Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jan;94(1):218-26.
doi: 10.4269/ajtmh.15-0475. Epub 2015 Oct 26.

Hypoglycemia and Risk Factors for Death in 13 Years of Pediatric Admissions in Mozambique

Lola Madrid  1 , Sozinho Acacio  2 , Tacilta Nhampossa  2 , Miguel Lanaspa  2 , Antonio Sitoe  2 , Sónia Amós Maculuve  2 , Helio Mucavele  2 , Llorenç Quintó  2 , Betuel Sigaúque  2 , Quique Bassat  2
Affiliations

Hypoglycemia and Risk Factors for Death in 13 Years of Pediatric Admissions in Mozambique

Lola Madrid et al. Am J Trop Med Hyg. 2016 Jan.

Abstract

Hypoglycemia is a life-threatening complication of several diseases in childhood. We describe the prevalence and incidence of hypoglycemia among admitted Mozambican children, establishing its associated risk factors. We retrospectively reviewed clinical data of 13 years collected through an ongoing systematic morbidity surveillance in Manhiça District Hospital in rural Mozambique. Logistic regression was used to identify risk factors for hypoglycemia and death. Minimum community-based incidence rates (MCBIRs) for hypoglycemia were calculated using data from the demographic surveillance system. Of 49,089 children < 15 years hospitalized in Manhiça District Hospital, 45,573 (92.8%) had a glycemia assessment on admission. A total of 1,478 children (3.2%) presented hypoglycemia (< 3 mmol/L), of which about two-thirds (972) were with levels < 2.5 mmol/L. Independent risk factors for hypoglycemia on admission and death among hypoglycemic children included prostration, unconsciousness, edema, malnutrition, and bacteremia. Hypoglycemic children were significantly more likely to die (odds ratio [OR] = 7.11; P < 0.001), with an associated case fatality rate (CFR) of 19.3% (245/1,267). Overall MCBIR of hypoglycemia was 1.57 episodes/1,000 child years at risk (CYAR), significantly decreasing throughout the study period. Newborns showed the highest incidences (9.47 episodes/1,000 CYAR, P < 0.001). Hypoglycemia remains a hazardous condition for African children. Symptoms and signs associated to hypoglycemia should trigger the verification of glycemia and the implementation of life-saving corrective measures.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Study profile.
Figure 2.
Figure 2.
Distribution of normo-, hypo-, and hyperglycemia according to age group.
Figure 3.
Figure 3.
Case fatality rates (CFRs) according to glycemia level.
Figure 4.
Figure 4.
Minimum community-based incidence rates (MCBIRs) of hypoglycemia according to year (vertical bars indicate 95% confidence intervals [CI]).
See this image and copyright information in PMC

References

    1. Hirshberg E, Larsen G, Van Duker H. Alterations in glucose homeostasis in the pediatric intensive care unit: hyperglycemia and glucose variability are associated with increased mortality and morbidity. Pediatr Crit Care Med. 2008;9:361–366. - PubMed
    1. Faustino EV, Hirshberg EL, Bogue CW. Hypoglycemia in critically ill children. J Diabetes Sci Technol. 2012;6:48–57. - PMC - PubMed
    1. Ognibene KL, Vawdrey DK, Biagas KV. The association of age, illness severity, and glycemic status in a pediatric intensive care unit. Pediatr Crit Care Med. 2011;12:e386–e390. - PubMed
    1. Zijlmans WC, van Kempen AA, Serlie MJ, Kager PA, Sauerwein HP. Adaptation of glucose metabolism to fasting in young children with infectious diseases: a perspective. J Pediatr Endocrinol Metab. 2013;27:5–13. - PubMed
    1. Kraft R, Herndon DN, Mlcak RP, Finnerty CC, Cox RA, Williams FN, Jeschke MG. Bacterial respiratory tract infections are promoted by systemic hyperglycemia after severe burn injury in pediatric patients. Burns. 2014;40:428–435. - PMC - PubMed

Publication types