RT Journal Article
SR Electronic
T1 A Prospective, observational cohort study to identify neonates and children at risk of postdischarge mortality in Dar es Salaam, Tanzania and Monrovia, Liberia: the PPDM study protocol
JF BMJ Paediatrics Open
JO BMJ Paediatrics Open
FD BMJ Publishing Group Ltd
SP e001379
DO 10.1136/bmjpo-2021-001379
VO 6
IS 1
A1 Chris A Rees
A1 Rodrick Kisenge
A1 Readon C Ideh
A1 Julia Kamara
A1 Abraham Samma
A1 Evance Godfrey
A1 Hussein K Manji
A1 Christopher R Sudfeld
A1 Adrianna Westbrook
A1 Michelle Niescierenko
A1 Karim P Manji
A1 Christopher P Duggan
YR 2022
UL http://bmjpaedsopen.bmj.com/content/6/1/e001379.abstract
AB Introduction Over half of the 5 million annual deaths among children aged 0–59 months occur in sub-Saharan Africa. The period immediately after hospitalisation is a vulnerable time in the life of a child in sub-Saharan Africa as postdischarge mortality rates are as high as 1%–18%. Identification of neonates and children who are at highest risk for postdischarge mortality may allow for the direction of interventions to target patients at highest risk.Methods and analysis The Predicting Post-Discharge Mortality study is a prospective, observational study being conducted at Muhimbili National Hospital (Dar es Salaam, Tanzania) and John F. Kennedy Medical Center (Monrovia, Liberia). The aim is to derive and validate two, age population specific, clinical prediction rules for the identification of neonates (n=2000) and children aged 1–59 months (n=2000) at risk for all-cause mortality within 60 days of discharge from the neonatal intensive care unit or paediatric ward. Caregivers of participants will receive phone calls 7, 14, 30, 45 and 60 days after discharge to assess vital status. Candidate predictor variables will include demographic, anthropometric and clinical factors. Elastic net regression will be used to derive the clinical prediction rules. Bootstrapped selection with repetitions will be used for internal validation. Planned secondary analyses include the external validation of existing clinical prediction models, determination of clinicians’ ability to identify neonates and children at risk of postdischarge mortality at discharge, analysis of factors associated with hospital readmission and unplanned clinic visits and description of health-seeking behaviours in the postdischarge period.Ethics and dissemination This study received ethical clearance from the Tanzania National Institute of Medical Research, Muhimbili University of Health and Allied Sciences, the John F. Kennedy Medical Center Institutional Review Board, and the Boston Children’s Hospital Institutional Review Board. Findings will be disseminated at scientific conferences and as peer-reviewed publications.