In-hospital mortality attributable to severe anaemia and associated clinical signs in children admitted at hospitals in Bushenyi district

Abstract

Severe anaemia is one of the important causes of admissions and deaths among children in majority of African countries, especially in Sub-Saharan Africa. East Africa is one of the regions that have the highest burden of anaemia in the world. In Uganda, severe anaemia complicates one third of hospital admissions and with associated increased mortality. Many of the studies on severe anaemia which have done in Uganda are community based and on specific populations like HIV infected children. This study described the in-hospital mortality attributable to severe anaemia and associated clinical signs among children admitted at all hospitals in Bushenyi district. This was a cross sectional descriptive and analytical study that consecutively enrolled 225 children aged 2 months to 12 years admitted at hospitals in Bushenyi district, Kampala International University Teaching Hospital, Comboni Hospital and Ishaka Adventist Hospital from April 2017 to December 2017. Data was collected using a structured questionnaire and analyzed using STATA version 14. We determined the proportion of children who had severe anaemia and died in the course of admission and the clinical signs at admission that were associated with mortality using bivariate and multivariate logistic regression. The proportion of severely anaemia children who died was 8.4%. The clinical signs at admission that were independently associated with mortality were coma [aOR=5.97, (95%CI, 1.94-18.36), p=<0.002] and tachypnea [aOR=6.02, (95%CI, 1.44-25.14), p=<0.014]. The in-hospital mortality attributable to severe anaemia among children admitted to hospitals in Bushenyi district is high. The clinical signs at admission that were significantly associated with mortality were tachypnea and coma. We therefore recommend that clinicians should routinely do hemoglobin concentration screening for all admitted children and give the appropriate emergency and long term management. Clinicians may use coma and tachycardia to triage severely anaemic children.