TITLE:
Characteristics of Deaths of Children in the Pediatrics Department of Hôpital Spécialisé Mère-Enfant Blanche Gomes (Republic of the Congo) from 2019 to 2021
AUTHORS:
Pascal Diogène Bingui Outman, Nelly Sandrine Guembo Pandzou, Rolyne Vanissia Madzou Nganie, Verlem Bomelefa-Bomel, Benoite Diatewa, Kadidja Grace Nkounkou Milandou, Jean Brice Mouendenguia, Luopou Lamah, Audrey Niangui-Bakala, Dorthéa Banga Massalat, Rel Gérald Boukaka Kala, Jean Robert Mabiala Babela
KEYWORDS:
Death, Children, Associated Factors, Brazzaville
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.13 No.4,
July
28,
2023
ABSTRACT: Introduction: The United
Nations Sustainable Development Goals (SDGs) aim to decrease the global
maternal mortality ratio to below 70 per 100,000 live births and eliminate
preventable deaths of newborns and children under the age of five in all
countries by 2030. The pediatric department at Spécialisé Mère-Enfant Blanche
Gomes Hospital (HSMEBG) is divided into two sectors, one catering to children
aged one month to four years and the other dedicated to children aged five to
17 years. According to department records, over the past three years, there has
been an average of 1050 hospitalizations per year, with an average duration of
five days. Objectives: This study aims to describe the socio-demographic
characteristics of children who died while in the pediatrics department of the
HSMEBG and analyze the factors associated with their deaths. Methodology: A retrospective analytical cross-sectional study was conducted, collecting data
over a three-year period, covering the years 2019, 2020 and 2021. Data were
collected from medical records of deceased children using Excel software
version 2016, and statistical calculations and
logistic regression were performed using Epi info software version 7.2.5.0. Results: During the three years of operation, the pediatric department at HSMEBG
recorded 3060 new admissions, of which 271 resulted in death, representing an
overall frequency of 8.8%. December and January had the highest mortality
rates, accounting for 15.5% and 12.5%, respectively. Out of the 271 recorded
deaths, 143 (52.77%) occurred in children under the age of one, and 230
(84.87%) occurred in children under the age of five. The average age at death
was 2.4 years, ranging from one month to 17 years. The sex ratio was 1. More
than half of the deaths (51.66%) occurred during the night, and 165 (60.89%)
sought medical help more than three days after the onset of symptoms. Weekend
deaths accounted for nearly half (45.7%) of the cases. Upon admission, slightly
over half of the children (55.72%) had impaired consciousness, 219 (80.81%)
presented with respiratory distress, and 194 (71.59%) had a fever. The average
time from admission to administering the first
medication was 72 minutes. Respiratory infections were the leading cause of
death, accounting for 83 (30.26%) cases, followed by severe forms of malaria
(anemic and neurological) at 23.25%. Among the 271 recorded deaths, 33 (12.18%)
received no treatment before their demise, and 136 (50.18%) died within the
first 24 hours of hospitalization. The average duration of hospitalization for
patients who spent less than 24 hours was 15 hours, while those who died after
the 24th hour had an average hospital stay of five days, ranging from one to 41
days. Children under the age of five who were admitted with impaired
consciousness had roughly double the risk of dying compared to those without
this condition (p = 0.001). Conclusion: The overall mortality rate in
the pediatric department at HSMEBG is 8.8%. Acute respiratory infections are
the primary cause of death. Improving this rate necessitates reducing
consultation and treatment durations.