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

Abstract:

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.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1136/bmjopen-2020-042079

Authors

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Role:
Author
ORCID:
0000-0003-1269-5519
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Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
ORCID:
0000-0002-7427-0826
More by this author
Institution:
University of Oxford
Department:
External
Role:
Author
ORCID:
0000-0002-0851-3711
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
ORCID:
0000-0001-8760-1279

Contributors


Publisher:
BMJ Publishing Group
Journal:
BMJ Open More from this journal
Volume:
11
Issue:
6
Article number:
e042079
Publication date:
2021-06-18
Acceptance date:
2021-03-17
DOI:
EISSN:
2044-6055
ISSN:
2044-6055
Pmid:
34145005


Language:
English
Keywords:
Pubs id:
1183873
Local pid:
pubs:1183873
Deposit date:
2021-07-13
ARK identifier:

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