Tuesday, July 16, 2024

High Pediatric Hospital Mortality in LMICs: Urgent Call for Resource Allocation and Research

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The increasing rate of pediatric hospital deaths in low- and middle-income countries (LMICs) has become a pressing global health issue. Despite accounting for the majority of global child deaths, there is a significant gap in data needed for informed decision-making and resource distribution. This study addresses this gap by providing comprehensive estimates of the causes of pediatric hospital mortality and admissions in LMICs, aiming to guide both global and local health priorities.

Study Methodology and Data Collection

Researchers conducted a systematic review and meta-analysis, examining observational studies published from January 1, 2005, to February 26, 2021. The criteria included studies that focused on general pediatric admissions, causes of admission or death, and total admissions. Studies lacking a full text or containing data prior to the year 2000 were excluded. The methodological quality of the included studies was assessed using a modified version of the Quality in Prognosis Studies tool. Data was then pooled through random-effects models to determine prevalence rates.

Key Findings and Regional Variations

From the initial identification of 29,637 texts, 253 studies were analyzed, encompassing 21.8 million pediatric hospitalizations across 59 LMICs. The overall pediatric hospital mortality rate was 4.1% (95% CI 3.4%-4.7%). The leading causes of death were infectious diseases [12 deaths per 1,000 admissions (95% CI 9-14)], respiratory illnesses [9 deaths per 1,000 admissions (95% CI 5-13)], and gastrointestinal diseases [9 deaths per 1,000 admissions (95% CI 6-11)]. Admissions were predominantly due to respiratory [255 cases per 1,000 admissions (95% CI 231-280)], infectious [214 cases per 1,000 admissions (95% CI 193-234)], and gastrointestinal issues [166 cases per 1,000 admissions (95% CI 143-190)].

Actionable Insights for Policy Makers

– Prioritize funding for basic emergency and critical care services tailored to local disease profiles.
– Invest in training and support for local researchers to enhance the quality of pediatric health data.
– Implement targeted interventions to address the most common causes of pediatric hospital mortality.
– Increase global health efforts to reduce inequities in child health research and resource allocation.

The study highlights the urgent need for a concerted effort to reduce pediatric hospital mortality in LMICs. Improved access to emergency and critical care, alongside high-quality data collection, is essential to ensure equitable health outcomes for children in these regions. Immediate action and resource allocation are critical to address this significant health disparity.

Original Article:
Front Pediatr. 2024 Jun 7;12:1397232. doi: 10.3389/fped.2024.1397232. eCollection 2024. PMID: 38910960 | PMC: PMC11190367 | DOI: 10.3389/fped.2024.1397232

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