Outcome of Children Admitted to a General Highcare Unit in a Regional Hospital in the Western Cape; South Africa

Background. Critically ill children are often managed in non-tertiary general intensive care units admitting both adults and children; but few data are currently available regarding paediatric outcomes in these general units.Objective. To determine the outcome of critically ill neonates and children admitted to a general high-care unit in a large regional hospital in the Western Cape; South Africa.Methods. This was a retrospective descriptive analysis of outcome of all neonatal and paediatric (13 years of age) patients admitted with non-surgical disease; during a 1-year period; to a general high-care unit at a large regional hospital in Worcester; South Africa. Data included demography; admission time; length of stay; diagnoses; HIV status; therapeutic interventions and outcome. The primary outcome was defined as successful discharge; transfer to a central hospital or death.Results. There were 185 admissions; with the majority (83%) 12 months of age (median age 3.7 months; range 0 - 151 months) and a male:female ratio of 1.3:1. The majority (70%) were successfully discharged; while 24% were transferred to a tertiary paediatric intensive care unit (PICU) and only 6% died. Causes of death included acute lower respiratory tract infections (33%); acute gastroenteritis (33%); birth asphyxia (16%) and complications of prematurity (16%). Nasal continuous positive airway pressure (p0.001); ventilation (p0.001) and HIV infection (p

Compliance with Infant Formula Feeding By HIV-Positive Women One Week after Delivery in Khayelitsha; South Africa

When mixed feeding occurs a few days following delivery; the risk of HIV transmission is likely high. The study aim was to assess infant feeding practices; one week following delivery of HIV-positive mothers who intended to formula feed their infants. A consecutive sample of 95 HIV-positive mother-infant pairs was recruited soon after delivery from a midwife obstetric unit in Khayelitsha. Face-to-face interviews were conducted one week after delivery at the clinic to determine the actual infant feeding practices. Sixty-four HIV-positive mother-infant pairs completed the study. The response rate was 67. The median interview day was day 8. Sixty-two mothers (97) (95 CI: 95 to 99) exclusively formula fed their infants. Fifty (78) (95 CI: 73 to 83) mothers gave their infants formula milk only. Two mothers breast-fed their babies. Twelve (19) gave their babies other fluids or food. Eleven gave water; glucose water or gripe water and one gave cereal or porridge. Breast engorgement occurred in 51 (80) mothers. Only five (8) mothers had received advice about breast engorgement from the facility health providers. Compliance with formula feeding of HIV-positive mothers one week following delivery is at an acceptable level. Levels of breast engorgement and lack of counselling on breast engorgement were high. Advice about non-pharmacological methods of managing breast engorgement must be given to women choosing to formula feed their babies. Mothers must be informed about the dangers of mixed feeding during the first week after delivery