ArticlePaediatrics and international child health2021
Relationship between distance of referring facilities and haemoglobin change in children in Malawi.
Article in Paediatrics and international child health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06075108 (P-KIDs CARE), which is not on this map. Not yet cited in PubMed.
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P-KIDs CARE: An Intervention to Address Health Systems Delays to Care for Injured Children in Tanzania
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11 authors.
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Abstract
backgroundAnaemia is a significant cause of mortality in children in sub-Saharan Africa where blood transfusion is often available only at referral hospitals. Understanding the pattern of referrals by health facilities is essential to identify the delays that affect child survival.
aimTo determine if there was a correlation between change in haemoglobin (Hb) level and distance from referring facilities to Kamuzu Central Hospital (KCH) in Malawi, and whether distance affected mortality rates.
methodsThis was a retrospective cohort study of 2259 children referred to KCH whose Hb was measured at the referring facility or at KCH. Maps were created using ArcGIS® software. The relationship between distance from KCH and change in Hb was assessed by χ
resultsThe majority of children were referred by health facilities in the Lilongwe District. When categorised as Hb <4, 4-6 or >6 g/dL, 87.0% of children remained in the same category during transfer. There was no significant relationship between Hb drop and distance from KCH. Distance from KCH was not a significant predictor of Hb level at KCH or Hb change. However, mortality rates were significantly higher in facilities that were 10-50 km from KCH than in those which were <10 km away.
conclusionsUsing distance as a proxy for time, this suggests that referring facilities are transferring children sufficiently quickly to avert significant reductions in Hb. Despite this, there is a need to identify the factors that influence the decision to transfer anaemic children.
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