Table 2 Frequency of children presenting with signs of impaired circulation or shock to hospital in low-resource settings
Reference | Study design | Study site | Sample | Inclusion criteria | WHO shock and mortality | Number with ≥ 2 signs of impaired circulation |
|---|---|---|---|---|---|---|
Tamburlini, 1999 | Prospective cohort | Brazil | 3837 | Children 7 days to 5 years old presenting to emergency room | 4 (0.13%) 100% mortality | ETAT emergency signs (severe respiratory distress, shock, coma/convulsions or severe dehydration) in 98 children |
Robertson, 2001 | Prospective cohort | QEQH Blantyre, Malawi | 2281 | Emergency room triage Children aged < 5 years | Not reported | Emergencies (n = 92); only 7–11 had delayed CRT (staff differed in assessments) |
Ahmad, 2010 | Prospective cohort study | QECH Blantyre, Malawi | 583 | “Critically ill” children presenting to emergency room | Did not report WHO shock triad | 247 (42%) |
Maitland, 2011 | Phase III RCT | 6 hospitals Kenya, Uganda and Tanzania | 3141 | FEAST trial inclusion criteria | 65 (2%) 41.5% mortality | 3076 (98%) by inclusion criteria |
Mbevi, 2016, | Retrospective analysis | 14 hospitals Kenya | 42,937 | Admissions in children aged > 30 days to < 5 years (excluded patients with burns or malnutrition) | 41 (0.1%) Mortality not reported | 3219 (7.5%)a |
CPGH, 2017, unpublished | Prospective cohort | CPGH, Mombasa, Kenya | 26,104 | Admissions <=6 years over 6 years | 27 (0.1%) 85% mortality | 3403 (13.04%) – mortality 31% |
KDH, 2017, unpublished | Prospective cohort | KDH, Kilifi, Kenya | 22,911 | Admissions <=6 years over 6 years | 33 (0.14%) 58% mortality | 9788 (42.72%) – mortality 7.24% |