Verbal Autopsy to Assess Postdischarge Mortality in Children With Suspected Sepsis in Uganda

dc.contributor.authorKnappett, Martina
dc.contributor.authorHooft, Anneka
dc.contributor.authorMaqsood, Muhammad Bilal
dc.contributor.authorLavoie, Pascal M.
dc.contributor.authorKortz, Teresa
dc.contributor.authorMehta, Sonia
dc.contributor.authorDuby, Jessica
dc.contributor.authorAkech, Samuel
dc.contributor.authorMaina, Michuki
dc.contributor.authorCarter, Rebecca
dc.contributor.authorPopescu, Constantin R.
dc.contributor.authorDaftary, Rajesh
dc.contributor.authorMugisha, Nathan Kenya
dc.contributor.authorMwesigwa, Douglas
dc.contributor.authorKabakyenga, Jerome
dc.contributor.authorKumbakumba, Elias
dc.contributor.authorAnsermino, J. Mark
dc.contributor.authorKissoon, Niranjan
dc.contributor.authorMutekanga, Andrew
dc.contributor.authorHau, Duncan
dc.contributor.authorMoschovis, Peter
dc.contributor.authorKangwa, Mukuka
dc.contributor.authorChen, Carol
dc.contributor.authorFirnberg, Maytal
dc.contributor.authorGlomb, Nicolaus
dc.contributor.authorArgent, Andrew
dc.contributor.authorReid, Stephen J.
dc.contributor.authorBhutta, Adnan
dc.contributor.authorWiens, Matthew O.
dc.contributor.departmentPediatrics, School of Medicine
dc.date.accessioned2024-12-13T13:52:45Z
dc.date.available2024-12-13T13:52:45Z
dc.date.issued2023
dc.description.abstractBackground: Reducing child mortality in low-income countries is constrained by a lack of vital statistics. In the absence of such data, verbal autopsies provide an acceptable method to determining attributable causes of death. The objective was to assess potential causes of pediatric postdischarge mortality in children younger than age 5 years (under-5) originally admitted for suspected sepsis using verbal autopsies. Methods: Secondary analysis of verbal autopsy data from children admitted to 6 hospitals across Uganda from July 2017 to March 2020. Structured verbal autopsy interviews were conducted for all deaths within 6 months after discharge. Two physicians independently classified a primary cause of death, up to 4 alternative causes, and up to 5 contributing conditions using the Start-Up Mortality List, with discordance resolved by consensus. Results: Verbal autopsies were completed for 361 (98.6%) of the 366 (5.9%) children who died among 6191 discharges (median admission age: 5.4 months [interquartile range, 1.8-16.7]; median time to mortality: 28 days [interquartile range, 9-74]). Most deaths (62.3%) occurred in the community. Leading primary causes of death, assigned in 356 (98.6%) of cases, were pneumonia (26.2%), sepsis (22.1%), malaria (8.5%), and diarrhea (7.9%). Common contributors to death were malnutrition (50.5%) and anemia (25.7%). Reviewers were less confident in their causes of death for neonates than older children (P < .05). Conclusions: Postdischarge mortality frequently occurred in the community in children admitted for suspected sepsis in Uganda. Analyses of the probable causes for these deaths using verbal autopsies suggest potential areas for interventions, focused on early detection of infections, as well as prevention and treatment of underlying contributors such as malnutrition and anemia.
dc.eprint.versionAuthor's manuscript
dc.identifier.citationKnappett M, Hooft A, Maqsood MB, et al. Verbal Autopsy to Assess Postdischarge Mortality in Children With Suspected Sepsis in Uganda. Pediatrics. 2023;152(5):e2023062011. doi:10.1542/peds.2023-062011
dc.identifier.urihttps://hdl.handle.net/1805/45023
dc.language.isoen_US
dc.publisherAmerican Academy of Pediatrics
dc.relation.isversionof10.1542/peds.2023-062011
dc.relation.journalPediatrics
dc.rightsPublisher Policy
dc.sourcePMC
dc.subjectAftercare
dc.subjectAnemia
dc.subjectAutopsy
dc.subjectMalnutrition
dc.subjectSepsis
dc.titleVerbal Autopsy to Assess Postdischarge Mortality in Children With Suspected Sepsis in Uganda
dc.typeArticle
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