Long Term Outcome of Severe Anaemia in Malawian Children
Author Information
Author(s): Phiri Kamija S., Calis Job C. J., Faragher Brian, Nkhoma Ernest, Ng'oma Kondwani, Mangochi Bridget, Molyneux Malcolm E., van Hensbroek Michaël Boele
Primary Institution: Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, Blantyre, Malawi
Hypothesis
What are the short and long term outcomes of severe anaemia in Malawian children and what are the potential risk factors for death and recurrence of severe anaemia?
Conclusion
Severe anaemia carries a high hidden morbidity and mortality occurring in the months after initial diagnosis and treatment.
Supporting Evidence
- The in-hospital mortality for cases was 6.4%, significantly higher than controls.
- Post-discharge all cause mortality was 12.6% among cases compared to 2.9% in hospital controls and 1.4% in community controls.
- HIV was identified as a major risk factor for both post-discharge mortality and recurrence of severe anaemia.
Takeaway
Severe anaemia is a serious condition for children in Malawi that can lead to death even after treatment, especially if they have HIV.
Methodology
The study followed up children aged 6-60 months with severe anaemia for 18 months, comparing mortality and recurrence rates with hospital and community controls.
Potential Biases
Potential bias due to loss to follow-up and reliance on verbal autopsy for determining causes of death.
Limitations
The study was conducted when ART was not available to children, which may have affected outcomes.
Participant Demographics
Children aged 6-60 months, with a higher prevalence of HIV and severe anaemia among cases compared to controls.
Statistical Information
P-Value
p<0.0001
Confidence Interval
95% CI 0.075–0.138
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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