Project Details

Epidemiology and Prevention of Pediatric Post-Discharge Mortality in Rwanda

Anneka Hooft, MD, MPH

Summary

BACKGROUND: Death after recent hospital admission is an often overlooked cause of pediatric mortality in low-resource settings, however, prior studies suggest that it occurs in 5-10% of children under five. Previous work by the Smart Discharges team in Uganda suggests that simple, education and follow-up-based interventions can substantially decrease post-discharge mortality. GAP: Smart Discharges has developed a risk-prediction tool for post-discharge mortality in pediatric patients, but this has yet to be validated outside of Uganda. This study will explore epidemiology and risk prediction of post-discharge mortality in children in Rwanda. HYPOTHESIS: We hypothesize that the Smart Discharges risk-prediction tool for post-discharge mortality in children recently hospitalized for infection will demonstrate equivalent performance characteristics among a cohort of children in Rwanda as in the original development cohort from Uganda. We also expect a similar epidemiologic profile of post-discharge mortality in Rwanda as observed in Uganda. METHODS: We will prospectively enroll a consecutive cohort of 800 children under five years of age and admitted with a proven or suspected infection from two hospitals in Rwanda over a 6-month period and follow them up to 6 months post-hospital discharge. RESULTS: Pending. IMPACT: The identification of children most vulnerable to poor outcomes after hospital discharge is increasingly being recognized as a critical component in achieving the Sustainable Development Goals for child health. In conjunction with key stakeholders, results of this study will begin external validation and lead to widespread implementation of the Smart Discharges program among vulnerable populations to reduce pediatric mortality not only in East Africa, but in similar settings across the world. Website Link: https://www.bcchr.ca/smart-discharges