TABLE 1.
Demographic and Clinical Characteristics of Children who Died After Discharge
| <28 d (N = 19) |
28 d–5 y (N = 347) |
Overall (N = 366) |
|
|---|---|---|---|
| Demographic characteristics | |||
| Age at admission, mo, median (IQR) | 0.2 (0.1–0.4) | 5.8 (2.4–17.6) | 5.4 (1.8–16.7) |
| Female sex, N (%) | 5 (26) | 158 (45.5) | 163 (44.5) |
| Maternal education | |||
| No school/≤P3, N (%) | 7 (37) | 221 (63.7) | 228 (62.3) |
| P4–P7, N (%) | 10 (53) | 96 (27.7) | 106 (29.0) |
| S1–S6, N (%) | 2 (11) | 22 (6.3) | 24 (6.6) |
| Postsecondary, N (%) | 0 (0) | 8 (2.3) | 8 (2.2) |
| Household size, median (IQR) | 4 (3–5) | 5 (4–6) | 5 (4–6) |
| Distance to facility, km, median (IQR) | 24.0 (12.8–36.4) | 26.2 (11.4–42.2) | 26.2 (11.4–41.9) |
| Time from discharge to death, in days, median (IQR)a | 1.0 (0.5–5.5) | 32.0 (11.0–79.0) | 27.5 (9.0–74.0) |
| Index admission clinical and laboratory characteristics | |||
| Prior admission, N (%) | |||
| <7 d | 1 (5) | 22 (6.3) | 23 (6.3) |
| 7 d–1 mo | 0 (0) | 48 (13.8) | 48 (13.1) |
| >1 mo | 0 (0) | 72 (20.7) | 72 (19.6) |
| Admission Sp02 | |||
| 95%–100%, N (%) | 9 (47) | 200 (57.6) | 209 (57.1) |
| 90%–94%, N (%) | 5 (26) | 60 (17.3) | 65 (17.8) |
| <90%, N (%) | 5 (26) | 87 (25.1) | 92 (25.1) |
| Admission fever (temperature >37.5°C), N (%) | 7 (37) | 122 (35.2) | 129 (35.1) |
| Abnormal Blantyre Coma Scale (<5), N (%) | 5 (26) | 51 (14.7) | 56 (15.3) |
| HIV-positive, N (%) | 1 (5) | 19 (5.5) | 20 (5.5) |
| Malaria RDT positive, N (%) | 0 (0) | 62 (17.9) | 62 (16.9) |
| Admission hemoglobin | |||
| No anemia (Hb ≥11 g/dL), N (%) | 16 (84) | 183 (52.7) | 199 (54.4) |
| Mild anemia (Hb 7–11 g/dL), N (%) | 3 (16) | 99 (28.5) | 102 (27.9) |
| Severe anemia (Hb ≤7 g/dL), N (%) | 0 (0) | 65 (18.7) | 65 (17.8) |
| Admission lactate | |||
| Normal lactate (≤2 mmol), N (%) | 4 (21) | 152 (43.8) | 156 (42.6) |
| Hyperlactemia (2–4 mmol), N (%) | 10 (53) | 126 (36.3) | 136 (37.2) |
| Severe hyperlactemia (≥4 mmol), N (%) | 5 (26) | 69 (19.9) | 74 (20.2) |
| Referred, N (%) | 18 (95) | 205 (59.1) | 223 (60.9) |
| Duration of bad health, N (%) | |||
| In good health before this illness | 12 (63) | 243 (70.0) | 255 (69.7) |
| <1 wk | 5 (26) | 9 (2.6) | 14 (3.8) |
| 1 wk–≤1 mo | 2 (11) | 41 (11.8) | 43 (11.7) |
| >1 mo | 0 (0) | 54 (15.6) | 54 (14.8) |
| WFA Z-score | |||
| No malnutrition (Z > −2), N (%) | 9 (47) | 153 (44.1) | 162 (44.3) |
| Moderate malnutrition (−2 < Z < −3), N (%) | 3 (16) | 65 (18.7) | 68 (18.6) |
| Severe malnutrition (>−3), N (%) | 7 (37) | 129 (37.2) | 136 (37.2) |
| Index admission discharge characteristics | |||
| Discharge status | |||
| Routine discharge, N (%) | 6 (32) | 202 (58.2) | 208 (56.8) |
| Referred to higher level of care, N (%) | 7 (37) | 48 (13.8) | 55 (15.0) |
| Unplanned discharge, N (%) | 6 (32) | 97 (28.0) | 103 (28.1) |
| Length of stay, days, median (IQR) | 4.0 (3.0–6.5) | 6.0 (3.0–9.0) | 5.0 (3.0–9.0) |
| Circumstances of postdischarge death | |||
| Location of postdischarge deathb | |||
| At home, N (%) | 8 (42) | 154 (45.2) | 162 (45.0) |
| In-transit to seeking care, N (%) | 5 (26) | 61 (17.9) | 66 (18.3) |
| During readmission, N (%) | 6 (32) | 126 (37.0) | 132 (36.7) |
| Caregiver sought care between discharge and death, N (%) | 6 (32) | 162 (46.7) | 168 (45.9%) |
| Initial source of care seekingc | |||
| Self-referral, N (%) | 2 (33) | 122 (75.3) | 124 (73.8) |
| Referral from other health care facility, N (%) | 3 (50) | 21 (13.0) | 24 (14.3) |
| Other/unknown, N (%) | 1 (17) | 19 (11.7) | 20 (11.9) |
| Location of care seekingc | |||
| Untrained health worker/drug shop, N (%) | 0 (0) | 8 (4.9) | 8 (4.8) |
| Traditional healer, N (%) | 0 (0) | 2 (1.2) | 2 (1.2) |
| Health center, N (%) | 1 (17) | 26 (16.0) | 27 (16.1) |
| Hospital, N (%) | 5 (83) | 118 (72.8) | 123 (73.2) |
| Unknown | 0 (0) | 8 (4.9) | 8 (4.8) |
Abbreviations: Hb, hemoglobin; P3, primary 3; P4–P7, primary 4 to primary 7; RDT, Rapid Diagnostic Test; S1–S6, secondary 1 to secondary 6; WFA, weight-for-age.
a
n = 364; 2 children missing exact death date.
b
n = 360; 6 children missing data on location of death.
c
n = 168; 198 children/caregivers did not seek any care between discharge and death.