Journal Article

The Causes of Hospital Admission and Death among Children in Bamako, Mali

James D. Campbell, Samba O. Sow, Myron M. Levine and Karen L. Kotloff

in Journal of Tropical Pediatrics

Volume 50, issue 3, pages 158-163
Published in print June 2004 | ISSN: 0142-6338
Published online June 2004 | e-ISSN: 1465-3664 | DOI: http://dx.doi.org/10.1093/tropej/50.3.158
The Causes of Hospital Admission and Death among Children in Bamako, Mali

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The health burden and mortality caused by infections during childhood remain large in sub-Saharan Africa.We performed a review of the causes of hospitalization and death among children admitted to a pediatric teaching hospital in Bamako, Mali. Medical records of children admitted throughout 2000 were systematically sampled and abstracted for demographics, diagnosis, hospital course, and disposition. A sample of 1644 charts, from 5001 admitted children, were abstracted. The median age was 8 months. Half of the children had a febrile illness. All diagnoses were made clinically. The annual incidence per 100 000 and case fatality rates of the four most common serious infections, excluding malaria, were as follows: pneumonia, 165 (12 per cent); sepsis, 75 (37 per cent); meningitis, 71 (20 per cent); and enteric fever, 14 (12 per cent). An estimated 1300 children were admitted with thick-smear confirmed malaria; at least 64 per cent met World Health Organization criteria for severe malaria and 11 per cent died. Seventy-one per cent of admissions were due to infections. Overall 21 per cent of children admitted died in the hospital, most within the first 3 days of admission. Infectious diseases remain the primary cause of hospitalization among Malian children and frequently lead to death. A substantial proportion of this morbidity and mortality is probably attributable to vaccine-preventable diseases, such as Haemophilus influenzae type B, Streptococcus pneumoniae, and Neisseria meningitidis. Prospective surveillance using microbiological data is needed to delineate the organism-specific burdens.

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Subjects: Paediatrics

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