Prevalence, aetiology, and hospital outcomes of paediatric acute critical illness in resource-constrained settings (Global PARITY): a multicentre, international, point prevalence and prospective cohort study

作者：Teresa Bleakly Kortz, Adrian Holloway, Asya Agulnik, David L. He, Stephanie Gordon Rivera, Qalab Abbas, John Adabie Appiah, Anita V. Arias, Jonah E. Attebery, Jhon Hadersson Camacho, Paula Caporal, Karla Emília de Sá Rodrigues, Ericka L. Fink, Niranjan “Tex” Kissoon, Jan Hau Lee, Eliana López, Srinivas Murthy, Fiona Muttalib, Katie R. Nielsen, Kenneth E. Remy, Firas M. Sakaan, Amelie von Saint André-von Arnim, Adriana Teixeira Rodrigues, William C. Blackwelder, Matthew O. Wiens, Adnan T Bhutta, Alhassan Abdul-Mumin, Nabisere Allen, Paloma Amarillo, Kokou Hefoume Amegan-Aho, Pamela C Arancibia, Fehmina Arif, Liliana Y Arteaga, Jacqueline G Asibey, Nataly Ávila Guerrero, Tigist Bacha, Briam D Beltran Hernandez, Hippolyte Bwiza Muhire, Juan S Calderon-Cardenas, Mariana Lucía Cañete, Dulamragchaa Chimedbazar, Claudia P Curi, Tenywa Emmanuel, Maria L Escobar, Sofia Esposto, Arieth Figueroa Vargas, Ana L Fustiñana, Marina Giulietti, Muhammad Irfan Habib, Pascal Havugarurema, Lucia C Hernandez Somerson, Nayibe Hincapie Saldarriaga, Shubhada Hooli, Jacob Isabirye, Saifullah Jamro, Juan C Jaramillo-Bustamante, Liliana P Jurado Salcedo, Halima Kabir, Caleb K Karanja, Adama Mamby Keita, Marie-Charlyne F Kilba, Guillermo Kohn-Loncarica, Kandamaran Krishnamurthy, Jorhk D Lasso Noguera, Marianne N Majdalani, Isabel C Monje Cardona, Emilse N Montero Nuñez, Celia I Mulgado Aguas, Raya Y Mussa, John H Nebaza, María N Noya, Edna O Obodai, Carmen E Ocampo, Çağlar Ödek, Tagbo Oguonu, Afua K Osew-Gyamfi, Larko D Owusu, Sheila A Owusu, Mayerly M Palencia Bocarejo, Freddy I Pantoja Chamorro, Aurora L Pedroza, Walugembe S Peter, Javier Prego, Amal C Rahi, Carmen R Ramírez Hernández, Pedro Rino, Jhuma Sankar, Hendry Robert Sawe, Jesus A Serra, Agustin G Shaieb, Arianna McLain Shirk, Enkhtur Shonkhuuz, Javier M Sierra-Abaunza, Khurram Soomro, Samba O Sow, Abner V Tagoola, Atnafu M Tekleab, Margarita M Torres, Christian Umuhoza, Pablo Vasquez-Hoyos, Justin Q Y Wang, Rafiuk C Yakubu, Rita Fosu Yeboah, María P Zamarbide · 发表于：The Lancet Global Health · 年份：2025 · DOI：10.1016/s2214-109x(24)00450-9 · 被引用次数：20 · 研究领域：Sepsis Diagnosis and Treatment、Global Health and Surgery、Child Nutrition and Water Access

BACKGROUND: Children in resource-constrained settings (RCS) have disproportionately high illness and mortality; however, the prevalence in RCS of paediatric acute critical illness (P-ACI; life-threatening conditions that require time-sensitive interventions) is unknown. Most P-ACI can be managed with basic critical care (stabilisation, fluid resuscitation, oxygen, and vital-organ support), but RCS hospitals often lack such essential services. This study estimated the prevalence and examined the aetiology of P-ACI among children at RCS hospitals to support critical care capacity building and inform resource allocation. METHODS: We conducted a hybrid prospective cohort and multinational point prevalence study of acutely ill or injured children aged 28 days to 14 years who presented to RCS hospitals on four designated days between July 20, 2021, and July 12, 2022. We measured the proportion of participants with P-ACI, applying the definition for acute paediatric critical illness (DEFCRIT) framework for research in resource-variable settings, and followed up admitted patients for hospital outcomes. In participants with P-ACI, we report diagnoses associated with critical illness. We used descriptive statistics to summarise site and cohort data by country sociodemographic category (Socio-demographic Index; SDI) and multivariable logistic regression to assess whether country sociodemographic category was independently associated with P-ACI. FINDINGS: The study included 46 sites, 19 ...