Pre-hospital risk factors for inpatient death from severe febrile illness in Malian children.
<h4>Background</h4>Inpatient case fatality from severe malaria remains high in much of sub-Saharan Africa. The majority of these deaths occur within 24 hours of admission, suggesting that pre-hospital management may have an impact on the risk of case fatality.<h4>Methods</h4>...
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2014
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oai:doaj.org-article:a0497d0661c74c83b0cb960e4ff344792021-11-25T06:06:43ZPre-hospital risk factors for inpatient death from severe febrile illness in Malian children.1932-620310.1371/journal.pone.0102530https://doaj.org/article/a0497d0661c74c83b0cb960e4ff344792014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25075623/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Inpatient case fatality from severe malaria remains high in much of sub-Saharan Africa. The majority of these deaths occur within 24 hours of admission, suggesting that pre-hospital management may have an impact on the risk of case fatality.<h4>Methods</h4>Prospective cohort study, including questionnaire about pre-hospital treatment, of all 437 patients admitted with severe febrile illness (presumed to be severe malaria) to the paediatric ward in Sikasso Regional Hospital, Mali, in a two-month period.<h4>Findings</h4>The case fatality rate was 17.4%. Coma, hypoglycaemia and respiratory distress at admission were associated with significantly higher mortality. In multiple logistic regression models and in a survival analysis to examine pre-admission risk factors for case fatality, the only consistent and significant risk factor was sex. Girls were twice as likely to die as boys (AOR 2.00, 95% CI 1.08-3.70). There was a wide variety of pre-hospital treatments used, both modern and traditional. None had a consistent impact on the risk of death across different analyses. Reported use of traditional treatments was not associated with post-admission outcome.<h4>Interpretation</h4>Aside from well-recognised markers of severity, the main risk factor for death in this study was female sex, but this study cannot determine the reason why. Differences in pre-hospital treatments were not associated with case fatality.Merlin L WillcoxMoussa I DickoBertrand GrazMathieu ForsterBethany ShinkinsChiaka DiakiteSergio GianiJacques FalquetDrissa DialloEugène DembéléPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 7, p e102530 (2014) |
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Medicine R Science Q Merlin L Willcox Moussa I Dicko Bertrand Graz Mathieu Forster Bethany Shinkins Chiaka Diakite Sergio Giani Jacques Falquet Drissa Diallo Eugène Dembélé Pre-hospital risk factors for inpatient death from severe febrile illness in Malian children. |
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<h4>Background</h4>Inpatient case fatality from severe malaria remains high in much of sub-Saharan Africa. The majority of these deaths occur within 24 hours of admission, suggesting that pre-hospital management may have an impact on the risk of case fatality.<h4>Methods</h4>Prospective cohort study, including questionnaire about pre-hospital treatment, of all 437 patients admitted with severe febrile illness (presumed to be severe malaria) to the paediatric ward in Sikasso Regional Hospital, Mali, in a two-month period.<h4>Findings</h4>The case fatality rate was 17.4%. Coma, hypoglycaemia and respiratory distress at admission were associated with significantly higher mortality. In multiple logistic regression models and in a survival analysis to examine pre-admission risk factors for case fatality, the only consistent and significant risk factor was sex. Girls were twice as likely to die as boys (AOR 2.00, 95% CI 1.08-3.70). There was a wide variety of pre-hospital treatments used, both modern and traditional. None had a consistent impact on the risk of death across different analyses. Reported use of traditional treatments was not associated with post-admission outcome.<h4>Interpretation</h4>Aside from well-recognised markers of severity, the main risk factor for death in this study was female sex, but this study cannot determine the reason why. Differences in pre-hospital treatments were not associated with case fatality. |
format |
article |
author |
Merlin L Willcox Moussa I Dicko Bertrand Graz Mathieu Forster Bethany Shinkins Chiaka Diakite Sergio Giani Jacques Falquet Drissa Diallo Eugène Dembélé |
author_facet |
Merlin L Willcox Moussa I Dicko Bertrand Graz Mathieu Forster Bethany Shinkins Chiaka Diakite Sergio Giani Jacques Falquet Drissa Diallo Eugène Dembélé |
author_sort |
Merlin L Willcox |
title |
Pre-hospital risk factors for inpatient death from severe febrile illness in Malian children. |
title_short |
Pre-hospital risk factors for inpatient death from severe febrile illness in Malian children. |
title_full |
Pre-hospital risk factors for inpatient death from severe febrile illness in Malian children. |
title_fullStr |
Pre-hospital risk factors for inpatient death from severe febrile illness in Malian children. |
title_full_unstemmed |
Pre-hospital risk factors for inpatient death from severe febrile illness in Malian children. |
title_sort |
pre-hospital risk factors for inpatient death from severe febrile illness in malian children. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2014 |
url |
https://doaj.org/article/a0497d0661c74c83b0cb960e4ff34479 |
work_keys_str_mv |
AT merlinlwillcox prehospitalriskfactorsforinpatientdeathfromseverefebrileillnessinmalianchildren AT moussaidicko prehospitalriskfactorsforinpatientdeathfromseverefebrileillnessinmalianchildren AT bertrandgraz prehospitalriskfactorsforinpatientdeathfromseverefebrileillnessinmalianchildren AT mathieuforster prehospitalriskfactorsforinpatientdeathfromseverefebrileillnessinmalianchildren AT bethanyshinkins prehospitalriskfactorsforinpatientdeathfromseverefebrileillnessinmalianchildren AT chiakadiakite prehospitalriskfactorsforinpatientdeathfromseverefebrileillnessinmalianchildren AT sergiogiani prehospitalriskfactorsforinpatientdeathfromseverefebrileillnessinmalianchildren AT jacquesfalquet prehospitalriskfactorsforinpatientdeathfromseverefebrileillnessinmalianchildren AT drissadiallo prehospitalriskfactorsforinpatientdeathfromseverefebrileillnessinmalianchildren AT eugenedembele prehospitalriskfactorsforinpatientdeathfromseverefebrileillnessinmalianchildren |
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1718414179151380480 |