Demographic and mortality analysis of hospitalized children at a referral hospital in Addis Ababa, Ethiopia

Abstract

Background: Global childhood mortality rates remain high. Millennium Development Goal 4 focused efforts on reducing rates by two-thirds between 1990 and 2015. In Ethiopia, child mortality rates dropped 71 % from 1990 to 2015, however it is estimated that 184,000 Ethiopian children die each year. There is limited information about pediatric hospital admissions in Ethiopia. Our aims were to examine the temporal relationship of mortality to admission, describe the demographics, and identify cause mortality of children admitted to the Zewditu Memorial Hospital (ZMH). Methods: A four-year retrospective review of pediatric admissions was conducted at the pediatric emergency room and pediatric hospital ward at ZMH in Addis Ababa, Ethiopia. Admission entries from 2011-2014 of children age 29 days-14 years were reviewed. Age, gender, admission date, disease classification, discharge status and date were obtained. Patient gender was compared using Chi-square analysis. A descriptive analysis was used for age and cause mortality. Conclusions: Our study revealed a lower mortality rate than previously reported in Ethiopia. Despite this, 44 % of pediatric hospital mortality occurred early during hospitalization, higher than reported at other Ethiopian hospitals. This adds further evidence that systematic efforts should be dedicated to improve pediatric emergency care. Admissions included 58 % male patients, similar to other reports in Ethiopia implying that this may be a nation-wide phenomenon. The observed disparity may be due to societal factors regarding care-seeking behaviors or male predilection for respiratory illness warranting further investigation. Cause mortality patterns were similar to reports in analogous settings.

Sex Disparities in Access to Surgical Care at a Single Institution in Malawi

“…Female children may present less frequently for general hospital conditions in Africa as well; research in Ethiopia and Ghana looking at pediatric admissions and treatment of fever demonstrates different treatment patterns and fewer admission for female patients. [16,17] Studies in Bangladesh, Pakistan, Botswana, and Malawi have demonstrated that women are less likely to seek surgical treatment for cataract surgery, are more likely to present in a delayed fashion, and are more likely to have worse ophthalmologic outcomes than do men [10,[12][13][14].…”

“…A recent review of emergency general surgery cases in the USA demonstrated that 46% of patients were male and 54% were female [9]. Few investigations have evaluated sex disparities among surgical populations in resource-poor settings [10][11][12][13][14][15][16].…”