ArticlePloS one2012
Variations in mortality in children admitted with pneumonia to Kenyan hospitals.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- What are the risk factors for death among children with pneumonia in low- and middle-income countries? A systematic review.Journal of global health · 2023Pooled it
- A Systematic Review and Meta-analysis of Sex Differences in Morbidity and Mortality of Acute Lower Respiratory Tract Infections Among African Children.Journal of pediatrics review · 2020Article
- Viral etiology of pneumonia among severely malnourished under-five children in an urban hospital, Bangladesh.PloS one · 2020Article
- Article
- Modified systemic inflammatory response syndrome and provider gestalt predicting adverse outcomes in children under 5 years presenting to an urban emergency department of a tertiary hospital in Tanzania.Tropical medicine and health · 2019Article
- Risk factors for death among children aged 5-14 years hospitalised with pneumonia: a retrospective cohort study in Kenya.BMJ global health · 2019Article
- An observational study of monitoring of vital signs in children admitted to Kenyan hospitals: an insight into the quality of nursing care?Journal of global health · 2018Observational
- Comparable outcomes among trial and nontrial participants in a clinical trial of antibiotics for childhood pneumonia: a retrospective cohort study.Journal of clinical epidemiology · 2018Article
- Appropriateness of clinical severity classification of new WHO childhood pneumonia guidance: a multi-hospital, retrospective, cohort study.The Lancet. Global health · 2018Article
- Exploring sources of variability in adherence to guidelines across hospitals in low-income settings: a multi-level analysis of a cross-sectional survey of 22 hospitals.Implementation science : IS · 2015Article
- Etiology and Factors Associated with Pneumonia in Children under 5 Years of Age in Mali: A Prospective Case-Control Study.PloS one · 2015Article
- Risk factors for a poor outcome among children admitted with clinically severe pneumonia to a university hospital in Rabat, Morocco.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2014Article
- Reducing deaths from severe pneumonia in children in Malawi by improving delivery of pneumonia case management.PloS one · 2014Article
- Revisiting public health challenges in the new millennium.Annals of medical and health sciences research · 2013Review
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundThe existing case fatality estimates of inpatient childhood pneumonia in developing countries are largely from periods preceding routine use of conjugate vaccines for infant immunization and such primary studies rarely explore hospital variations in mortality. We analysed case fatality rates of children admitted to nine Kenyan hospitals with pneumonia during the era of routine infant immunization with Hib conjugate vaccine to determine if significant variations exist between hospitals.
methodsPneumonia admissions and outcomes in paediatric wards are described using data collected over two time periods: a one-year period (2007-2008) in nine hospitals, and data from a 9.25-year period (1999-March 2008) in one of the participating hospitals. Hospital case fatality rates for inpatient pneumonia during 2007 to 2008 were modeled using a fixed effect binomial regression model with a logit link. Using an interrupted time series design, data from one hospital were analysed for trends in pneumonia mortality during the period between 1997 and March 2008.
resultsOverall, 195 (5.9%) children admitted to all 9 hospitals with pneumonia from March 2007 to March 2008 died in hospital. After adjusting for child's sex, comorbidity, and hospital effect, mortality was significantly associated with child's age (p<0.001) and pneumonia severity (p<0.001). There was evidence of significant variations in mortality between hospitals (LR χ(2) =52.19; p<0.001). Pneumonia mortality remained stable in the periods before (trend -0.03, 95% CI -0.1 to 0.02) and after Hib introduction (trend 0.04, 95% CI -0.04 to 0.11).
conclusionsThere are important variations in hospital-pneumonia case fatality in Kenya and these variations are not attributed to temporal changes. Such variations in mortality are not addressed by existing epidemiological models and need to be considered in allocating resources to improve child health.
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