Risk factors for death in suspected severe bacterial infection in infants aged <90 days in Luanda, Angola
Background: Yearly, about two million infants die during the first 28 days of life. Most of these deaths occur in sub-Saharan Africa and a third of those are caused by severe infections. The early identification of infants at risk of death is important when trying to prevent poor outcomes. Objective...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-05-01
|
| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971221002885 |
| _version_ | 1818360499383828480 |
|---|---|
| author | Tuula Pelkonen Suvi Urtti Ondina Cardoso Moe H. Kyaw Irmeli Roine Heikki Peltola |
| author_facet | Tuula Pelkonen Suvi Urtti Ondina Cardoso Moe H. Kyaw Irmeli Roine Heikki Peltola |
| author_sort | Tuula Pelkonen |
| collection | DOAJ |
| description | Background: Yearly, about two million infants die during the first 28 days of life. Most of these deaths occur in sub-Saharan Africa and a third of those are caused by severe infections. The early identification of infants at risk of death is important when trying to prevent poor outcomes. Objective: The aim of this study was to identify risk factors for death among young infants with possible serious bacterial infection (pSBI) at hospital admission. Methods: This prospective, observational, single-site, descriptive study forms part of a larger study on bacterial meningitis in infants <90 days of age admitted to the Pediatric Hospital of Luanda, the capital of Angola, from February 1, 2016 to October 23, 2017. Infants with pSBI, a known outcome, and a final diagnosis were included. Results: Of 574 young infants with pSBI, 115 (20%) died in hospital. An altered level of consciousness, absence of spontaneous movements, dyspnea, CSF that is not clear, low CSF glucose, high CSF protein, heart rate over the median, and seizures were identified as risk factors for death in the univariate analysis. In the multivariate analysis, only heart rate over the median and seizures were independent predictors of death. Conclusions: Easily recognizable clinical signs – tachycardia and seizures – may guide clinicians to identify infants at high risk of death due to severe bacterial infections in sub-Saharan Africa. |
| first_indexed | 2024-12-13T21:01:46Z |
| format | Article |
| id | doaj.art-b4fd099953cc42b79e882e5699b4a5c2 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-13T21:01:46Z |
| publishDate | 2021-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-b4fd099953cc42b79e882e5699b4a5c22022-12-21T23:31:34ZengElsevierInternational Journal of Infectious Diseases1201-97122021-05-01106223227Risk factors for death in suspected severe bacterial infection in infants aged <90 days in Luanda, AngolaTuula Pelkonen0Suvi Urtti1Ondina Cardoso2Moe H. Kyaw3Irmeli Roine4Heikki Peltola5New Children’s Hospital, Pediatric Research Center, Helsinki, Finland; Pediatrics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Hospital Pediátrico David Bernardino (HPDB), Luanda, Angola; Corresponding author at: Children’s Hospital, Helsinki University Central Hospital, PO Box 347, 00029 HUS, Helsinki, Finland.New Children’s Hospital, Pediatric Research Center, Helsinki, Finland; Pediatrics, University of Helsinki and Helsinki University Hospital, Helsinki, FinlandHospital Pediátrico David Bernardino (HPDB), Luanda, AngolaSanofi Pasteur, Epidemiology, Swiftwater, Pennsylvania, USAFaculty of Medicine, University Diego Portales, Santiago, ChileNew Children’s Hospital, Pediatric Research Center, Helsinki, Finland; Pediatrics, University of Helsinki and Helsinki University Hospital, Helsinki, FinlandBackground: Yearly, about two million infants die during the first 28 days of life. Most of these deaths occur in sub-Saharan Africa and a third of those are caused by severe infections. The early identification of infants at risk of death is important when trying to prevent poor outcomes. Objective: The aim of this study was to identify risk factors for death among young infants with possible serious bacterial infection (pSBI) at hospital admission. Methods: This prospective, observational, single-site, descriptive study forms part of a larger study on bacterial meningitis in infants <90 days of age admitted to the Pediatric Hospital of Luanda, the capital of Angola, from February 1, 2016 to October 23, 2017. Infants with pSBI, a known outcome, and a final diagnosis were included. Results: Of 574 young infants with pSBI, 115 (20%) died in hospital. An altered level of consciousness, absence of spontaneous movements, dyspnea, CSF that is not clear, low CSF glucose, high CSF protein, heart rate over the median, and seizures were identified as risk factors for death in the univariate analysis. In the multivariate analysis, only heart rate over the median and seizures were independent predictors of death. Conclusions: Easily recognizable clinical signs – tachycardia and seizures – may guide clinicians to identify infants at high risk of death due to severe bacterial infections in sub-Saharan Africa.http://www.sciencedirect.com/science/article/pii/S1201971221002885Risk factorsOutcomeNewbornBacterial meningitisNeonatal sepsisAngola |
| spellingShingle | Tuula Pelkonen Suvi Urtti Ondina Cardoso Moe H. Kyaw Irmeli Roine Heikki Peltola Risk factors for death in suspected severe bacterial infection in infants aged <90 days in Luanda, Angola International Journal of Infectious Diseases Risk factors Outcome Newborn Bacterial meningitis Neonatal sepsis Angola |
| title | Risk factors for death in suspected severe bacterial infection in infants aged <90 days in Luanda, Angola |
| title_full | Risk factors for death in suspected severe bacterial infection in infants aged <90 days in Luanda, Angola |
| title_fullStr | Risk factors for death in suspected severe bacterial infection in infants aged <90 days in Luanda, Angola |
| title_full_unstemmed | Risk factors for death in suspected severe bacterial infection in infants aged <90 days in Luanda, Angola |
| title_short | Risk factors for death in suspected severe bacterial infection in infants aged <90 days in Luanda, Angola |
| title_sort | risk factors for death in suspected severe bacterial infection in infants aged 90 days in luanda angola |
| topic | Risk factors Outcome Newborn Bacterial meningitis Neonatal sepsis Angola |
| url | http://www.sciencedirect.com/science/article/pii/S1201971221002885 |
| work_keys_str_mv | AT tuulapelkonen riskfactorsfordeathinsuspectedseverebacterialinfectionininfantsaged90daysinluandaangola AT suviurtti riskfactorsfordeathinsuspectedseverebacterialinfectionininfantsaged90daysinluandaangola AT ondinacardoso riskfactorsfordeathinsuspectedseverebacterialinfectionininfantsaged90daysinluandaangola AT moehkyaw riskfactorsfordeathinsuspectedseverebacterialinfectionininfantsaged90daysinluandaangola AT irmeliroine riskfactorsfordeathinsuspectedseverebacterialinfectionininfantsaged90daysinluandaangola AT heikkipeltola riskfactorsfordeathinsuspectedseverebacterialinfectionininfantsaged90daysinluandaangola |