Logo of archdischArchives of Disease in ChildhoodVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Arch Dis Child. 2003 May; 88(5): 438–443.
PMCID: PMC1719579

Causes and outcome of young infant admissions to a Kenyan district hospital

Abstract

Aims: To provide a comprehensive description of young infant admissions to a first referral level health facility in Kenya. These data, currently lacking, are important given present efforts to standardise their care through the integrated management of childhood illness (IMCI) and for prioritising both health care provision and disease prevention strategies.

Methods: Prospective, 18 month observational study in a Kenyan district hospital of all admissions less than 3 months of age to the paediatric ward.

Results: A total of 1080 infants were studied. Mortality was 18% overall, though in those aged 0–7 days it was 34%. Within two months of discharge a further 5% of infants aged <60 days on admission had died. Severe infection and prematurity together accounted for 57% of inpatient deaths in those aged <60 days, while jaundice and tetanus accounted for another 27%. S pneumoniae, group B streptococcus, E coli, and Klebsiella spp. were the most common causes of invasive bacterial disease. Hypoxaemia, hypoglycaemia, and an inability to feed were each present in more than 20% of infants aged 0–7 days. Both hypoxaemia and the inability to feed were associated with inpatient death (OR 3.8 (95% CI 2.5 to 5.8) and 7.4 (95% CI 4.8 to 11.2) respectively).

Conclusions: Young infants contribute substantially to paediatric inpatient mortality at the first referral level, highlighting the need both for basic supportive care facilities and improved disease prevention strategies.

Full Text

The Full Text of this article is available as a PDF (128K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Slutsker L, Bloland P, Steketee RW, Wirima JJ, Heymann DL, Breman JG. Infant and second-year mortality in rural Malawi: causes and descriptive epidemiology. Am J Trop Med Hyg. 1996;55(1 Suppl):77–81. [PubMed]
  • Snow RW, Armstrong JR, Forster D, Winstanley MT, Marsh VM, Newton CR, Waruiru C, Mwangi I, Winstanley PA, Marsh K. Childhood deaths in Africa: uses and limitations of verbal autopsies. Lancet. 1992 Aug 8;340(8815):351–355. [PubMed]
  • Nathoo KJ, Mason PR, Chimbira TH. Neonatal septicaemia in Harare Hospital: aetiology and risk factors. The Puerperal Sepsis Study Group. Cent Afr J Med. 1990 Jun;36(6):150–156. [PubMed]
  • Petit PL, van Ginneken JK. Analysis of hospital records in four African countries, 1975-1990, with emphasis on infectious diseases. J Trop Med Hyg. 1995 Aug;98(4):217–227. [PubMed]
  • Meme JS. A prospective study of neonatal deaths in Nairobi, Kenya. East Afr Med J. 1978 Jun;55(6):262–267. [PubMed]
  • Owa JA, Olusanya O. Neonatal bacteraemia in Wesley Guild Hospital, Ilesha, Nigeria. Ann Trop Paediatr. 1988 Jun;8(2):80–84. [PubMed]
  • Costello AM. Perinatal health in developing countries. Trans R Soc Trop Med Hyg. 1993 Jan-Feb;87(1):1–2. [PubMed]
  • Ashworth A, Waterlow JC. Infant mortality in developing countries. Arch Dis Child. 1982 Nov;57(11):882–884. [PMC free article] [PubMed]
  • Stoll BJ. The global impact of neonatal infection. Clin Perinatol. 1997 Mar;24(1):1–21. [PubMed]
  • Leach A, McArdle TF, Banya WA, Krubally O, Greenwood AM, Rands C, Adegbola R, de Francisco A, Greenwood BM. Neonatal mortality in a rural area of The Gambia. Ann Trop Paediatr. 1999 Mar;19(1):33–43. [PubMed]
  • Parkin JM, Hey EN, Clowes JS. Rapid assessment of gestational age at birth. Arch Dis Child. 1976 Apr;51(4):259–263. [PMC free article] [PubMed]
  • Bloland P, Slutsker L, Steketee RW, Wirima JJ, Heymann DL, Breman JG. Rates and risk factors for mortality during the first two years of life in rural Malawi. Am J Trop Med Hyg. 1996;55(1 Suppl):82–86. [PubMed]
  • Duke Trevor, Michael Audrey, Mgone Joyce, Frank Dale, Wal Tilda, Sehuko Rebecca. Etiology of child mortality in Goroka, Papua New Guinea: a prospective two-year study. Bull World Health Organ. 2002;80(1):16–25. [PMC free article] [PubMed]
  • Duke T, Willie L, Mgone JM. The effect of introduction of minimal standards of neonatal care on in-hospital mortality. P N G Med J. 2000 Mar-Jun;43(1-2):127–136. [PubMed]
  • Daoud AS, Abuekteish F, Obeidat A, el-Nassir Z, al-Rimawi H. The changing face of neonatal septicaemia. Ann Trop Paediatr. 1995;15(1):93–96. [PubMed]
  • Fischer GW, Ottolini MG, Mond JJ. Prospects for vaccines during pregnancy and in the newborn period. Clin Perinatol. 1997 Mar;24(1):231–249. [PubMed]
  • Brair ME, Brabin BJ, Milligan P, Maxwell S, Hart CA. Reduced transfer of tetanus antibodies with placental malaria. Lancet. 1994 Jan 22;343(8891):208–209. [PubMed]
  • George SM, Latham MC, Abel R, Ethirajan N, Frongillo EA., Jr Evaluation of effectiveness of good growth monitoring in south Indian villages. Lancet. 1993 Aug 7;342(8867):348–352. [PubMed]
  • Bang AT, Bang RA, Baitule SB, Reddy MH, Deshmukh MD. Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet. 1999 Dec 4;354(9194):1955–1961. [PubMed]
  • Taha TE, Gray RH, Abdelwahab MM. Determinants of neonatal mortality in central Sudan. Ann Trop Paediatr. 1993;13(4):359–364. [PubMed]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Group

Formats:

Save items

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • PubMed
    PubMed
    PubMed citations for these articles
  • Taxonomy
    Taxonomy
    Taxonomy records associated with the current articles through taxonomic information on related molecular database records (Nucleotide, Protein, Gene, SNP, Structure).
  • Taxonomy Tree
    Taxonomy Tree

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...