학술논문

Provider adherence to clinical care recommendations for infants and children who died in seven low- and middle-income countries in the Child Health and Mortality Prevention Surveillance (CHAMPS) networkResearch in context
Document Type
article
Author
Chris A. ReesKitiezo Aggrey IgunzaZachary J. MadewellVictor AkeloDickens OnyangoShams El ArifeenEmily S. GurleyMohammad Zahid HossainAfruna RahmanMuntasir AlamJ. Anthony G. ScottNega AssefaLola MadridAnteneh BelachewHaleluya LeulsegedKaren L. KotloffSamba O. SowMilagritos D. TapiaAdama Mamby KeitaDiakaridia SidibeAntonio SitoeRosauro VaroSara AjanovicQuique BassatInácio MandomandoBeth A. Tippett BarrIkechukwu OgbuanuCarrie Jo CainIma-Abasi BasseyRonita LukeKhadija GassamaShabir MadhiZiyaad DangorSana MahtabSithembiso VelaphiJeanie du ToitPortia C. MutevedziDianna M. BlauRobert F. BreimanCynthia G. WhitneyFatima SolomonGillian SorourHennie LombaardJeannette WadulaKaren PetersenMartin HaleNelesh P. GovenderPeter J. SwartSanjay G. LalaRichard ChawanaYasmin AdamAmy WiseAshleigh FritzNellie MyburghPedzisai NdagurwaCleopas HwinyaSanwarul BariShahana ParveenMohammed KamalA.S.M. Nawshad Uddin AhmedMahbubul HoqueSaria TasnimFerdousi IslamFarida AriumanMohammad Mosiur RahmanFerdousi BegumK. ZamanMustafizur RahmanDilruba AhmedMeerjady Sabrina FloraTahmina ShirinMahbubur RahmanJoseph OundoAlexander M. IbrahimFikremelekot TemesgenTadesse GureAddisu AlemuMelisachew Mulatu YeshiMahlet Abayneh GizawStian OrlienSolomon AliPeter OtienoPeter Nyamthimba OnyangoJanet AgayaRichard OliechJoyce Akinyi WereDickson GethiSammy KhagayiGeorge AolThomas MisoreHarun OwuorChristopher MugahBernard OluochChristine OcholaSharon M. TennantCarol L. GreeneAshka MehtaJ. Kristie JohnsonBrigitte GaumeRima KokaKaren D. FairchildDiakaridia KoneDoh SanogoUma U. OnwuchekwaNana KouroumaSeydou SissokoCheick Bougadari TraoreJane JumaKounandji DiarraAwa TraoreTiéman DiarraKiranpreet ChawlaTacilta NhampossaZara ManhiqueSibone MocumbiClara MenéndezKhátia MunguambeAriel NhacoloMaria MaixenchsAndrew MoserayFatmata Bintu TarawallyMartin SeppehRonald MashJulius OjulongBabatunde DuduyemiJames BunnAlim Swaray-DeenJoseph BanguraAmara JambaiMargaret MannahOkokon ItaCornell ChukwuegboSulaiman SannohPrincewill NwajiobiDickens KowuorErick KalumaOluseyi BalogunSolomon SamuraSamuel PrattFrancis MosesTom SesayJames SquireJoseph Kamanda SesayOsman KaykayBinyam HaluHailemariam LegesseFrancis SmartSartie KennehSoter AmehJana RitterTais WilsonJonas WinchellJakob WitherbeeNavit T. SalzbergJeffrey P. KoplanMargaret BasketAshutosh WadhwaKyu Han LeeValentine WangaRoosecelis MartinesShamta WarangMaureen DiazJessica WallerShailesh NairLucy LiuCourtney BursucKristin LaHatteSarah RaymerJohn BlevinsSolveig ArgeseanuKurt VyasManu Bhandari
Source
EClinicalMedicine, Vol 63, Iss , Pp 102198- (2023)
Subject
Childhood
Mortality
Clinical care
Guideline adherence
Medicine (General)
R5-920
Language
English
ISSN
2589-5370
Abstract
Summary: Background: Most childhood deaths globally are considered preventable through high-quality clinical care, which includes adherence to clinical care recommendations. Our objective was to describe adherence to World Health Organization recommendations for the management of leading causes of death among children. Methods: We conducted a retrospective, descriptive study examining clinical data for children aged 1–59 months who were hospitalized and died in a Child Health and Mortality Prevention Surveillance (CHAMPS) catchment, December 2016–June 2021. Catchment areas included: Baliakandi and Faridpur, Bangladesh; Kersa, Haramaya, and Harar, Ethiopia; Kisumu and Siaya, Kenya; Bamako, Mali; Manhiça and Quelimane, Mozambique; Makeni, Sierra Leone; Soweto, South Africa. We reviewed medical records of those who died from lower respiratory tract infections, sepsis, malnutrition, malaria, and diarrheal diseases to determine the proportion who received recommended treatments and compared adherence by hospitalization duration. Findings: CHAMPS enrolled 460 hospitalized children who died from the leading causes (median age 12 months, 53.0% male). Median hospital admission was 31 h. There were 51.0% (n = 127/249) of children who died from lower respiratory tract infections received supplemental oxygen. Administration of intravenous fluids for sepsis (15.9%, n = 36/226) and supplemental feeds for malnutrition (14.0%, n = 18/129) were uncommon. There were 51.4% (n = 55/107) of those who died from malaria received antimalarials. Of the 80 children who died from diarrheal diseases, 76.2% received intravenous fluids. Those admitted for ≥24 h more commonly received antibiotics for lower respiratory tract infections and sepsis, supplemental feeds for malnutrition, and intravenous fluids for sepsis than those admitted