Hypoglycemia and Risk Factors for Death in 13 Years of Pediatric Admissions in Mozambique

Madrid, Lola; Acácio, Sozinho; Nhampossa, Tacilta; Lanaspa, Miguel; Sitoe, António; Maculuve, Sónia Amós; Mucavele, Hélio; Quintó, Llorenç; Sigaùque, Betuel

doi:10.4269/ajtmh.15-0475

Cited by 14 publications

(19 citation statements)

References 44 publications

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“…Increased glucose demand during illness [19] coupled with illness induced anorexia [20] and subsequently poor feeding [21] may possibly contribute to the increased risk to develop low and hypo glycaemia among sick children, hence the importance of adequate feeding during illness must be emphasized [22]. Fasting has been suggested to be associated with an increased risk of hypoglycaemia in children in earlier studies [2,9,23]. This study supports these findings with results from a large sample of severely ill children on admission irrespective of underlying diseases.…”

Section: Discussionsupporting

confidence: 81%

“…Hypoglycaemia is a complication of many common illnesses in children in low income countries [1][2][3] and is also a well-recognised predictor of in-hospital death [4][5][6]. The World Health Organisation (WHO) currently defines paediatric hypoglycaemia as a blood glucose value below 2.5 mmol/l in a well-nourished child and < 3 mmol/l in a severely malnourished child [7].…”

Section: Introductionmentioning

confidence: 99%

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Feeding practices and association of fasting and low or hypo glycaemia in severe paediatric illnesses in Malawi – a mixed method study

et al. 2020

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Background: The presence of low or hypo glycaemia in children upon admission to hospital in low income countries is a marker for poor outcome. Fasting during illness may contribute to low blood glucose and caretakers' feeding practices during childhood illnesses may thus play a role in the development of low or hypo glycaemia. This study aims to describe the caretaker's feeding practices and association of fasting with low or hypo glycaemia in sick children in Malawi. Methods: A mixed method approach was used combining quantitative cross-sectional data for children aged 0-17 years admitted to Queen Elizabeth Central Hospital (QECH), a tertiary hospital in Malawi, with qualitative focus group discussions conducted with caretakers of young children who were previously referred to QECH from the five health centres around QECH. Logistic regression was used to analyse the quantitative data and thematic content analysis was conducted for qualitative data analysis. Results: Data for 5131 children who were admitted through the hospital's Paediatric Accident and Emergency Department (A&E) were analysed whereof 2.1% presented with hypoglycaemia (< 2.5 mmol/l) and 6.6% with low glycaemia (≥2.5mmoll/l-< 5 mmol/l). Fasting for more than eight hours was associated with low glycaemia as well as hypoglycaemia with Adjusted Odds Ratios (AOR) of 2.9 (95% Confidence Interval (CI) of 2.3-3.7) and 4.6, (95% CI 3.0-7.0), respectively. Caretakers demonstrated awareness of the importance of feeding during childhood illness and reported intensified feeding attention to sick children but face feeding challenges when illness becomes severe causing them to seek care at a health facility. Conclusion: Results suggests that caretakers understand the importance of feeding during illness and make efforts to intensify feeding a sick child but challenges occur when illness is severe leading to fasting. Fasting among children admitted to hospitals may serve as a marker of severe illness and determine those at risk of low and hypoglycaemia.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Feeding practices and association of fasting and low or hypo glycaemia in severe paediatric illnesses in Malawi – a mixed method study

et al. 2020

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“…Hypoglycemia appears to identify patients at particularly high risk for death who are critically ill 6,8 and is probably a marker of severe underlying disease process.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Death in Bangladeshi Children Under 5 Years of Age Hospitalized for Diarrhea and Severe Respiratory Distress in an Urban Critical Care Ward

Alam

Ahmed

Sarmin

et al. 2017

Global Pediatric Health

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Children with diarrhea hospitalized for respiratory distress often have fatal outcome in resource-limited settings, although data are lacking on risk factors for death in such children. We sought to evaluate clinical predictors for death in such children. In this prospective cohort study, we enrolled under-5 children with diarrhea admitted with severe respiratory distress to the intensive care unit of Dhaka Hospital of International Centre for Diarhoeal Disease Research, Bangladesh, from September 2014 through September 2015. We compared clinical and laboratory characteristics between study children those who died (n = 29) and those who survived (n = 62). In logistic regression analysis, after adjusting for potential confounders, the independent predictors for death in children hospitalized for diarrhea and severe respiratory distress were severe sepsis and hypoglycemia (P < .05 for all). Thus, recognition of these simple parameters may help clinicians identify children with diarrhea at risk of deaths in order to initiate prompt management for the better outcome, especially in resource-poor settings.

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“…It is one of the life threaten complications in children and, signs and symptoms related to hypoglicemia provide confirmation of hypoglicemia and enable to take life saving measures 7 .…”

Section: Discussionmentioning

confidence: 99%

bilinç değişikliği ile acil servise başvuran çocuk hasta: travma mı değil mi

Çelik¹,

Çelik²,

Güven³

2017

Cumhuriyet Medical Journal

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SUMMARYConsciousness is the state of ability of a person to perceive himself/herself and environment and to give an appropriate response to stimuli. The most frequent causes of childhood consciousness change include electrolyte disorders, encephalopathy, infections, overdose, intoxication, uremia, trauma, seizures, stroke, hypo-hyperglycaemia. Hypoglycemia is a very common metabolic problem in children. Our aim is to make sure that the diagnosis of hypoglycemia, one of the most common causes of consciousness change in children, is kept in mind and considered in differential diagnosis. Keywords: Emergency department, child, falling, altered consciousness, hypoglicemia ÖZET Bilinç; kişinin kendisini ve çevresini algılayabilmesi ve uyaranlara uygun yanıt verebilmesi durumudur. Çocuklarda çok sayıda bilinç değişikliği nedeni olmakla birlikte bunların en sık görülenleri: elektrolit bozuklukları, ensefalopati, enfeksiyonlar, aşırı doz ilaç alımı, zehirlenmeler, üremi, travma, nöbet, inme, hipo-hiperglisemi gibi sıralanabilir. Hipoglisemi çocuklarda çok yaygın görülen metabolik bir problemdir. Amacımız çocuklarda bilinç bozukluğunun çok sık görülen nedenlerinden biri olan hipoglisemiyi yaptığımız muayene ve tetkiklerle diğer nedenlerden ayırt etmektir.

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Hypoglycemia and Risk Factors for Death in 13 Years of Pediatric Admissions in Mozambique

Cited by 14 publications

References 44 publications

Feeding practices and association of fasting and low or hypo glycaemia in severe paediatric illnesses in Malawi – a mixed method study

Feeding practices and association of fasting and low or hypo glycaemia in severe paediatric illnesses in Malawi – a mixed method study

Risk Factors for Death in Bangladeshi Children Under 5 Years of Age Hospitalized for Diarrhea and Severe Respiratory Distress in an Urban Critical Care Ward

bilinç değişikliği ile acil servise başvuran çocuk hasta: travma mı değil mi

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