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Prevalence and fluid management of dehydration in children without diarrhoea admitted to Kenyan hospitals: a multisite observational study

OBJECTIVES: To examine the prevalence of dehydration without diarrhoea among admitted children aged 1–59 months and to describe fluid management practices in such cases. DESIGN: A multisite observational study that used routine in-patient data collected prospectively between October 2013 and Decembe...

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Autores principales: Omoke, Sylvia, English, Mike, Aluvaala, Jalemba, Gathara, David, Agweyu, Ambrose, Akech, Samuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215254/
https://www.ncbi.nlm.nih.gov/pubmed/34145005
http://dx.doi.org/10.1136/bmjopen-2020-042079
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author Omoke, Sylvia
English, Mike
Aluvaala, Jalemba
Gathara, David
Agweyu, Ambrose
Akech, Samuel
author_facet Omoke, Sylvia
English, Mike
Aluvaala, Jalemba
Gathara, David
Agweyu, Ambrose
Akech, Samuel
author_sort Omoke, Sylvia
collection PubMed
description OBJECTIVES: To examine the prevalence of dehydration without diarrhoea among admitted children aged 1–59 months and to describe fluid management practices in such cases. DESIGN: A multisite observational study that used routine in-patient data collected prospectively between October 2013 and December 2018. SETTINGS: Study conducted in 13 county referral hospitals in Kenya. PARTICIPANTS: Children aged 1–59 months with admission or discharge diagnosis of dehydration but had no diarrhoea as a symptom or diagnosis. Children aged <28 days and those with severe acute malnutrition were excluded. RESULTS: The prevalence of dehydration in children without diarrhoea was 3.0% (2019/68 204) and comprised 15.9% (2019/12 702) of all dehydration cases. Only 55.8% (1127/2019) of affected children received either oral or intravenous fluid therapy. Where fluid treatment was given, the volumes, type of fluid, duration of fluid therapy and route of administration were similar to those used in the treatment of dehydration secondary to diarrhoea. Pneumonia (1021/2019, 50.6%) and malaria (715/2019, 35.4%) were the two most common comorbid diagnoses. Overall case fatality in the study population was 12.9% (260/2019). CONCLUSION: Sixteen per cent of children hospitalised with dehydration do not have diarrhoea but other common illnesses. Two-fifths do not receive fluid therapy; a regimen similar to that used in diarrhoeal cases is used in cases where fluid is administered. Efforts to promote compliance with guidance in routine clinical settings should recognise special circumstances where guidelines do not apply, and further studies on appropriate management for dehydration in the absence of diarrhoea are required.
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spelling pubmed-82152542021-07-01 Prevalence and fluid management of dehydration in children without diarrhoea admitted to Kenyan hospitals: a multisite observational study Omoke, Sylvia English, Mike Aluvaala, Jalemba Gathara, David Agweyu, Ambrose Akech, Samuel BMJ Open Paediatrics OBJECTIVES: To examine the prevalence of dehydration without diarrhoea among admitted children aged 1–59 months and to describe fluid management practices in such cases. DESIGN: A multisite observational study that used routine in-patient data collected prospectively between October 2013 and December 2018. SETTINGS: Study conducted in 13 county referral hospitals in Kenya. PARTICIPANTS: Children aged 1–59 months with admission or discharge diagnosis of dehydration but had no diarrhoea as a symptom or diagnosis. Children aged <28 days and those with severe acute malnutrition were excluded. RESULTS: The prevalence of dehydration in children without diarrhoea was 3.0% (2019/68 204) and comprised 15.9% (2019/12 702) of all dehydration cases. Only 55.8% (1127/2019) of affected children received either oral or intravenous fluid therapy. Where fluid treatment was given, the volumes, type of fluid, duration of fluid therapy and route of administration were similar to those used in the treatment of dehydration secondary to diarrhoea. Pneumonia (1021/2019, 50.6%) and malaria (715/2019, 35.4%) were the two most common comorbid diagnoses. Overall case fatality in the study population was 12.9% (260/2019). CONCLUSION: Sixteen per cent of children hospitalised with dehydration do not have diarrhoea but other common illnesses. Two-fifths do not receive fluid therapy; a regimen similar to that used in diarrhoeal cases is used in cases where fluid is administered. Efforts to promote compliance with guidance in routine clinical settings should recognise special circumstances where guidelines do not apply, and further studies on appropriate management for dehydration in the absence of diarrhoea are required. BMJ Publishing Group 2021-06-18 /pmc/articles/PMC8215254/ /pubmed/34145005 http://dx.doi.org/10.1136/bmjopen-2020-042079 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Paediatrics
Omoke, Sylvia
English, Mike
Aluvaala, Jalemba
Gathara, David
Agweyu, Ambrose
Akech, Samuel
Prevalence and fluid management of dehydration in children without diarrhoea admitted to Kenyan hospitals: a multisite observational study
title Prevalence and fluid management of dehydration in children without diarrhoea admitted to Kenyan hospitals: a multisite observational study
title_full Prevalence and fluid management of dehydration in children without diarrhoea admitted to Kenyan hospitals: a multisite observational study
title_fullStr Prevalence and fluid management of dehydration in children without diarrhoea admitted to Kenyan hospitals: a multisite observational study
title_full_unstemmed Prevalence and fluid management of dehydration in children without diarrhoea admitted to Kenyan hospitals: a multisite observational study
title_short Prevalence and fluid management of dehydration in children without diarrhoea admitted to Kenyan hospitals: a multisite observational study
title_sort prevalence and fluid management of dehydration in children without diarrhoea admitted to kenyan hospitals: a multisite observational study
topic Paediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215254/
https://www.ncbi.nlm.nih.gov/pubmed/34145005
http://dx.doi.org/10.1136/bmjopen-2020-042079
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