Risk Factors for Death in Bangladeshi Children Under 5 Years of Age Hospitalized for Diarrhea and Severe Respiratory Distress in an Urban Critical Care Ward

Alam, Tahmina; Ahmed, Tahmeed; Sarmin, Monira; Shahrin, Lubaba; Afroze, Farzana; Sharifuzzaman, Md.; Akhter, Shamima; Shahunja, K. M.; Shahid, Abu Sadat Mohammad Sayeem Bin; Bardhan, Pradip Kumar; Chisti, Mohammod Jobayer

doi:10.1177/2333794x17696685

Cited by 10 publications

(14 citation statements)

References 12 publications

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“…A high AG metabolic acidosis has also been described in diarrheic children and infants [ 30 , 31 ]. The presence of severe malnutrition, clinical dehydration, sepsis, pneumonia or respiratory distress, drowsiness, meningitis, abdominal distention, and absent peripheral pulses, as well as hypoglycemia, hypoxemia, hypoalbuminemia, hyponatremia and hypernatremia, have been identified as independent predictors of death in diarrheic children [ 28 , 32 – 35 ]. These results suggest that the prognostic accuracy can be improved in diarrheic children when clinical signs are evaluated in combination with laboratory values, instead of basing prognosis only on the results of laboratory analysis.…”

Section: Introductionmentioning

confidence: 99%

Clinical signs, profound acidemia, hypoglycemia, and hypernatremia are predictive of mortality in 1,400 critically ill neonatal calves with diarrhea

et al. 2017

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Profound acidemia impairs cellular and organ function and consequently should be associated with an increased risk of mortality in critically ill humans and animals. Neonatal diarrhea in calves can result in potentially serious metabolic derangements including profound acidemia due to strong ion (metabolic) acidosis, hyper-D-lactatemia, hyper-L-lactatemia, azotemia, hypoglycemia, hyperkalemia and hyponatremia. The aim of this retrospective study was to assess the prognostic relevance of clinical and laboratory findings in 1,400 critically ill neonatal calves with diarrhea admitted to a veterinary teaching hospital. The mortality rate was 22%. Classification tree analysis indicated that mortality was associated with clinical signs of neurologic disease, abdominal emergencies, cachexia, orthopedic problems such as septic arthritis, and profound acidemia (jugular venous blood pH < 6.85). When exclusively considering laboratory parameters, classification tree analysis identified plasma glucose concentrations < 3.2 mmol/L, plasma sodium concentrations ≥ 151 mmol/L, serum GGT activity < 31 U/L and a thrombocyte count < 535 G/L as predictors of mortality. However, multivariable logistic regression models based on these laboratory parameters did not have a sufficiently high enough sensitivity (59%) and specificity (79%) to reliably predict treatment outcome. The sensitivity and specificity of jugular venous blood pH < 6.85 were 11% and 97%, respectively, for predicting non-survival in this study population. We conclude that laboratory values (except jugular venous blood pH < 6.85) are of limited value for predicting outcome in critically ill neonatal calves with diarrhea. In contrast, the presence of specific clinical abnormalities provides valuable prognostic information.

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Section: Introductionmentioning

confidence: 99%

Clinical signs, profound acidemia, hypoglycemia, and hypernatremia are predictive of mortality in 1,400 critically ill neonatal calves with diarrhea

et al. 2017

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“…In Bangladesh, 15% and 6% of 119,000 total under-5 children deaths are still due to diarrhoea and pneumonia diseases in 2015 [26]. Delay in seeking appropriate care and lack of access to multiple sources for treatment are recognized as the underlying risk factors for children death due to diarrhoea and pneumonia in Bangladesh in several research works [12,13]. Thus, government should focus on the effective interventions of proper life-saving treatment for the children with suspected pneumonia and diarrhoea to achieve the GDDP goals on reducing child mortality due to ARI and diarrhoea.…”

Section: Discussionmentioning

confidence: 99%

“…No study has also been found conducted at the sub-district or lower administrative units. Most of the studies of ICDDR'B are related to environmental and clinical risk factors of different types of diarrhoeal diseases [12,13]. Using BDHS data, there are studies on modelling diarrhoea or ARI prevalence based on logistic or logistic mixed model for determining their risk factors [14,15], not for prediction purpose since information of the risk factors are not available in the census data.…”

Section: Introductionmentioning

confidence: 99%

Identification of Disaggregated Hotspots of Child Morbidity in Bangladesh: An Application of Small Area Estimation Method

Kawsar

Das

Kumar

2019

Preprint

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Acute respiratory infection (ARI) and diarrhoea are two major causes of child morbidity and mortality in Bangladesh. National and regional level prevalence of ARI and diarrhoea are calculated from nationwide surveys; however, prevalence at micro-level administrative units (say, district and sub-district) is not possible due to lack of sufficient data. In such case, small area estimation (SAE) methods can be applied by combining a survey data with a census data.Using a SAE method for dichotomous response variable, this study aims to estimate the proportions of under-5 children experienced with ARI and diarrhoea separately as well as either ARI or diarrhoea within a period of two-week preceding the survey. The ARI and diarrhoea information extracted from Bangladesh Demographic and Health Survey 2011 are used to develop a random effect logistic model for each of the indicators, and then the prevalence is estimated adapting the World Bank SAE approach for the dichotomous response variable using the 5% data of the Census 2011. The estimated prevalence of each indicator significantly varied by district and sub-district (1.4-11.3% for diarrhoea, 2.2-11.8% for ARI and 4.3-16.5% for ARI/diarrhoea at sub-district level). In a number of districts and sub-district, the proportions are found double the national level. District and sub-district levels spatial distributions of the indicators might help the policy makers to identify the vulnerable disaggregated and remote hotspots. Particularly, aid industries can provide effective interventions at the highly vulnerable spots to overcome the gaps between micro and macro level administrative units.

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“…Diarrhea, one of the leading causes of death in children younger than five years, accounted for 9% of 5.8 million global deaths and 6% of 0.119 million deaths in Bangladesh in 2015 [34].…”

Section: Ceh In Bangladeshmentioning

confidence: 99%

Children’s Environmental Health in South and Southeast Asia: Networking for Better Child Health Outcomes

Sly

Trottier

Carpenter

et al. 2019

Annals of Global Health

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Children are particularly vulnerable to environmental hazards because they receive higher doses of pollutants in any given environment and often do not have equitable access to social protection mechanisms such as environmental and health care services. The World Health Organization established a global network of collaborating centres that address children’s environmental health (CEH). The network developed a focus on low- and middle-income countries (LMICs) and is broadening its reach by conducting regional workshops for CEH. Objective: This paper reports on the outcomes of a workshop held in conjunction with the 17th International Conference (November 2017) of the Pacific Basin Consortium for Environment and Health, focused on the state of CEH in South and Southeast Asia as presented by seven countries from the region (India, Bangladesh, Nepal, Bhutan, Vietnam, Thailand, Sri Lanka). Workshop outcomes: Country reports presented at the meeting show a high degree of similarity with respect to the issues threatening the health of children. The most common problems are outdoor and household air pollution in addition to exposure to heavy metals, industrial chemicals, and pesticides. Many children still do not have adequate access to clean water and improved sanitation while infectious diseases remain a problem, especially for children living in poverty. Child labour is widely prevalent, generally without adequate training or personal protective equipment. The children now face the dual burden of undernutrition and stunting on the one hand and overnutrition and obesity on the other. Conclusion: It is evident that some countries in these regions are doing better than others in varying areas of CEH. By establishing and participating in regional networks, countries can learn from each other and harmonise their efforts to protect CEH so that all can benefit from closer interactions.

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Risk Factors for Death in Bangladeshi Children Under 5 Years of Age Hospitalized for Diarrhea and Severe Respiratory Distress in an Urban Critical Care Ward

Cited by 10 publications

References 12 publications

Clinical signs, profound acidemia, hypoglycemia, and hypernatremia are predictive of mortality in 1,400 critically ill neonatal calves with diarrhea

Clinical signs, profound acidemia, hypoglycemia, and hypernatremia are predictive of mortality in 1,400 critically ill neonatal calves with diarrhea

Identification of Disaggregated Hotspots of Child Morbidity in Bangladesh: An Application of Small Area Estimation Method

Children’s Environmental Health in South and Southeast Asia: Networking for Better Child Health Outcomes

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