title: Predictors of Hospitalization During the First Year of Life among 31999 Tanzanian Infants.
abstract: OBJECTIVE
  This study explored the risk factors for infant hospitalization in urban and peri-urban/rural Tanzania.
  
  
  METHODS
  We conducted a prospective cohort study examining predictors of hospitalization during the first year of life among infants enrolled at birth in a large randomized controlled trial of neonatal vitamin A supplementation conducted in urban Dar es Salaam (n = 11,895) and peri-urban/rural Morogoro region (n = 20,104) in Tanzania. Demographic, socioeconomic, environmental and birth outcome predictors of hospitalization were assessed using proportional hazard models.
  
  
  RESULTS
  The rate of hospitalization was highest during the neonatal period in both Dar es Salaam (102/10,000 neonatal-months) and Morogoro region (78/10,000 neonatal-months). Hospitalization declined with increased age and was lowest for infants 6-12 months of age in both Dar es Salaam (11/10,000 infant-months) and Morogoro region (16/10,000 infant-months). In both Dar es Salaam and Morogoro region, older maternal age, male sex, low birth weight and being small for gestational age were significant predictors of higher risk of hospitalization (p < 0.05). Increased wealth and having a flush toilet were significantly associated with an increased risk of hospitalization in Morogoro region only (p < 0.05).
  
  
  CONCLUSIONS
  This study determined high rates of neonatal hospitalization in Tanzania. Interventions to increase birth size may decrease risk of hospitalization. Equity in access to hospitals for poor rural families in Tanzania requires attention.
authors.affiliation: Harvard School of Public Health, Department of Global Health and Population, 655 Huntington Avenue, Boston, MA 02115, USA briegleb.harvard@gmail.com.
authors.forename: Christina
authors.initials: C
authors.lastname: Briegleb
authors.affiliation: Harvard School of Public Health, Department of Global Health and Population, 655 Huntington Avenue, Boston, MA 02115, USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Sudfeld
authors.affiliation: Harvard School of Public Health, Department of Global Health and Population, 655 Huntington Avenue, Boston, MA 02115, USA.
authors.forename: Emily R
authors.initials: ER
authors.lastname: Smith
authors.affiliation: Harvard School of Public Health, Department of Global Health and Population, 655 Huntington Avenue, Boston, MA 02115, USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Ruben
authors.affiliation: African Academy for Public Health, P.O. Box 79810, Dar es Salaam, Tanzania.
authors.forename: Alfa
authors.initials: A
authors.lastname: Muhihi
authors.affiliation: African Academy for Public Health, P.O. Box 79810, Dar es Salaam, Tanzania.
authors.forename: Salum
authors.initials: S
authors.lastname: Mshamu
authors.affiliation: Harvard School of Public Health, Department of Global Health and Population, 655 Huntington Avenue, Boston, MA 02115, USA African Academy for Public Health, P.O. Box 79810, Dar es Salaam, Tanzania.
authors.forename: Ramadhani Abdallah
authors.initials: RA
authors.lastname: Noor
authors.affiliation: Ifakara Health Institute, Plot 463 Kiko Avenue, Mikocheni, Tanzania.
authors.forename: Honorati
authors.initials: H
authors.lastname: Masanja
authors.affiliation: Harvard School of Public Health, Department of Global Health and Population, 655 Huntington Avenue, Boston, MA 02115, USA.
authors.forename: Wafaie W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: D000328:Adult; D001724:Birth Weight; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D009017:Morbidity; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D011272:Pregnancy, Multiple; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors; D013636:Tanzania / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data; D014801:Vitamin A / Q000008:administration & dosage*; D014802:Vitamin A Deficiency / Q000188:drug therapy* / Q000453:epidemiology; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D014815:Vitamins; D014801:Vitamin A
keywords: Tanzania; hospitalization; infancy; morbidity; neonatal