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Measles in a S outh A frican paediatric intensive care unit: Again!
Author(s) -
Coetzee Saskia,
Morrow Brenda M,
Argent Andrew C
Publication year - 2014
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12486
Subject(s) - medicine , interquartile range , pediatrics , pediatric intensive care unit , pneumonia , measles , intensive care unit , mortality rate , retrospective cohort study , emergency medicine , vaccination , immunology
Aim The aim of this study is to evaluate the outcomes of children with measles‐related disease ( MRD ) admitted to a paediatric intensive care unit ( PICU ) and the effect on PICU resources and elective surgery of a recent measles epidemic. Methods This was a retrospective observational study of all patients admitted to the PICU of R ed C ross W ar M emorial C hildren's H ospital, C ape T own, S outh A frica, with MRD from January to December 2010. Patient admission characteristics, duration of PICU admission and mortality were recorded. Costs were calculated using bed days utilised and estimated daily PICU admission cost. Results A total of 1274 children were admitted over the study period, 58 (4.6%) with MRD (median (interquartile range) age 7 (5–9) months). Pneumonia was the most common reason for admission (81%) and the main cause of mortality. Non‐ MRD mortality was 8.8% compared with MRD mortality of 31% ( P < 0.0001). Standardised mortality for non‐ MRD was 0.7 versus 1.7 in MRD ( P = 0.002). HIV comorbidity and being underweight for age were associated with increased mortality. Patients with MRD occupied 379 bed days with a median (interquartile range) duration of stay of 5.5 (3.0–9.0) days at an estimated overall cost of R4 813 300 (approximately $543 900). During the study period, 67 children booked for elective surgery, and 87 other referrals were refused PICU admission. Conclusions MRD was associated with significant morbidity and mortality, and substantial strain on scarce PICU resources.