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Etiology of hospital mortality in children living in low-and middle-income countries: a systematic review and meta-analysis Kortz, Teresa B; Mediratta, Rishi; Smith, Audrey M; Nielsen, Katie R; Agulnik, Asya; Gordon Rivera, Stephanie; Reeves, Hailey; O'Brien, Nicole F; Hau Lee, Jan; Abbas, Qalab; Attebery, Jonah E; Bacha, Tigist; Bhutta, Emaan G; Biewen, Carter; Camacho-Cruz, Jhon; Munoz, Alvaro Coronado; DeAlmeida, Mary L; Domeryo Owusu, Larko; Fonseca, Yudy; Hooli, Shubhada; Johnson, Hunter C; Leimanis-Laurens, Mara; Mally, Deogratisu Nicholaus; McCarthy, Amanda M; Mutekanga, Andrew; Pineda, Carol; Remy, Kenneth E; Sanders, Sara C.; Tabor, Erica; Rodrigues Teixeira, Adriana; Qi Jyuee Want, Justin; Kissoon, Niranjan; Takwoingi, Yemisi; Wiens, Matthew O; Bhutta, Adnan

Description

<br/><strong>Background:</strong> In 2019, 80% of the 7.4 million global child deaths occurred in low- and middle-income countries (LMICs). Global and regional estimates of cause of hospital death and admission in LMIC children are needed to guide global and local priority setting and resource allocation but are currently lacking. The study objective was to estimate global and regional prevalence for common causes of pediatric hospital mortality and admission in LMICs.<br /> <br /><strong>Methods:</strong> We performed a systematic review and meta-analysis to identify LMIC observational studies published January 1, 2005-February 26, 2021. Eligible studies included: a general pediatric admission population, a cause of admission or death, and total admissions. We excluded studies with data before 2000 or without a full text. Two authors independently screened and extracted data. We performed methodological assessment using domains adapted from the Quality in Prognosis Studies tool. Data were pooled using random-effects models where possible. We reported prevalence as a proportion of cause of death or admission per 1000 admissions with 95% confidence intervals (95%CI).<br /> <br /><strong>Findings:</strong> ur search identified 29,637 texts. After duplicate removal and screening, we analyzed 253 studies representing 21.8 million pediatric hospitalizations in 59 LMICs. All-cause pediatric hospital mortality was 4.1% [95%CI 3.4-4.7%]. The most common causes of mortality (deaths/1000 admissions) were infectious (12 [95%CI 9-14]); respiratory (9 [95%CI 5-13]); and gastrointestinal (9 [95%CI 6-11]). Common causes of admission (cases/1000 admissions) were respiratory (255 [95%CI 231-280]); infectious (214 [95%CI193-234]); and gastrointestinal (166 [95%CI 143-190]). We observed regional variation in estimates. Pediatric hospital mortality remains high in LMICs.<br /> <br /><strong>Implications:</strong> Global child health efforts must include measures to reduce hospital mortality including basic emergency and critical care services tailored to the local disease burden. Resources are urgently needed to promote equity in child health research, support researchers, and collect high-quality data in LMICs to further guide priority setting and resource allocation.<br />; <br /><strong>NOTE for restricted files:</strong> If you are not yet a CoLab member, please complete our <a href = "https://rc.bcchr.ca/redcap/surveys/?s=EDCYL7AC79">membership application survey</a> to gain access to restricted files within 2 business days. <br />Some files may remain restricted to CoLab members. These files are deemed more sensitive by the file owner and are meant to be shared on a case-by-case basis. Please contact the CoLab coordinator at <a href = mailto:sepsiscolab@bccchr.ca>sepsiscolab@bcchr.ca</a> or visit our <a href = "https://wfpiccs.org/pediatric-sepsis-colab/">website</a>.

Item Metadata

Title
Etiology of hospital mortality in children living in low-and middle-income countries: a systematic review and meta-analysis
Creator
Kortz, Teresa B; Mediratta, Rishi; Smith, Audrey M; Nielsen, Katie R; Agulnik, Asya; Gordon Rivera, Stephanie; Reeves, Hailey; O'Brien, Nicole F; Hau Lee, Jan; Abbas, Qalab; Attebery, Jonah E; Bacha, Tigist; Bhutta, Emaan G; Biewen, Carter; Camacho-Cruz, Jhon; Munoz, Alvaro Coronado; DeAlmeida, Mary L; Domeryo Owusu, Larko; Fonseca, Yudy; Hooli, Shubhada; Johnson, Hunter C; Leimanis-Laurens, Mara; Mally, Deogratisu Nicholaus; McCarthy, Amanda M; Mutekanga, Andrew; Pineda, Carol; Remy, Kenneth E; Sanders, Sara C.; Tabor, Erica; Rodrigues Teixeira, Adriana; Qi Jyuee Want, Justin; Kissoon, Niranjan; Takwoingi, Yemisi; Wiens, Matthew O; Bhutta, Adnan
Contributor
Trawin, Jessica
Date Issued
2024-06-12
Description
<br/><strong>Background:</strong> In 2019, 80% of the 7.4 million global child deaths occurred in low- and middle-income countries (LMICs). Global and regional estimates of cause of hospital death and admission in LMIC children are needed to guide global and local priority setting and resource allocation but are currently lacking. The study objective was to estimate global and regional prevalence for common causes of pediatric hospital mortality and admission in LMICs.<br /> <br /><strong>Methods:</strong> We performed a systematic review and meta-analysis to identify LMIC observational studies published January 1, 2005-February 26, 2021. Eligible studies included: a general pediatric admission population, a cause of admission or death, and total admissions. We excluded studies with data before 2000 or without a full text. Two authors independently screened and extracted data. We performed methodological assessment using domains adapted from the Quality in Prognosis Studies tool. Data were pooled using random-effects models where possible. We reported prevalence as a proportion of cause of death or admission per 1000 admissions with 95% confidence intervals (95%CI).<br /> <br /><strong>Findings:</strong> ur search identified 29,637 texts. After duplicate removal and screening, we analyzed 253 studies representing 21.8 million pediatric hospitalizations in 59 LMICs. All-cause pediatric hospital mortality was 4.1% [95%CI 3.4-4.7%]. The most common causes of mortality (deaths/1000 admissions) were infectious (12 [95%CI 9-14]); respiratory (9 [95%CI 5-13]); and gastrointestinal (9 [95%CI 6-11]). Common causes of admission (cases/1000 admissions) were respiratory (255 [95%CI 231-280]); infectious (214 [95%CI193-234]); and gastrointestinal (166 [95%CI 143-190]). We observed regional variation in estimates. Pediatric hospital mortality remains high in LMICs.<br /> <br /><strong>Implications:</strong> Global child health efforts must include measures to reduce hospital mortality including basic emergency and critical care services tailored to the local disease burden. Resources are urgently needed to promote equity in child health research, support researchers, and collect high-quality data in LMICs to further guide priority setting and resource allocation.<br />; <br /><strong>NOTE for restricted files:</strong> If you are not yet a CoLab member, please complete our <a href = "https://rc.bcchr.ca/redcap/surveys/?s=EDCYL7AC79">membership application survey</a> to gain access to restricted files within 2 business days. <br />Some files may remain restricted to CoLab members. These files are deemed more sensitive by the file owner and are meant to be shared on a case-by-case basis. Please contact the CoLab coordinator at <a href = mailto:sepsiscolab@bccchr.ca>sepsiscolab@bcchr.ca</a> or visit our <a href = "https://wfpiccs.org/pediatric-sepsis-colab/">website</a>.
Subject
Medicine, Health and Life Sciences; Global Health; Resource-limited settings; Low-and middle-income countries; Pediatric; Hospital death; Hospital admission; Accute Illness; Critical Illness
Type
Dataset
Language
English
Date Available
2024-05-28
Provider
University of British Columbia Library
License
CC BY-NC-SA 4.0
DOI
10.14288/1.0443957
URI
https://doi.org/10.5683/SP3/2UKUKW
Publisher DOI
https://doi.org/10.5683/SP3/2UKUKW
Grant Funding Agency
ational Institute of Allergy and Infectious Diseases; National Institutes of Health (NIH), the Conquer Cancer Foundation (AA), the National Cancer Institute; Eunice Kennedy Shriver National Institute of Child Health and Human Development; National Institute of General Medical Sciences; Fogarty International Center; American Lung Association; National Medical Research Council, Singapore; National Institute for Health Research, Birmingham Biomedical Research Centre of the National Health Services
Rights URI
http://creativecommons.org/licenses/by-nc-sa/4.0
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CC BY-NC-SA 4.0