Increased mortality in the year following discharge from a paediatric ward in Bissau, Guinea‐Bissau

Abstract

There was a marked increase in mortality after hospitalization, the effect being particularly strong for children who fled the hospital. Improved discharge and follow-up policies might have an important impact on survival after paediatric hospitalization. Studies on the effect of focused intervention at discharge are needed.

Long term mortality after community and facility based treatment of severe acute malnutrition: Analysis of data from Bangladesh, Kenya, Malawi and Niger

“…Studies have shown that long term survival of children discharged after treatment for malaria, diarrhoea and respiratory infection may be worse than that reported here for children discharged from therapeutic feeding programmes (Islam et al, 1996;Phiri et al, 2008;Roy et al, 1983;Snow et al, 2000;Veirum et al, 2007;West et al, 1999). Indeed, in Bangladesh an incidence mortality rate of 465 deaths per 1000 PY has been reported in children followed in the community after recovery from acute diarrhoea (Islam et al, 1996).…”

“…This is much higher than the figure of 25.3 deaths per 1000 PY for SAM reported in this paper for the same country (Khanum et al, 1998). In a study in Guinea-Bissau, Veirum et al (2007) also showed that the post hospital discharge period, especially the first 3 to 12 months, was a critical period for children when compared to the level of mortality in the community. In their study, children discharge from hospital had increased risk of dying, varying between 2.5 and 12 times depending on the duration of the period of observation (Veirum et al, 2007).…”

“…In a study in Guinea-Bissau, Veirum et al (2007) also showed that the post hospital discharge period, especially the first 3 to 12 months, was a critical period for children when compared to the level of mortality in the community. In their study, children discharge from hospital had increased risk of dying, varying between 2.5 and 12 times depending on the duration of the period of observation (Veirum et al, 2007). In the Veirum et al (2007) study, all the common childhood diseases were associated with excess long term mortality, but as in the Snow et al (2000) Kenyan study diarrhoea had the highest level of mortality excess, up to 3.3 times higher than that of the general under-five population (Veirum et al, 2007;West et al, 1999).…”

“…In their study, children discharge from hospital had increased risk of dying, varying between 2.5 and 12 times depending on the duration of the period of observation (Veirum et al, 2007). In the Veirum et al (2007) study, all the common childhood diseases were associated with excess long term mortality, but as in the Snow et al (2000) Kenyan study diarrhoea had the highest level of mortality excess, up to 3.3 times higher than that of the general under-five population (Veirum et al, 2007;West et al, 1999). All these figures are higher than most of those reported for SAM in this paper.…”

Pediatric out-of-hospital deaths following hospital discharge: a mixed-methods study

“…This relationship is of critical importance since previous research has shown that most children who die following discharge do not successfully return to the hospital for care prior to death. 3 Post-discharge death in children is increasingly being recognized as a major contributor to overall child mortality. Several factors, including inadequate health seeking behavior and poor access to hospital care, were responsible for the high occurrence of out of hospital death among children with ARIs.…”