{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T10:13:59Z","timestamp":1770977639305,"version":"3.50.1"},"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Most deaths among children under 5 years occur within the first 24 hours of hospital admission from preventable causes such as diarrhea, pneumonia, malaria, and HIV\/AIDS. The predictors of these deaths are not yet well documented in our setting. This study aimed to describe the patterns and predictors of these mortalities among children aged 1\u201359 months at a regional hospital in South Western Uganda. We conducted a prospective cohort study among 208 children aged 1\u201359 months admitted to Mbarara Regional Referral Hospital. The mortality rate within the first 24 hours was 7.7% (95% CI 4\u201312) and the median time to death was 7.3(2.62\u20138.75) hours. Most deaths occurred in infants, with severe pneumonia, severe acute malnutrition, and malaria as leading causes. Factors predicting mortality included admission during the night (AHR: 3.7, 95% CI 1.02\u201313.53, p-value 0.047) and abnormal neutrophil count(AHR: 3.5, 95% CI 1.10\u201311.31, p-value 0.034). The study highlights the importance of timely interventions, particularly for infants, and suggests extra monitoring for those admitted at night or with abnormal neutrophil counts.<\/jats:p>","DOI":"10.1371\/journal.pone.0312316","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T19:23:42Z","timestamp":1735845822000},"page":"e0312316","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Patterns and predictors of mortality in the first 24 hours of admission among children aged 1\u201359 months admitted at a Regional Referral Hospital in South Western Uganda"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9609-6021","authenticated-orcid":true,"given":"Moses","family":"Ochora","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stella","family":"Kyoyagala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lydia","family":"Kyasimire","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mercy","family":"Akambasisa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Twine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muna","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Lutasingwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorah","family":"Nampijja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elias","family":"Kumbakumba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"key":"pone.0312316.ref001","article-title":"Levels and trends in child mortality 2020 | UNICEF","year":"2024","journal-title":"Accessed"},{"key":"pone.0312316.ref002","article-title":"Child Mortality","year":"2024","journal-title":"UNICEF DATA. Accessed"},{"issue":"1","key":"pone.0312316.ref003","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1186\/s12887-017-0850-8","article-title":"Variation in and risk factors for paediatric inpatient all-cause mortality in a low income setting: data from an emerging clinical information network","volume":"17","author":"D. Gathara","year":"2017","journal-title":"BMC Pediatrics"},{"issue":"12","key":"pone.0312316.ref004","article-title":"Sources of variation in under-5 mortality across sub-Saharan Africa: a spatial analysis","volume":"4","year":"2016","journal-title":"The Lancet. Global health"},{"issue":"1","key":"pone.0312316.ref005","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s43054-024-00271-5","article-title":"Predictors of mortality among children at a tertiary hospital in Tanzania: a cohort study","volume":"72","author":"D. K. Damian","year":"2024","journal-title":"Egyptian Pediatric Association Gazette"},{"issue":"6","key":"pone.0312316.ref006","doi-asserted-by":"crossref","first-page":"e0234343","DOI":"10.1371\/journal.pone.0234343","article-title":"Predictors of in-hospital mortality among under-five children with severe acute malnutrition in South-Western Uganda","volume":"15","author":"T. Nduhukire","year":"2020","journal-title":"PLOS ONE"},{"key":"pone.0312316.ref007","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.1016\/S2214-109X(15)70150-6","article-title":"Post-discharge mortality prediction in under 5s with acute infectious diseases: a prospective cohort study","volume":"3","author":"M. Wiens","year":"2015","journal-title":"The Lancet Global Health"},{"issue":"3","key":"pone.0312316.ref008","doi-asserted-by":"crossref","first-page":"e0150683","DOI":"10.1371\/journal.pone.0150683","article-title":"Pediatric in-Hospital Death from Infectious Disease in Uganda: Derivation of Clinical Prediction Models","volume":"11","author":"N. Lowlaavar","year":"2016","journal-title":"PLOS ONE"},{"key":"pone.0312316.ref009","doi-asserted-by":"crossref","first-page":"160","DOI":"10.11604\/pamj.2018.30.160.15286","article-title":"Caregiver delay in seeking healthcare during the acute phase of pediatric illness, Kigali, Rwanda","volume":"30","author":"C. Umuhoza","year":"2018","journal-title":"Pan Afr Med J"},{"issue":"1","key":"pone.0312316.ref010","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1186\/s12913-018-2950-z","article-title":"Delays in seeking and receiving health care services for pneumonia in children under five in the Peruvian Amazon: a mixed-methods study on caregivers\u2019 perceptions","volume":"18","author":"M. J. Pajuelo","year":"2018","journal-title":"BMC Health Services Research"},{"issue":"1","key":"pone.0312316.ref011","article-title":"[WHO growth standards for infants and young children]","volume":"16","author":"O. M de","year":"2009","journal-title":"Archives de pediatrie: organe officiel de la Societe francaise de pediatrie,"},{"issue":"2","key":"pone.0312316.ref012","article-title":"Global, regional, and national causes of under-5 mortality in 2000\u201319: an updated systematic analysis with implications for the Sustainable Development Goals","volume":"6","author":"P. J","year":"2022","journal-title":"The Lancet. Child & adolescent health"},{"issue":"2","key":"pone.0312316.ref013","doi-asserted-by":"crossref","DOI":"10.30442\/ahr.0402-8-19","article-title":"Pattern of childhood morbidities and outcome of childhood admissions in a Nigerian public secondary healthcare facility","volume":"4","author":"S. O. Oninla","year":"2018","journal-title":"Annals of Health Research (The Journal of the Medical and Dental Consultants Association of Nigeria, OOUTH, Sagamu, Nigeria),"},{"issue":"1","key":"pone.0312316.ref014","article-title":"Prevalence and associated factors of pediatric emergency mortality at Tikur Anbessa specialized tertiary hospital: a 5 year retrospective case review study","volume":"18","year":"2018","journal-title":"BMC pediatrics"},{"issue":"1","key":"pone.0312316.ref015","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/s12873-020-00352-9","article-title":"Mortality at the pediatric emergency unit of the Mohammed VI teaching hospital of Marrakech","volume":"20","author":"W. Lahmini","year":"2020","journal-title":"BMC Emerg Med"},{"issue":"10226","key":"pone.0312316.ref016","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/S0140-6736(19)32007-0","article-title":"Variations in common diseases, hospital admissions, and deaths in middle-aged adults in 21 countries from five continents (PURE): a prospective cohort study","volume":"395","author":"G. R. Dagenais","year":"2020","journal-title":"The Lancet"},{"issue":"8","key":"pone.0312316.ref017","article-title":"Does admission time matter in a paediatric intensive care unit? A prospective cohort study","volume":"57","year":"2021","journal-title":"Journal of paediatrics and child health"},{"issue":"5","key":"pone.0312316.ref018","doi-asserted-by":"crossref","first-page":"e0232406","DOI":"10.1371\/journal.pone.0232406","article-title":"The pattern of neonatal admissions and mortality at a regional and district hospital in the Upper West Region of Ghana; a cross sectional study","volume":"15","author":"E. M. A. Tette","year":"2020","journal-title":"PLoS One"},{"issue":"7","key":"pone.0312316.ref019","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1007\/s12098-008-0130-6","article-title":"Admission time and mortality rates","volume":"75","author":"A. E. Arslankoylu","year":"2008","journal-title":"Indian J Pediatr"},{"issue":"1","key":"pone.0312316.ref020","article-title":"Time of Pediatric Intensive Care Unit Admission and Mortality: A Systematic Review and Meta-Analysis","volume":"9","year":"2020","journal-title":"Journal of pediatric intensive care"},{"key":"pone.0312316.ref021","doi-asserted-by":"crossref","first-page":"615","DOI":"10.18203\/2320-6012.ijrms20160326","article-title":"Mortality audit in the paediatrics department of the University of Uyo teaching hospital, Uyo, Nigeria","author":"E. Ijezie","year":"2016","journal-title":"International Journal of Research in Medical Sciences"},{"issue":"10","key":"pone.0312316.ref022","doi-asserted-by":"crossref","first-page":"e035045","DOI":"10.1136\/bmjopen-2019-035045","article-title":"Prognostic models for predicting in-hospital paediatric mortality in resource-limited countries: a systematic review","volume":"10","author":"M. Ogero","year":"2020","journal-title":"BMJ Open"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0312316","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T19:23:51Z","timestamp":1735845831000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0312316"}},"subtitle":[],"editor":[{"given":"Kahsu","family":"Gebrekidan","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,2]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,2]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0312316","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,2]]}}}