post treatment. Further research is needed to identify risk factors and determine the long-term effects of poor neurodevelopment in young children with severe anaemia.

SUBMITTER: Ssemata AS

PROVIDER: S-EPMC7641407 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Neurodevelopmental performance among pre-schoolers treated for severe anaemia at Lira Regional Referral Hospital, Uganda.

Ssemata Andrew S AS Opoka Robert O RO Ssenkusu John M JM Nakasujja Noeline N John Chandy C CC Bangirana Paul P

PloS one 20201104 11

<h4>Background</h4>Severe anaemia is a common clinical problem among young children in sub-Saharan Africa. However, the effect of severe anaemia on neurodevelopment of these children is not well described. Therefore, we assessed the neurodevelopmental performance of preschool children diagnosed with severe anaemia in Northern Uganda.<h4>Methods</h4>We conducted a prospective cohort study among children < 5 years of age 14 days post discharge after an episode of severe anaemia (Hb < 5.0 g/dl; n = ...[more]

PMID: 33147287

Similar Datasets

Project description:BackgroundThe World Health Organization (WHO) defines Preterm Birth (PTB) as "a live birth taking place before the expected 37 weeks of gestation". Annually, approximately 15 million infants are born prematurely, constituting significantly to infant mortality during the initial four weeks of life, responsible for 40% of deaths among children under the age of five. Evidently, preterm deliveries have contributed to 46% of admissions to the neonatal intensive care unit (NICU) at Lira Regional Referral Hospital (LRRH) over the past three years. Paradoxically, while the prevalence of preterm births remains high, there is a lack of documented information regarding the underlying risk factors. Consequently, the primary objective of this study was to assess the potential risk factors associated with preterm birth at LRRH.MethodsAn analytical cross-sectional research was undertaken at LRRH, employing a quantitative methodology. The study utilized secondary data obtained from a total of 590 comprehensive maternal medical records, of deliveries that occurred at the facility between April 2020 and July 2021. The collected data underwent analysis using STATA version 17 software. To identify predictors of preterm birth, a Logistic regression model was applied, yielding adjusted odds ratios (AOR) alongside 95% confidence intervals (CI). The significance level was set at p < 0.05 to establish statistical significance. Furthermore, assessments for multicollinearity and model fitness were conducted using the Variance Inflation Factor (VIF) and linktest, respectively.ResultsThe prevalence of preterm delivery among mothers who gave birth at LRRH stood at 35.8%. The outcomes of logistic regression analysis revealed that maternal employment status had a statistically significant association with preterm birth (AOR = 0.657, p = 0.037, 95%CI: 0.443-0.975); having a baby with low birth weight (AOR = 0.228, p < 0.001, 95% CI: 0.099-0.527) and experiencing preeclampsia (AOR = 0.142, p < 0.001, 95% CI: 0.088-0.229) were also identified as significant predictors of preterm birth in the study.Conclusions and recommendationsThe occurrence of preterm delivery is significantly higher (35.8%) among mothers who gave birth at LRRH when compared to the national average (13.6%). The prevalence of preterm birth among mothers was linked to factors such as employment status, delivery of low birth weight infants, and the presence of preeclampsia. Consequently, the research proposes a set of recommendations. Firstly, the Ministry of Health (MoH) should evaluate the present state of readiness within the healthcare system to effectively handle cases of preterm birth both within medical facilities and the community. Secondly, the Ministry of Gender, Labour, and Social Development should leverage Labor Officers to implement and uphold the regulations stipulated in the Employment Act and Labor Laws.

Project description:ObjectiveIn India, national databases indicate anaemia prevalence of 80 % among 6-35-month-old children and 58 % among 36-59-month-old children. The present study aimed to characterise anaemia and the associated factors among infants and pre-schoolers living in rural India.DesignMultivariate logistic regression analysis of data collected prior to an intervention trial. Fe-deficiency with anaemia (IDA), Fe deficiency with no anaemia (IDNA) and anaemia without Fe deficiency were defined. Serum ferritin, soluble transferrin receptor (sTfR) and sTfR/log ferritin index were used to indicate Fe status.SettingTwenty-six villages of Nalgonda district, Telangana, India. Data were collected in community sites. Participants Four hundred and seventy-six infants (aged 6-12 months), 316 pre-schoolers (aged 29-56 months) and their mothers.ResultsPrevalence of anaemia among infants and pre-schoolers was 66·4 and 47·8 %, prevalence of IDA was 52·2 and 42·1 %, prevalence of IDNA was 22·2 and 29·8 %, prevalence of anaemia without Fe deficiency was 14·2 and 5·7 %. Among infants, anaemia was positively associated with maternal anaemia (OR=3·31; 95 % CI 2·10, 5·23; P<0·001), and sTfR/log ferritin index (OR=2·21; 95 % CI 1·39, 3·54; P=0·001). Among pre-schoolers, anaemia was positively associated with maternal anaemia (OR=3·77; 95 % CI 1·94, 7·30; P<0·001), sTfR/log ferritin index (OR=5·29; 95 % CI 2·67, 10·50; P<0·001), high C-reactive protein (OR=4·39; 95 % CI 1·91, 10·06, P<0·001) and young age (29-35 months: OR=1·92; 05 % CI 1·18, 3·13, P=0·009).ConclusionsAnaemia prevalence continues to be high among infants and pre-schoolers in rural India. Based on sTfR/ferritin index, Fe deficiency is a major factor associated with anaemia. Anaemia is also associated with inflammation among pre-schoolers and with maternal anaemia among infants and pre-schoolers, illustrating the importance of understanding the aetiology of anaemia in designing effective control strategies.

Project description:IntroductionPreterm neonatal mortality contributes substantially to the high neonatal mortality globally. In Uganda, preterm neonatal mortality accounts for 31% of all neonatal deaths. Previous studies have shown variability in mortality rates by healthcare setting. Also, different predictors influence the risk of neonatal mortality in different populations. Understanding the predictors of preterm neonatal mortality in the low-resource setting where we conducted our study could guide the development of interventions to improve outcomes for preterm neonates. We thus aimed to determine the incidence and predictors of mortality among preterm neonates born at Mbarara Regional Referral Hospital (MRRH) in South Western Uganda.MethodsWe prospectively enrolled 538 live preterm neonates born at MRRH from October 2019 to September 2020. The neonates were followed up until death or 28 days, whichever occurred first. We used Kaplan Meier survival analysis to describe preterm neonatal mortality and Cox proportional hazards regression to assess predictors of preterm neonatal mortality over a maximum of 28 days of follow up.ResultsThe cumulative incidence of preterm neonatal mortality was 19.8% (95% C.I: 16.7-23.5) at 28 days from birth. Birth asphyxia (adjusted hazard ratio [aHR], 14.80; 95% CI: 5.21 to 42.02), not receiving kangaroo mother care (aHR, 9.50; 95% CI: 5.37 to 16.78), delayed initiation of breastfeeding (aHR, 9.49; 95% CI: 2.84 to 31.68), late antenatal care (ANC) booking (aHR, 1.81 to 2.52; 95% CI: 1.11 to 7.11) and no ANC attendance (aHR, 3.56; 95% CI: 1.51 to 8.43), vaginal breech delivery (aHR, 3.04; 95% CI: 1.37 to 5.18), very preterm births (aHR, 3.17; 95% CI: 1.24 to 8.13), respiratory distress syndrome (RDS) (aHR, 2.50; 95% CI: 1.11 to 5.64) and hypothermia at the time of admission to the neonatal unit (aHR, 1.98; 95% CI: 1.18 to 3.33) increased the risk of preterm neonatal mortality. Attending more than 4 ANC visits (aHR, 0.35; 95% CI: 0.12 to 0.96) reduced the risk of preterm neonatal mortality.ConclusionsWe observed a high cumulative incidence of mortality among preterm neonates born at a low-resource regional referral hospital in Uganda. The predictors of mortality among preterm neonates were largely modifiable factors occurring in the prenatal, natal and postnatal period (lack of ANC attendance, late ANC booking, vaginal breech delivery, birth asphyxia, respiratory distress syndrome, and hypothermia at the time of admission to the neonatal unit, not receiving kangaroo mother care and delayed initiation of breastfeeding). These findings suggest that investment in and enhancement of ANC attendance, intrapartum care, and the feasible essential newborn care interventions by providing the warm chain through kangaroo mother care, encouraging early initiation of breastfeeding, timely resuscitation for neonates when indicated and therapies reducing the incidence and severity of RDS could improve outcomes among preterm neonates in this setting.

Project description:Patients with severe mental illness (SMI) have a higher burden of premature cardio-metabolic abnormalities, including diabetes mellitus, hypertension, hyperlipidemia, and obesity resulting into a 3-fold increase in mortality, and up to 20% reduction in life expectancy compared to the general population. Although over 30% of Ugandans have some form of mental illness, there are no national or hospital-based screening guidelines for cardio-metabolic abnormalities among these patients a general trend in most low-income countries. The screening rates for cardio-metabolic abnormalities in most low-income countries are at only 0.6%. The objective of this study was to describe the cardio-metabolic abnormalities among patients with SMI at Mbarara Regional Referral Hospital. Through a cross-sectional study, we recruited 304 patients with SMI and evaluated them for cardio-metabolic abnormalities using the National Cholesterol Education Programme Adult Treatment Panel III criteria for dyslipidemias, World Health Organisation criteria for diabetes mellitus, obesity, and the Joint national committee criteria for hypertension. We then determined the proportion of participants who met the criteria for each of the individual cardio-metabolic abnormalities. Of the 304 participants, 44.41% were male and 55.59% female with a mean age of 38.56±13.66 years. Almost half (46.38%) of the participants were either overweight or obese, 33.22% had abdominal obesity, 40.46% were hypertensive, 34.11% had low high-density lipoproteins, 37.42% had hypertriglyceridemia and 34.77% had hypercholesterolemia. Based on fasting blood sugar, 11.18% and 9.87% had pre-diabetes and diabetes respectively. There is a high level of cardio-metabolic abnormalities among patients with psychiatric disorders and thus metabolic screening for these abnormalities should be done routinely during psychiatric reviews. There is a need for national guidelines for screening of metabolic abnormalities among patients with SMI so that these abnormalities can be detected early enough at stages where they can be either reversed or delayed to progress to cardiovascular disease.

Project description:BackgroundThe advent of the novel coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide. As of December 2021, there is inadequate data on the outcome of hospitalized patients suffering from COVID-19 in Africa. This study aimed at identifying factors associated with hospital mortality in patients who suffered from COVID-19 at Gulu Regional Referral Hospital in Northern Uganda from March 2020 to October 2021.MethodsThis was a single-center, retrospective cohort study in patients hospitalized with confirmed SARS-CoV-2 at Gulu Regional Referral Hospital in Northern Uganda. Socio-demographic characteristics, clinical presentations, co-morbidities, duration of hospital stay, and treatments were analyzed, and factors associated with the odds of mortality were determined.ResultsOf the 664 patients treated, 661 (99.5%) were unvaccinated, 632 (95.2%) recovered and 32 (4.8%) died. Mortality was highest in diabetics 11 (34.4%), cardiovascular diseases 12 (37.5%), hypertensives 10 (31.3%), females 18 (56.3%), ≥50-year-olds 19 (59.4%), no formal education 14 (43.8%), peasant farmers 12 (37.5%) and those who presented with difficulty in breathing/shortness of breath and chest pain 32 (100.0%), oxygen saturation (SpO2) at admission <80 4 (12.5%), general body aches and pains 31 (96.9%), tiredness 30 (93.8%) and loss of speech and movements 11 (34.4%). The independent factors associated with mortality among the COVID-19 patients were females AOR = 0.220, 95%CI: 0.059-0.827; p = 0.030; Diabetes mellitus AOR = 9.014, 95%CI: 1.726-47.067; p = 0.010; Ages of 50 years and above AOR = 2.725, 95%CI: 1.187-6.258; p = 0.018; tiredness AOR = 0.059, 95%CI: 0.009-0.371; p < 0.001; general body aches and pains AOR = 0.066, 95%CI: 0.007-0.605; p = 0.020; loss of speech and movement AOR = 0.134, 95%CI: 0.270-0.660; p = 0.010 and other co-morbidities AOR = 6.860, 95%CI: 1.309-35.957; p = 0.020.ConclusionThe overall Gulu Regional Hospital mortality was 32/664 (4.8%). Older age, people with diabetics, females, other comorbidities, severe forms of the disease, and those admitted to HDU were significant risk factors associated with hospital mortality. More efforts should be made to provide "additional social protection" to the most vulnerable population to avoid preventable morbidity and mortality of COVID-19 in Northern Uganda.

Project description:The emergency department (ED) of the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) handles many cases of poisoning. However, there is scant information on the factors, agents, and outcomes of poisoning at the hospital. The aim of this work was to determine the factors, agents, and outcomes of poisoning at JOOTRH. Records of patients who presented to JOOTRH with symptoms of poisoning between January 2011 and December 2016 were retrieved. Data on age, gender, offending agents, time, and season of exposure were collected. Information on the route of exposure, motive, and clinical symptoms of poisoning was also included. Other information included the laboratory evaluation, first aid measures, period of hospitalization, and outcome of poisoning. Mean, standard deviation, frequencies and bar graphs were used to describe the demographic factors of the study population. Multivariate logistic regression was used to determine the strength of association between risk factors and outcome of poisoning among patients. The level of significance for inferential analysis was set at 5%. There were 385 cases of poisoning: 57.9% (223/385) were male, 31.9% (123/385) were 13?24 years of age, and 83.9% (323/385) of exposures were in Kisumu County. The peak time of exposure was 6:00?00:00, and 23.6% (91/385) presented 1?4 h after exposure. About 62.9% (242/385) of the cases were due to accidental poisoning. Snakebites and organophosphates (OPPs) contributed to 33.0% (127/385) and 22.1% (85/385) of all cases, respectively. About 62.1% (239/385) of exposures were oral, and 63.9% (246/385) of all cases occurred in the rainy season. Additionally, 49.2% (60/122) of intentional poisoning was due to family disputes, and 16.1% (10/62) of pre-hospital first aid involved the use of tourniquets and herbal medicine. About 28.6% (110/385) of the victims were subjected to laboratory evaluation and 83.9% (323/385) were hospitalized for between 1?5 days. Other results indicated that 80.0% (308/385) responded well to therapy, while 7.3% (28/385) died, 68% (19/28) of whom were male. Furthermore, 39.3% (11/28) of the deaths were related to OPPs. Our findings suggest that the earlier the victims of poisoning get to the hospital, the more likely they are to survive after treatment is initiated. Similarly, victims of poisoning due to parental negligence are more likely to survive after treatment compared to other causes of poisoning, including family disputes, love affairs, snakebites, and psychiatric disorders. The management of JOOTRH should consider allocating resources to support the development of poison management and control.

Dataset Information

Neurodevelopmental performance among pre-schoolers treated for severe anaemia at Lira Regional Referral Hospital, Uganda.

Background

Methods

Results

Conclusion

Publications

Neurodevelopmental performance among pre-schoolers treated for severe anaemia at Lira Regional Referral Hospital, Uganda.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets