Abstract:

Background: Critically ill children appropriate and time conscious management to reverse their poor health status otherwise they are at increased risk of disability and mortality. Management of these children still present a big challenge globally with increased vulnerability in resources-limited setting especially in sub-Saharan Africa. In this study our main objective was to determine the prevalence and immediate outcomes and determinants of outcomes of critically ill children aged 2 – 59 months admitted at Bugando Medical Centre.

Methods: A hospital-based, cross-sectional study with a prospective follow up component was done from November 2015 to March 2016, among children aged 2 – 59 months admitted at BMC. All children were screened for signs and symptoms of critical illness ass per operational definition of this study. Questionnaires were used to elicit demographic, clinical information and follow up information. The outcome was assessed after 48 hours of follow up. Data was analyzed using STATA version 13.

Results: A total of 410 children were enrolled in the study. Median [IQR] age was 15 [9-26] months. Majority were males, 57.1%. At admission, 220/410 (53.7%) were critically ill out of which 52 (23.6%) died at the end of follow up and 62 (28.2%) were still in critical condition. Of 190 children who were admitted in non-critical condition, 12(6.3%) children deteriorated to critical illness and 5 of them (41.7%), died at the end of follow up. Overall mortality was 14% (57/410). Factors associated with mortality were pallor (p<0.01), coma (p=0.01), hypoglycemia (p=0.01), inability to feed or drink (p=0.01), night time admission (p=0.03) and lethargy (p=0.03).

Conclusion and Recommendations: More than half of patients are admitted in critical condition, and this accounts for higher mortality within 48 hours of hospital stay. The non-critical patients on admission can change to critical condition and end up with poor outcome. Therefore, this recommends more close monitoring and follow up in the ward for both critically ill and non-critically ill whose condition changes after admission.