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TITLE:

MORTALITY AFTER INPATIENT TREATMENT FOR DIARRHEA IN CHILDREN: A COHORT STUDY

AUTHORS:

Dr.Samra Asif, Dr.mevish Altaf Dr.Tayyaba Asma

ABSTRACT:

Background: Children remaining at higher risk of death following discharge from health facilities in resource-poor conditions and settings the awareness is increasing. Diarrhoea has previously been highlighted as a risk factor for post-discharge mortality. Methods: This retrospective study was undertaken to estimate the incidence and demographic, clinical, and biochemical features associated with inpatient and 1-year post-discharge mortality amongst children aged 2–59 months admitted with diarrhoea from December 2017 to 2019 in mayo Hospital lahore . The method used to identify risk factors for inpatient mortality was Log-binomial regression. From the date of discharge to the date of death the time of risk, out-migration, or 365 days later. Post-discharge mortality rate was computed per 1000 child-years of observation, and Cox proportion regression used to identify risk factors for mortality. Results: Two thousand six hundred twenty-six child residents were admitted with diarrhoea, median age 13 (IQR 8–21) months, of which 415 (16%) were severely malnourished and 130 (5.0%) had a positive HIV test. 121 (4.6%) died in the hospital, and of 2505 children discharged alive, 49 (2.1%) died after discharge: that is 21.4 (95% CI 16.1–28.3) deaths per 1000 child-years. Admission with signs of both diarrhoea and severe pneumonia or severe pneumonia alone had a higher risk of both inpatient and post-discharge mortality than admission for diarrhoea alone. No significant difference was found in both inpatient and post-discharge mortality between children admitted with diarrhoea alone and those with others excluding severe pneumonia. HIV, low mid-upper arm circumference (MUAC), and bacteraemia were associated with both inpatient and post-discharge mortality. Age, stunted growth, and persistent or bloody diarrhoea were not associated with mortality before or after discharge. Conclusions: The results of this study highlight the need for more research should be undertaken to improve the uptake and outcomes of services for malnutrition to elucidate causal pathways and test interventions to mitigate these risks.

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