Hypoglycemia and Risk Factors for Death in 13 Years of Pediatric Admissions in Mozambique.
Hypoglycemia is a life-threatening complication of several diseases in childhood. We describe the prevalence and incidence of hypoglycemia among admitted Mozambican children, establishing its associated risk factors. We retrospectively reviewed clinical data of 13 years collected through an ongoing systematic morbidity surveillance in Manhiça District Hospital in rural Mozambique. Logistic regression was used to identify risk factors for hypoglycemia and death. Minimum community-based incidence rates (MCBIRs) for hypoglycemia were calculated using data from the demographic surveillance system. Of 49,089 children < 15 years hospitalized in Manhiça District Hospital, 45,573 (92.8%) had a glycemia assessment on admission. A total of 1,478 children (3.2%) presented hypoglycemia (< 3 mmol/L), of which about two-thirds (972) were with levels < 2.5 mmol/L. Independent risk factors for hypoglycemia on admission and death among hypoglycemic children included prostration, unconsciousness, edema, malnutrition, and bacteremia. Hypoglycemic children were significantly more likely to die (odds ratio [OR] = 7.11; P < 0.001), with an associated case fatality rate (CFR) of 19.3% (245/1,267). Overall MCBIR of hypoglycemia was 1.57 episodes/1,000 child years at risk (CYAR), significantly decreasing throughout the study period. Newborns showed the highest incidences (9.47 episodes/1,000 CYAR, P < 0.001). Hypoglycemia remains a hazardous condition for African children. Symptoms and signs associated to hypoglycemia should trigger the verification of glycemia and the implementation of life-saving corrective measures.
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Barcelona Institute for Global Health, Barcelona Centre for International Health Research, Hospital Clínic Universitat de Barcelona, Barcelona, Spain; Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique lola.madrid@isglobal.org.
Lola
L
Madrid
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Barcelona Institute for Global Health, Barcelona Centre for International Health Research, Hospital Clínic Universitat de Barcelona, Barcelona, Spain; Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
Sozinho
S
Acacio
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Barcelona Institute for Global Health, Barcelona Centre for International Health Research, Hospital Clínic Universitat de Barcelona, Barcelona, Spain; Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
Tacilta
T
Nhampossa
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Barcelona Institute for Global Health, Barcelona Centre for International Health Research, Hospital Clínic Universitat de Barcelona, Barcelona, Spain; Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
Miguel
M
Lanaspa
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Barcelona Institute for Global Health, Barcelona Centre for International Health Research, Hospital Clínic Universitat de Barcelona, Barcelona, Spain; Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
Antonio
A
Sitoe
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Barcelona Institute for Global Health, Barcelona Centre for International Health Research, Hospital Clínic Universitat de Barcelona, Barcelona, Spain; Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
Sónia Amós
SA
Maculuve
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Barcelona Institute for Global Health, Barcelona Centre for International Health Research, Hospital Clínic Universitat de Barcelona, Barcelona, Spain; Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
Helio
H
Mucavele
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Barcelona Institute for Global Health, Barcelona Centre for International Health Research, Hospital Clínic Universitat de Barcelona, Barcelona, Spain; Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
Llorenç
L
Quintó
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Barcelona Institute for Global Health, Barcelona Centre for International Health Research, Hospital Clínic Universitat de Barcelona, Barcelona, Spain; Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
Betuel
B
Sigaúque
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Barcelona Institute for Global Health, Barcelona Centre for International Health Research, Hospital Clínic Universitat de Barcelona, Barcelona, Spain; Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
Quique
Q
Bassat
D001786:Blood Glucose; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology* / Q000401:mortality*; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009073:Mozambique / Q000453:epidemiology; D012307:Risk Factors
D001786:Blood Glucose