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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Relationship between distance of referring facilities and haemoglobin change in children in Malawi
Paediatrics and International Child Health, Volume 41, No. 4, Year 2021
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Description
Background: Anaemia is a significant cause of mortality in children in sub-Saharan Africa where blood transfusion is often available only at referral hospitals. Understanding the pattern of referrals by health facilities is essential to identify the delays that affect child survival. Aim: To determine if there was a correlation between change in haemoglobin (Hb) level and distance from referring facilities to Kamuzu Central Hospital (KCH) in Malawi, and whether distance affected mortality rates. Methods: This was a retrospective cohort study of 2259 children referred to KCH whose Hb was measured at the referring facility or at KCH. Maps were created using ArcGIS® software. The relationship between distance from KCH and change in Hb was assessed by χ2 analysis and multiple linear regression with SAS© software. Results: The majority of children were referred by health facilities in the Lilongwe District. When categorised as Hb <4, 4–6 or >6 g/dL, 87.0% of children remained in the same category during transfer. There was no significant relationship between Hb drop and distance from KCH. Distance from KCH was not a significant predictor of Hb level at KCH or Hb change. However, mortality rates were significantly higher in facilities that were 10–50 km from KCH than in those which were <10 km away. Conclusions: Using distance as a proxy for time, this suggests that referring facilities are transferring children sufficiently quickly to avert significant reductions in Hb. Despite this, there is a need to identify the factors that influence the decision to transfer anaemic children.
Authors & Co-Authors
Keating, Elizabeth M.
United States, Salt Lake City
University of Utah School of Medicine
Malawi, Lilongwe
Kamuzu Central Hospital
Robison, Jeff A.
United States, Salt Lake City
University of Utah School of Medicine
Chiume, Msandeni Esther
Malawi, Lilongwe
Kamuzu Central Hospital
Taddie, Marissa
United States, Salt Lake City
The University of Utah
VanDerslice, James A.
United States, Salt Lake City
The University of Utah
Benson, Scott Scott
United States, Salt Lake City
The University of Utah
Fitzgerald, Elizabeth F.
United States, Chapel Hill
Unc School of Medicine
Crouse, Heather L.
United States, Houston
Baylor College of Medicine
Eckerle, Michelle D.
United States, Cincinnati
Cincinnati Children's Hospital Medical Center
United States, Cincinnati
University of Cincinnati College of Medicine
Ciccone, Emily J.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Porucznik, Christina A.
United States, Salt Lake City
The University of Utah
Statistics
Citations: 11
Authors: 11
Affiliations: 8
Identifiers
Doi:
10.1080/20469047.2022.2044674
ISSN:
20469047
e-ISSN:
20469055
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
Malawi