Pediatric Emergency Care in a Low-income Country: Characteristics and Outcomes of Presentations to a Tertiary-care Emergency Department in Mozambique

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2020 Nov 4

PMID 33147242

Citations 9

Authors

Valentina Brugnolaro

Laura Nai Fovino

Serena Calgaro

Giovanni Putoto

Arlindo Rosario Muhelo

Dario Gregori

Danila Azzolina

Silvia Bressan

Liviana Da Dalt

Affiliations

Soon will be listed here.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Citing Articles

Infectious Disease Management in Pediatric Emergency Departments in Low- and Middle-Income Countries: A Review of Diagnostic Tools, Treatment Protocols, and Preventive Measures.

Alsabri M, Siddiq A, Aderinto N, Ishola I, Shahid M, Kaul A Glob Pediatr Health. 2025; 11:2333794X241304663.

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Perspectives from clinicians from different levels of care in Maputo, Mozambique: qualitative study of the barriers to and facilitators of paediatric injury care in resource-poor hospital settings.

Amado V, Zandamela A, Couto M, Wallis L, Laflamme L BMJ Open. 2024; 14(11):e085270.

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Epidemiological analysis of a 10-year retrospective study of pediatric trauma in intensive care.

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Capacity for delivery of paediatric emergency care and the current use of emergency triage, assessment and treatment in health facilities in the Busoga region, Uganda-A mixed methods study.

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Factors associated with hospitalization in a pediatric population of rural Tanzania: findings from a retrospective cohort study.

Mancini V, Borellini M, Belardi P, Colucci M, Kadinde E, Mwibuka C Ital J Pediatr. 2024; 50(1):53.

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