Paediatric Mortality: Aetiologies and Predictors among Children Aged 1 Month to 15 Years in a Tertiary Hospital in Douala, Cameroon

Background: Children and adolescent mortality remains a public health concern in developing countries. This study aimed to describe risk factors and aetiologies of mortality among children and young adolescents at a tertiary hospital in the town of Douala, Cameroon. Methods: We carried out a retrospective cohort study from January 1st to May 31st, 2019 among deceased patients aged 1 month to 15 years admitted to the paediatric ward of the Gynaeco-Obstetric and Paediatric Hospital. Data of interest were collected and analysed. Results: Out of 3088 children admitted, 123 death cases were recorded. The overall hospital mortality rate was 3.98%. Females accounted for 51% of the deceased patients. Fever was the main reason for consultation. Severe malaria was the most common diagnosis. In univariate logistic regression analysis, factors associated with mortality included hyperthermia (OR = 0.24;95% CI 0.80 - 1.33;p = 0.012), coma/impaired consciousness (OR = 0.30;95% CI 0.10 - 0.88;p = 0.029), pneumonia (OR = 3.95;95% CI 1.42 - 10.97;p = 0.008), antipyretic therapy (OR = 0.28;95% CI 0.11 - 0.73;p = 0.009), and no medication (OR = 4.50;95% CI 1.05 - 9.29;p = 0.043). In multivariate regression analysis, coma/impaired consciousness was found to be the only factor associated with mortality (OR = 6.24;95% CI 1.15 - 33.73;p = 0.034). Conclusion: The present study reveals that most of death cases were due to preventable causes, especially infectious diseases. Efficient reduction in children and adolescent mortality could be achieved by adequately addressing these causes.

Neonatal Transfer Situation Following Implementation of a Perinatal Network: An Analysis in Douala, Cameroon

Background: Postnatal transfer (PT) is interhospital transport of care-needing newborns. In 2016, a perinatal network was implemented to facilitate PT in the town of Douala, Cameroon. The network was supposed to improve PT-related care standards. This study aimed at determining characteristics of PT five years following the implementation of this network. Methods: A cross-sectional study was carried out from February to May 2021 at neonatology wards of six hospitals in Douala. Medical records of newborns transferred to the hospitals were scrutinized to document their characteristics. Parents were contacted to obtain information on PT route and itinerary. Data were analyzed using Epi Info software and summarized as percentages, mean and odds ratio. Results: In total, 234 of the 1159 newborns admitted were transferred, giving a PT prevalence of 20.2% (95% CI 17.9% - 22.6%). Male-to-female ratio of the transferred newborns was 1.3. Neonatal infection (26.5%), prematurity (23.5%) and respiratory distress (15.4%) were the main reasons for transfer. Only 3% of the PT was medicalized while only 2% of the newborns were transferred through perinatal network. On admission, hypothermia and respiratory distress were found in 31% and 35% of the newborns, respectively. The mortality rate among babies was 20% and these had a two-fold risk of dying (95% CI 1.58 - 3.44, p Conclusion: PT and the perinatal network are lowly organized and implemented in Douala. Sensitization of medical staff on in utero transfer, creating center for coordination of the network, and implementation of neonatal transport system could improve the quality of PT.