Burden associated with childhood bloodstream infection in a resource-constrained setting

Background: In children, bloodstream infection (BSI) causes significant morbidity and mortality. Most studies in Nigeria focused on the aetiology of childhood BSI with little or no appraisal of burden.

Objectives: To determine the direct cost of childhood BSI, length of hospital stay, and deaths in a tertiary health facility in northcentral Nigeria.

Method: This prospective observational study was conducted in a tertiary hospital in Nigeria. We recruited children aged 0-14 years with the diagnosis of sepsis. Blood samples were collected and processed following standard microbiological techniques. The culture was performed using BacT/Alert machine. The direct costs of caregivers were obtained daily using receipts of all rendered services till outcome (discharged/death). This study's length of stay (LOS) was defined as the number of days the children stayed after admission prior to discharge/death.

Results: Of the 179 blood samples obtained, 91 (50.8%) had bacterial BSI. Gram-positive organisms were the commonest isolated pathogens (70.3%). The mean length of hospitalisation was significantly higher among children with BSI than those without BSI (10.24 ± 8.88 vs. 7.640 ± 5.825 days, p=0.034). Similarly, the mean cost was higher among those with BSI than those without BSI ($89.70±4.91 vs. $66.13±3.98, p <0.001). However, the mortality rate was comparable between those with BSI and without BSI (13.2% vs. 7.9% p=0.361).

Conclusions: This study showed that childhood BSI was associated with an increased direct cost, extended hospitalisation, and relatively high mortality.

Sri Lanka Journal of Child Health, 2023; 52(1): 75-80