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Eposse Ekoube C, Heles Nsang E, Épée P, Mandeng Ma Linwa E, Djike Puepi Y, Mbono Betoko R, Noukeu Njinkui D, Enyama D, Mbonjo Bitsie D, Disso Massako J, Abba S, Ngo Linwa EE, Ida Penda C. Predictors of prolonged length of hospital stay and in-hospital mortality in patients aged 1-24 months with acute bronchiolitis in Douala, Cameroon. BMC Pediatr 2024; 24:150. [PMID: 38424505 PMCID: PMC10903055 DOI: 10.1186/s12887-024-04653-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/17/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION In Cameroon, acute bronchiolitis has been reported as the third commonest lower respiratory infection and is usually associated with low mortality. Nonetheless, respiratory distress associated with non-adherence to management guidelines can prolong hospital stay. This study aimed to explore predictors of prolonged hospital stay (≥ 5 days) and mortality in patients aged < 2years hospitalised for acute bronchiolitis. METHODOLOGY We conducted a retrospective cohort study at three paediatric units in the city of Douala, Cameroon. Factors associated with prolonged hospital stay and mortality were determined using multivariable linear regression model. Threshold for significance was set at p ≤ 0.05. RESULTS A total of 215 patients with bronchiolitis were included with mean age of 6.94 ± 5.71 months and M/F sex ratio of 1.39/1. Prolonged hospital stay was reported in 46.98% and mortality in 10.70% of patients hospitalised for bronchiolitis. Factors independently associated with prolonged hospital duration were oxygen administration [b = 0.36, OR = 2.35 (95% CI:1.16-4.74), p = 0.017], abnormal respiratory rate [b = 0.38, OR = 2.13 (1.00-4.55), p = 0.050] and patients presenting with cough [b = 0.33, OR = 2.35 (95% CI: 1.22-4.51), p = 0.011], and diarrhoea [b = 0.71, OR = 6.44 (95% CI: 1.6-25.86), p = 0.009] on admission. On the other hand, factors independently associated with mortality were age of the patient [b= -0.07, OR = 0.84 (95% CI: 0.74-0.97), p = 0.014] and oxygen administration [b = 1.08, OR = 9.64 (95% CI:1.16-79.85), p = 0.036] CONCLUSION: Acute bronchiolitis represented 1.24% of admissions and was common in the rainy season, in males and 3-11-month-old patients. Management guidelines were poorly respected. Prolonged length of stay was reported in half of the patients hospitalized and mortality was high, especially in younger patients and in patients receiving oxygen.
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Affiliation(s)
- Charlotte Eposse Ekoube
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.
- Paediatric unit, Douala Laquintinie Hospital, Douala, Cameroon.
| | - Emmanuel Heles Nsang
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Patricia Épée
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | | | - Ritha Mbono Betoko
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Diomède Noukeu Njinkui
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - Dominique Enyama
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - Dora Mbonjo Bitsie
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | - Soumaiyatou Abba
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | - Calixte Ida Penda
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
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Ahmadi A, Shariatmadari F, Yousefichaijan P, Sarmadian R, Dorreh F, Arjmand Shabestari A. Evaluation of Renal Function and Urinalysis in Children With Simple Febrile Convulsions. Clin Pediatr (Phila) 2022:99228221142127. [PMID: 36476164 DOI: 10.1177/00099228221142127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Febrile convulsion (FC) is the most prevalent type of seizure in children. Febrile diseases have been associated with alterations in kidney function and urine indices. Therefore, in this study, renal function and urine analysis were examined in children with simple FC. The study comprised children with simple FC who were referred to the Amirkabir hospital in Arak between 2020 and 2021. Children were examined for urinalysis and kidney function by assessing the estimated glomerular filtration rate (eGFR). A total of 157 patients with FC were admitted. Hematuria, proteinuria, and pyuria were detected in 8.9%, 1.9%, and 5.1% of cases, respectively. The urine cultures of 2 children were positive. Moreover, it was found that in simple FC, eGFR decreases regardless of gender (P > .05), although kidney function decreases more in children older than 24 months. In conclusion, all children with FC must undergo renal function assessments. Furthermore, urinalysis and urine culture are advised to rule out infection.
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Affiliation(s)
| | | | | | - Roham Sarmadian
- Infectious Disease Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Fatemeh Dorreh
- Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran
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Matera MG, Rogliani P, Ora J, Cazzola M. Current pharmacotherapeutic options for pediatric lower respiratory tract infections with a focus on antimicrobial agents. Expert Opin Pharmacother 2018; 19:2043-2053. [PMID: 30359143 DOI: 10.1080/14656566.2018.1534957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Antibiotics are frequently prescribed to children in the community and in nosocomial settings, mainly because of lower respiratory tract infections(LRTIs), which include influenza, bronchitis, bronchiolitis, pneumonia, and tuberculosis, in addition to bronchiectasis and cystic fibrosis lung disease. It is important to note, however, that more than 50% of these prescriptions are unnecessary or inappropriate. Areas covered: The current choice of antimicrobial therapy for etiological agents of LRTIs is examined and discussed considering each type of LRTI. Expert opinion: There is a clear need for the appropriate utilization of antibiotics in children. Therefore, accurate drug selection and choice of best dosage and duration of the antibacterial treatment are important to optimize the treatment of LRTIs. It's fundamental to bear in mind that children differ from adults in how LRTIs manifest and evolve not only because of the diversity in the immunological profiles but also the fundamental age-related differences in absorption, distribution, metabolism, and elimination of drugs. Since comprehensive antibiotic guideline recommendations for the treatment of pediatric LRTIs are generally lacking, there is an undeniable need for the introduction of pediatric antimicrobial stewardship programmes in both community and hospital settings.
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Affiliation(s)
- Maria Gabriella Matera
- a Department of Experimental Medicine , University of Campania Luigi Vanvitelli , Naples , Italy
| | - Paola Rogliani
- b Department of Experimental Medicine and Surgery , University of Rome Tor Vergata , Rome , Italy
| | - Josuel Ora
- b Department of Experimental Medicine and Surgery , University of Rome Tor Vergata , Rome , Italy
| | - Mario Cazzola
- b Department of Experimental Medicine and Surgery , University of Rome Tor Vergata , Rome , Italy
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Manzano S, Bailey B, Girodias JB, Galetto-Lacour A, Cousineau J, Delvin E. Impact of procalcitonin on the management of children aged 1 to 36 months presenting with fever without source: a randomized controlled trial. Am J Emerg Med 2010; 28:647-53. [PMID: 20637377 DOI: 10.1016/j.ajem.2009.02.022] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Revised: 02/11/2009] [Accepted: 02/11/2009] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The aim of the study was to evaluate the impact of procalcitonin (PCT) measurement on antibiotic use in children with fever without source. METHOD Children aged 1 to 36 months presenting to a pediatric emergency department (ED) with fever and no identified source of infection were eligible to be included in a randomized controlled trial. Patients were randomly assigned to 1 of 2 groups as follows: PCT+ (result revealed to the attending physician) and PCT- (result not revealed). Patients from both groups also had complete blood count, blood culture, urine analysis, and culture performed. Chest radiography or lumbar puncture could be performed if required. RESULTS Of the 384 children enrolled and equally randomized into the PCT+ and PCT- groups, 62 (16%) were diagnosed with a serious bacterial infection (urinary tract infection, pneumonia, occult bacteremia, or bacterial meningitis) by primary ED investigation. Ten were also found to be neutropenic (<500 x 10(6)/L). Of the remaining undiagnosed patients, 14 (9%) of 158 received antibiotics in the PCT+ group vs 16 (10%) of 154 in the PCT- group (Delta -2%; 95% confidence interval [CI], -8 to 5). A strategy to treat all patients with PCT of 0.5 ng/mL or greater with prophylactic antibiotic in this group of patients would have resulted in an increase in antibiotic use by 24% (95% CI, 15-33). CONCLUSION Semiquantitative PCT measurement had no impact on antibiotic use in children aged 1 to 36 months who presented with fever without source. However, a strategy to use prophylactic antibiotics in all patients with abnormal PCT results would have resulted in an increase use of antibiotics.
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Affiliation(s)
- Sergio Manzano
- Division of Emergency Medicine, Department of Pediatrics, CHU Sainte-Justine, Quebec, Canada H3T 1C5
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