An audit of primary medical conditions in children admitted to the paediatric intensive care unit of Charlotte Maxeke Johannesburg Academic Hospital

Mopeli, Refiloe Keketso; White, Debbie A; Ballot, Daynia

doi:10.7196/sajch.2016.v10i4.1187

Cited by 5 publications

(12 citation statements)

References 17 publications

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“…The mortality rate in paediatric ICU can provide an indication of the quality of care and guide allocation of scarce resources. A review of the current study unit, which is a combined Paediatric/Neonatal Intensive Care Unit (PNICU) in Johannesburg, South Africa, showed that 59% of admissions were neonates, 27% had primary surgical conditions and 14% were for primary medical conditions [ 6 ]. Neonatal care in the same PNICU has been previously described [ 7 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

A comparison between raw and predicted mortality in a paediatric intensive care unit in South Africa

et al. 2018

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ObjectivePaediatric intensive care resources are limited in sub-Saharan Africa. The mortality rate in a combined Paediatric/Neonatal Intensive Care Unit in Johannesburg, South Africa was almost double that in a dedicated paediatric intensive care unit in the same country. This study aimed to compare the raw mortality rate with that predicted with the Paediatric Index of Mortality (version 3), by doing a retrospective analysis of an existing database.ResultsA total of 530 patients admitted to the intensive care unit between 1 January 2015 and 31 December 2017 were included. The raw mortality rate was 27.1% and the predicted mortality rate was 27.0% (p = 0.971). Cardiac arrest during ICU admission (p < 0.001), non-reactive pupils (0.035), inotropic support (p < 0.001) and renal disease (p = 0.002) were all associated with an increased risk of mortality. These findings indicate that the high mortality rate is due to the severity of illness in the patients that are admitted. It also indicates that the quality of care delivered is acceptable.

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Section: Introductionmentioning

confidence: 99%

A comparison between raw and predicted mortality in a paediatric intensive care unit in South Africa

et al. 2018

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“…Furthermore, other studies found that 61% and 85% of HIV positive children were diagnosed with LRTI on admission [11,21]. HIV is considered a risk factor for LRTI among children [9,28] and this is attributed to the limited protection from maternal antibodies [21]. In this study, acute gastroenteritis (AGE) was the second most commonly diagnosed condition among admitted children.…”

Section: The Prevalence Of Hiv and Admission Diagnosis Of The Childrenmentioning

confidence: 62%

Disease profile, HIV prevalence and vaccination status of HIV-infected children admitted at a hospital complex, Northern Cape Province, South Africa

Gadzama,

Mogale,

Oguntibeju

2023

ijirss

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Despite the availability of vertical transmission prevention, treatment, and immunisation programmes for better health outcomes, children are still infected and affected by HIV/AIDS. Those accessing treatment are either virally unsuppressed or have severe forms of diseases, while others have missed opportunities for vaccination. HIV infected children are vulnerable to infections, re-hospitalisation, and missing vaccinations. The study determined the disease profile, HIV prevalence, readmission, and immunisation status of children admitted to Robert Mangaliso Sobukwe Hospital in Northern Cape Province, South Africa. This was a retrospective review of 328 medical records of children less than 14 years, admitted from January 2017 to January 2018. The mean age was 3.6 years, and the majority were females. Most children presented with appetite loss and fatigue, and the most common admission diagnoses were lower respiratory tract infection and acute gastroenteritis. The prevalence of HIV in this group was 24%. Over 50% were readmitted, and 17% of those were HIV positive. Most HIV positive children (62%) had missed vaccinations, predominantly measles, and pneumococcal conjugate vaccines. Older children, those infected with HIV, and those who had missed the measles vaccine were significantly associated with readmission. Children of mothers with higher educational status who were either single or married were less likely to be readmitted compared to those with a lower education level and divorced parents. The rate of readmission is relatively high; therefore, improving care and scaling up catch-up immunisations for children, especially among HIV-infected, may offer them better protection and outcomes against vaccine-preventable diseases considering their risk for incomplete immunisation and infectious diseases.

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“…[ 11 ] This argument is also strengthened by a study from the paediatric intensive care unit at CMJAH from 2013 to 2014 which showed a HIV-exposure rate of 34.1%, potentially caused by more severe illnesses amongst HIV-exposed children. [ 29 ] Nationally in 2017, 28.7% of women receiving antenatal care were HIV-positive, but in another urban hospital in Johannesburg the rate was lower at 23.2%. [ 30 , 31 ]…”

Section: Discussionmentioning

confidence: 99%

“…The increased requirement of respiratory support was also found in the study from 2013 to 2014; HIV exposure may be associated with more severe illness. [ 29 ] Another possible reason is more prematurity amongst HIV-exposed neonates. Interestingly, neonatal sepsis and specifically LOS was found to be significantly more common amongst HEU neonates, which previously had shown heterogenous associations.…”

Section: Discussionmentioning

confidence: 99%

The effects of exposure to HIV in neonates at a referral hospital in South Africa

et al. 2021

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Background Fewer infants are infected with HIV through mother-to-child transmission, making HIV-exposed but uninfected (HEU) infants a growing population. HIV-exposure seems to affect immunology, early growth and development, and is associated with higher morbidity and mortality rates. Currently, there is a lack of information regarding the clinical effects of HIV-exposure during the neonatal period. Objectives To identify a possible difference in mortality and common neonatal morbidities in HEU neonates compared to HIV-unexposed neonates. Methods This was a retrospective, descriptive study of all neonates admitted to the neonatal unit at Charlotte Maxeke Johannesburg Academic Hospital between 1 January 2017 and 31 December 2018. HEU neonates were compared to HIV-unexposed neonates. Results There were 3236 neonates included, where 855 neonates were HEU. The HEU neonates had significantly lower birth weight and gestational age. The HEU neonates had higher rates of neonatal sepsis (19.8% vs 14.2%, OR 1.49, p < 0.001), specifically for late onset sepsis, and required more respiratory support. NCPAP and invasive ventilation was more common in the HEU group (36.3% vs 31.3% required NCPAP, p = 0.008, and 20.1% vs 15,0% required invasive ventilation, p < 0.001). Chronic lung disease was more common among HIV-exposed neonates (12.2% vs 8.7%, OR 1.46, p = 0.003). The difference in mortality rates between the study groups was not significant (10.8% of HEU neonates and 13.3% of HIV-unexposed). Conclusions HEU neonates had higher rates of neonatal sepsis, particularly late-onset sepsis, required more respiratory support and had higher rates of chronic lung disease. Mortality of HEU neonates was not different HIV-unexposed neonates.

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An audit of primary medical conditions in children admitted to the paediatric intensive care unit of Charlotte Maxeke Johannesburg Academic Hospital

Cited by 5 publications

References 17 publications

A comparison between raw and predicted mortality in a paediatric intensive care unit in South Africa

A comparison between raw and predicted mortality in a paediatric intensive care unit in South Africa

Disease profile, HIV prevalence and vaccination status of HIV-infected children admitted at a hospital complex, Northern Cape Province, South Africa

The effects of exposure to HIV in neonates at a referral hospital in South Africa

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