Abstract
An effective pediatric emergency care (PEC) system is key to reduce pediatric mortality in low-income countries. While data on pediatric emergencies from these countries can drive the development and adjustment of such a system, they are very scant, especially from Africa. We aimed to describe the characteristics and outcomes of presentations to a tertiary-care Pediatric Emergency Department (PED) in Mozambique. We retrospectively reviewed PED presentations to the "Hospital Central da Beira" between April 2017 and March 2018. Multivariable logistic regression was used to identify predictors of hospitalization and death. We retrieved 24,844 presentations. The median age was 3 years (IQR 1-7 years), and 92% lived in the urban area. Complaints were injury-related in 33% of cases and medical in 67%. Data on presenting complaints (retrieved from hospital paper-based registries) were available for 14,204 (57.2%) records. Of these, respiratory diseases (29.3%), fever (26.7%), and gastrointestinal disorders (14.2%) were the most common. Overall, 4,997 (20.1%) encounters resulted in hospitalization. Mortality in the PED was 1.6% (62% ≤4 hours from arrival) and was the highest in neonates (16%; 89% ≤4 hours from arrival). A younger age, especially younger than 28 days, living in the extra-urban area and being referred to the PED by a health care provider were all significantly associated with both hospitalization and death in the PED at the multivariable analysis. Injuries were a common presentation to a referral PED in Mozambique. Hospitalization rate and mortality in the PED were high, with neonates being the most vulnerable. Optimization of data registration will be key to obtain more accurate data to learn from and guide the development of PEC in Mozambique. Our data can help build an effective PEC system tailored to the local needs.
Highlights
Over the last two decades, child mortality significantly decreased worldwide thanks to the development of the Millennium Development Goals (MDGs) and the Sustainable Development Goals (SDGs), elaborated by the United Nations to reduce healthcare disparities [1,2,3,4,5]
A younger age, especially younger than 28 days, living in the extra-urban area and being referred to the Pediatric Emergency Department (PED) by a health care provider were all significantly associated with both hospitalization and death in the PED at the multivariable analysis
Injuries were a common presentation to a referral PED in Mozambique
Summary
Over the last two decades, child mortality significantly decreased worldwide thanks to the development of the Millennium Development Goals (MDGs) and the Sustainable Development Goals (SDGs), elaborated by the United Nations to reduce healthcare disparities [1,2,3,4,5]. Child mortality remains high in low-income countries (LICs) and, in particular, in Sub-Saharan Africa [6, 7]. The development of efficacious pediatric emergency care services has been identified as one of the crucial steps to reduce child mortality [8,9,10]. The study of the burden and profile of pediatric emergencies is important to understand how to optimize resource allocation and healthcare facilities to develop a structured emergency care system that could further reduce child mortality. In Mozambique, as in other sub-Saharan countries, the health care system is extremely diverse. Two of the four tertiary-care referral hospitals have a Pediatric Emergency Department (PED), one of which is in Beira, the capital of the Province of Sofala. An effective pediatric emergency care (PEC) system is key to reduce pediatric mortality in low-income countries.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
