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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Autores principales: Merlin L Willcox, Moussa I Dicko, Bertrand Graz, Mathieu Forster, Bethany Shinkins, Chiaka Diakite, Sergio Giani, Jacques Falquet, Drissa Diallo, Eugène Dembélé
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Publicado: Public Library of Science (PLoS) 2014
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spelling 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)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle 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.
description <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
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