title: Three years of paediatric morbidity and mortality at the National Hospital in Dili, East Timor.
abstract: OBJECTIVE
  The aim of this study was to undertake a retrospective review of admissions and discharges to the paediatric wards at the National Hospital Guido Valadares, Dili, as the epidemiology of hospitalised children in East Timor cannot be easily understood from the hospital health management information system.
  
  
  METHODS
  Data were sourced from unit registers for 3 years, 2008-2010 inclusive. Demographic characteristics and principal diagnoses were related to the risk of dying using stepwise multivariate logistic regression.
  
  
  RESULTS
  There were 5909 children admitted to the wards over the study period and 60% were <2 years of age. The commonest reasons for admission were lower respiratory tract infections (LRIs) and gastroenteritis (43% and 16%, respectively). Severe malnutrition (MN) was recorded in only 5% of admissions. Overall, 6% of children died, mainly attributed to LRI (28%), central nervous system infections (16%) and MN (11%). Younger age, residence outside of Dili and admission during a busier period were independently associated with an increased risk of death. Nine per cent of hospitalised infants aged 1-6 months of age died and half of all deaths occurred within 2 days of admission.
  
  
  CONCLUSIONS
  The study provides, for the first time, an understanding of the admissions and outcomes of the busiest paediatric inpatient unit in East Timor. It emphasises important health system issues which impact on both data quality and hospital outcomes.
authors.affiliation: Paediatrics, National Hospital Guido Valadares, Dili, East Timor.
authors.forename: Ingrid Kirsten
authors.initials: IK
authors.lastname: Bucens
authors.forename: Alison
authors.initials: A
authors.lastname: Reid
authors.forename: Aniceto Cardoso
authors.initials: AC
authors.lastname: Barreto
authors.forename: Vikas
authors.initials: V
authors.lastname: Dwivedi
authors.forename: Megan
authors.initials: M
authors.lastname: Counahan
mesh_terms: D000367:Age Factors; D002494:Central Nervous System Infections / Q000401:mortality; D002648:Child; D046688:Child Mortality; D002675:Child, Preschool; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D008297:Male; D009017:Morbidity; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D049648:Timor-Leste / Q000453:epidemiology
keywords: Democratic Republic of East Timor; East Timor; child; child mortality; hospital