Autor/a:
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Madrid, Lola; Acácio, Sozinho; Nhampossa, Tacilta; Lanaspa, Miguel; Sitoe, Antonio; Maculuve, Sónia Amós; Mucavele, Helio; Quintó, Llorenç; Sigaúque, Betuel; Bassat Orellana, Quique
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Abstract:
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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 Manhica 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 Manhica 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. |