Paediatric admissions to a rural South African hospital: value of hospital data in helping to define intervention priorities and allocate district resources.
OBJECTIVE
To audit paediatric medical admissions to a rural district hospital in order to help define intervention priorities and allocate district resources.


METHODS
Prospective audit of consecutive admissions to the paediatric medical service of Hlabisa Hospital, KwaZulu-Natal, between March 1995 and February 1996.


METHODS
Number of admissions, month of admission, age, sex, diagnosis, nutritional status, HIV status, outcome and length of stay.


RESULTS
Of 1,364 children admitted, 995 (73%) were aged under 24 months and 584 (43%) were either underweight for age or severely malnourished. Acute respiratory tract infection (384, 28%), acute diarrhoea (200, 15%), dysentery (168, 12%) and severe malnutrition (149, 11%) were the major causes for admission and were responsible for most deaths (113, 75%). The overall case fatality rate was 11% and most (90, 60%) died within 48 hours of admission. Forty-five per cent of the 332 children tested were HIV-positive.


CONCLUSIONS
Most severe morbidity and mortality result from four common conditions, reflecting poor socioeconomic conditions in the area. Opportunities for clincial intervention to reduce their impact include identification of 'at risk' children, focusing care early in admissions, use of standardised protocols of care, and integrated management of the sick child.
Chopra
M
M
University of the Western Cape, Hlabisa Hospital, KwaZulu-Natal.
Stirling
S
S
Wilkinson
D
D
Connolly
C
C
McCoy
D
D
D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D004403:Dysentery / Q000401:mortality; D005260:Female; D015658:HIV Infections / Q000401:mortality; D006292:Health Priorities; D017052:Hospital Mortality / Q000639:trends; D006780:Hospitals, Rural; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008485:Medical Audit; D009748:Nutrition Disorders / Q000401:mortality; D009752:Nutritional Status; D010343:Patient Admission / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000401:mortality; D018570:Risk Assessment; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology