ARE PEDIATRIC WARDS IN DEVELOPING-COUNTRIES ONLY PLACES TO DIE - A STUDY OF PRIOR TO HOSPITALIZATION RISK-FACTORS OF DEATH AMONG 0-2-YEAR-OLD HOSPITALIZED CHILDREN IN NIAMEY, CAPITAL OF NIGER

The 461 0-2-year-old children admitted to the paediatric ward of the N ational Hospital in Niamey over a 2-month period were closely followed up from admission to discharge or death. The in-hospital mortality ra te was 30 per cent, a great proportion of deaths occurring during the first 24 h of hospitalization. Malnutrition was highly prevalent (76 p er cent). Children referred from other health facilities (72 per cent) did not experience a higher probability of survival. Using multivaria te analysis, three variables remained significantly associated with de ath: nutritional status, consultation of a traditional practitioner, a nd a neonate disease. Neonate diseases are the third major cause of de ath because of a high case fatality rate. For the other causes, the ma in underlying factor is malnutrition. Most in-hospital deaths are due to events that occurred prior to hospitalization. The role of hospital s' pediatric wards of developing countries is discussed.