Peer-reviewed article
Factors associated with paediatric ward abscondment in four district hospitals in Malawi
Kelvin M. Maziya, Madalitso D. Zulu, Christopher C. Stanley, Davie Kondowe, Eglina Chisale et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5This study looked at children under five who left hospital wards in Malawi before their treatment was finished, a practice called abscondment. Researchers compared children who left early with similar children who stayed, using hospital records from four district hospitals. About 2% of admitted children absconded during the study period. Children with severe anaemia and those who had been in hospital longer than three days were more likely to leave early. The study suggests these factors could help hospitals identify children at risk of leaving before treatment is complete.
Key points
- 2.17% (454 of 20,925) of admitted paediatric patients absconded from hospital.
- Severe anaemia was more common among children who absconded (17.54%) than those who did not (8.91%), p<0.01.
- Hospital stays longer than three days were more common among cases (42.22%) than controls (25.40%), p<0.01.
- The study used a case-control design matching absconders with non-absconders from the same area and similar admission dates.
- Authors suggest these factors may warrant further investigation for abscondment prevention.
Limitations
The study only identifies associations, not causes, and does not test any intervention to reduce abscondment; findings may not generalise beyond the four district hospitals studied.
Abstract
Abscondment from hospital poses risks to patients. The epidemiology of abscondment from hospitals remains unclear in Malawi and other sub-Saharan African settings. This case-control study used data from a hospital surveillance of the Malaria Vaccine Implementation Program in four district hospitals in Malawi to describe factors associated with abscondment among paediatric inpatients. The cases and controls (1:1 match) were children aged 1–59 months hospitalised with an acute medical illness. The cases were children who absconded from the hospital. Controls were children admitted within ± 7 days of the admission date of the corresponding cases who did not abscond, residing in the same geographical cluster. Baseline characteristics between cases and controls were compared using the chi-squared test of independence or Fisher’s Exact test. Over the period of analysis, 2.17% (454/20925) of admitted patients absconded. Severe anaemia was more prevalent in cases than controls (17.54% (50/285) vs. 8.91% (27/303), p < 0.01). Hospital stay longer than three days was more prevalent in cases than controls (42.22% (141/334) vs. 25.40% (112/441), p < 0.01). In this analysis, hospital stay for > 3 days and severe anaemia showed possible trends towards increased odds of abscondment, hence may warrant further investigation as potential indicators for the prevention of abscondment.