The association between severely deranged vital signs and Dysglycaemia in severely ill children admitted to Queen Elizabeth Central Hospital (QECH), Blantyre Malawi

Abnormal blood glucose level commonly occurs in children presenting to the hospitals in low income settings. The presence of low blood glucose levels could be a marker of disease severity. Vital signs are routinely checked in sick children and most settings use a combination of deranged vital sig...

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Autor principal: Mayani, Ednas Billiat
Formato: Tesis
Lenguaje:English
Publicado: Kamuzu University of Health Sciences 2022
Acceso en línea:http://nkhokwe.kuhes.ac.mw/handle/20.500.12845/639
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Sumario:Abnormal blood glucose level commonly occurs in children presenting to the hospitals in low income settings. The presence of low blood glucose levels could be a marker of disease severity. Vital signs are routinely checked in sick children and most settings use a combination of deranged vital signs to determine disease severity. Blood glucose is a quick, bed side test and could serve as a complementary indicator of disease severity in low resource settings. The study aims to determine the association between the presence of severely deranged vital signs and dysglycaemia in severely ill children admitted to a tertiary hospital in Malawi. This was a crosssectional study which used secondary data from Paediatric department collected from December 2016 to January 2019. Multinomial logistic regression was used to determine the association between severely deranged vital signs and dysglycaemia. A total of 5247 children, aged 0 to 18years were recruited into the study. 353(6.7%) had lowglycaemia,105(2.0%) had hypoglycaemia and 771(14.7%) had hyperglycaemia. The presence of any severely deranged vital sign, specifically, hypoxia (oxygen saturation <90%) and coma score of<2 were associated with both hypoglycaemia and hyperglycaemia. The Adjusted Odds Ratio (AOR) for the association of any severely deranged vital sign with hypoglycaemia was 1.76(95% CI 1.2–2.6) and 1.5(95% CI 1.3–1.8) with hyperglycaemia. Hypoxia had odds ratio of 2.0(95% CI 1.2–3.4) for hypoglycaemia and 1.5 (95% CI 1.2–1.9) for hyperglycaemia whilst for reduced coma score the odds was 6.5(95% CI 4.2–10.2) and 2.3(95% CI 1.8–2.9) respectively. The results have shown that the presence of any severely deranged vital sign is associated with dysglycaemia especially hypoglycaemia and hyperglycaemia. As such dysglycaemia might be used as a complementary marker of disease severity in low resource settings.