Are Pediatric Wards in Developing Countries Only Places to Die? A study of prior to hospitalization risk factors of death among 0-2 year old hospitalized children in Niamey, capital of Niger

Abstract

The 461 0-2-year-old children admitted to the paediatric ward of the National Hospital in Niamey over a 2-month period were closely followed up from admission to discharge or death. The in-hospital mortality rate was 30 per cent, a great proportion of deaths occurring during the first 24 h of hospitalization. Malnutrition was highly prevalent (76 per cent). Children referred from other health facilities (72 per cent) did not experience a higher probability of survival. Using multivariate analysis, three variables remained significantly associated with death: nutritional status, consultation of a traditional practitioner, and a neonate disease. Neonate diseases are the third major cause of death because of a high case fatality rate. For the other causes, the main underlying factor is malnutrition. Most in-hospital deaths are due to events that occurred prior to hospitalization. The role of hospitals' pediatric wards of developing countries is discussed.

A review of the literature from developed and developing countries relating to the effects of hospitalization on children and parents

“…There is meagre literature about the care of children in hospitals in developing countries. Where it does exist, it usually covers topics such as morbidity and/or mortality of certain diseases (Nakamura 1992; Choudhury et al 1990; Gamatie et al 1994; Loro et al 1994), the use of technology (Basch 1993; Perry & Marx 1992) and services for disabled children (Wallace 1991). Nursing in developing countries has been discussed, usually by nurses from developed countries who visit to teach nursing (Toyoshima 1994; Conrad 1997) or to develop research programmes (Kirkpatrick 1990; Mangay‐Maglacas 1992).…”

The impact of the human immunodeficiency virus type 1 on the management of severe malnutrition in Malawi

“…2 This in-hospital mortality rate is similar to that of other low-income countries in Africa. 3,4 It is associated with late presentation of severe disease, over-crowded and under-resourced wards, unreliable supplies of food and a lack of important micronutrients such as zinc and potassium. As the World Food Programme (WFP) gradually withdraws support of nutrition units in Malawi, there is increasing pressure to rationalise the use of available nutritional supplies and resources.…”

Length of stay is associated with incidence of in-hospital malnutrition in a group of low-income Brazilian children

“…[8][9][10] However, there is a vast international literature on the topic. 2,4,7,[11][12][13] The development of studies focusing on this topic in Brazil would be important to define more precisely clinical protocols for nutritional management during admission and hospitalization.…”