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Indications for hospitalisation and predictors of 30-day re-admission of patients with sickle cell disease in Uganda: a retrospective study

Por: Kibone · W. · Muzoora · C. · Bongomin · F. · Namiiro · M. A. · Ssenkungu · S. · Ochola · E. · Kasirye · P. · Hamer · D. H.
Background

Sickle cell disease (SCD) is associated with significant mortality and morbidity, especially in low- and middle-income countries.

Objectives

We determined the indications for hospitalisation and predictors of 30-day re-admission among patients with SCD in Northern and Central Uganda.

Design

Retrospective chart review.

Setting

Mulago National Referral Hospital in Kampala, St. Mary’s Hospital Lacor in Gulu and Gulu Regional Referral Hospital in Gulu, Uganda.

Participants

Patients with confirmed SCD admitted between January 2020 and January 2025 were included.

Outcomes

Primary outcome: indication for hospitalisation. Secondary outcomes: rate and predictors of 30-day hospital re-admission. Socio-demographic, clinical history and hospitalisation data were extracted using a pretested data extraction tool.

Results

We enrolled 505 patients, accounting for 714 hospital admissions, with a mean age of 8.1±6.2 years. Most participants (n=489, 96.8%) had less than four admissions per year, with a median of 1 admission (IQR: 0–2). The most common indications for hospitalisation were infection (n=375, 52.5%), painful crisis (n=366, 51.3%) and anaemia (n=186, 26.1%). Malaria was the most prevalent infection (n=244, 65%). The median length of hospital stay was 4 days (IQR: 3–6), with a 30-day re-admission rate of 6.9% (n=49). Admission with painful crisis (adjusted OR (AOR): 0.45, 95% CI: 0.23 to 0.89, p=0.021), receiving a blood product (AOR: 0.32, 95% CI: 0.16 to 0.66, p=0.002) and having four or more admissions per year (AOR: 0.84, 95% CI: 0.04 to 0.17, p

Conclusions

Infections, especially malaria, and painful crises were the leading causes of hospitalisation among Ugandan patients with SCD. Frequent admissions, painful crises and blood transfusions were associated with lower 30-day re-admission risk. There is an urgent need to strengthen malaria prevention strategies and optimise access to disease-modifying therapy, such as hydroxyurea, to improve patient outcomes.

Disabilities and depression in young adolescents living in underdeveloped areas of Indonesia: results from the 2018 Indonesia Basic Health Survey

Por: Tjandrarini · D. H. · Ashar · H. · Nari · J. P. · Malakauseya · M. L. V. · Senewe · F. P. · Musoddaq · M. A. · Nazarina · N. · Mulyantoro · D. K. · Wardhani · Y. F. · Izza · N. · Titaley · C. R.
Objectives

This study aimed to investigate the association between the type and severity of disabilities and depression among adolescents aged 15–17 years living in underdeveloped areas of Indonesia.

Design

Cross-sectional study.

Setting

Data were derived from the 2018 Indonesia Basic Health Research, a nationally representative data of Indonesia.

Participant

We used information collected from 4811 adolescents aged 15–17 living in underdeveloped areas of Indonesia.

Primary outcome

The primary outcome was depression, based on the conditions experienced by respondents during the last 2 weeks.

Results

The analysis showed that 5.65% of adolescents aged 15–17 years living in underdeveloped areas of Indonesia had depressive symptoms. Adolescents with severe physical and psychological disabilities were most at risk, exhibiting significantly higher odds of developing depression (aOR=12.09, 95% CI: 5.41 to 27.03, p0.001). Other significant predictors included female adolescents (aOR=2.18, 95% CI: 1.51 to 3.14, p0.001) and those who had a non-communicable disease (aOR=3.50, 95% CI: 1.00 to 12.18, p=0.049).

Conclusions

These findings highlight the critical need for targeted depression interventions and collaborative efforts to support vulnerable adolescents in underdeveloped areas of Indonesia, particularly those with disabilities, girls and those with non-communicable diseases. Efforts to engage healthcare providers, educators and policymakers to improve access to mental health resources will enhance the overall well-being of vulnerable populations.

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