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1. Group B streptococcus infection during pregnancy and infancy: estimates of regional and global burden

Author

Søgaard, Kirstine K., van Kassel, Merel N., Snoek, Linde, de Gier, Brechje, van der Ende, Arie, Hahné, Susan J M, Harden, Lois M., Ghoor, Azra, Mbatha, Sibongile, Lowick, Sarah, Laughton, Barbara, Jaye, Tamara, Lala, Sanjay G, Sithole, Pamela, Msayi, Jacqueline, Kumalo, Ntombifuthi, Msibi, Tshepiso Nompumelelo, Arumugam, Asha, Murugesan, Nandhini, Rajendraprasad, Nandhini, Priya, Mohana, Mabrouk, Adam, Katana, Patrick Vidzo, Mwangome, Eva, Newton, Charles R., Mucasse, Humberto, Aerts, Celine, Massora, Sergio, Medina, Valeria, Rojas, Andrea, Amado, Daniel, Llapur, Conrado J., Hossain, A. K. M. Tanvir, Rahman, Qazi Sadeq-ur, Ip, Margaret, Seale, Anna, Heath, Paul T., Le Doare, Kirsty, Khalil, Asma, Schrag, Stephanie J., Sobanjo-ter Meulen, Ajoke, Mason, Elizabeth, Blau, Dianna M, El Arifeen, Shams, Assefa, Nega, Onyango, Dickens, Sow, Samba O., Mandomando, Inacio, Ogbuanu, Ikechukwu, Kotloff, Karen L., Scott, J. Anthony G., Gurley, Emily S., Barr, Beth A. Tippet, Mahtab, Sana, Gonçalves, Bronner P, Procter, Simon R, Paul, Proma, Chandna, Jaya, Lewin, Alexandra, Seedat, Farah, Koukounari, Artemis, Dangor, Ziyaad, Leahy, Shannon, Santhanam, Sridhar, John, Hima B, Bramugy, Justina, Bardají, Azucena, Abubakar, Amina, Nasambu, Carophine, Libster, Romina, Sánchez Yanotti, Clara, Horváth-Puhó, Erzsébet, Sørensen, Henrik T, van de Beek, Diederik, Bijlsma, Merijn W, Gardner, William M, Kassebaum, Nicholas, Trotter, Caroline, Bassat, Quique, Madhi, Shabir A, Lambach, Philipp, Jit, Mark, and Lawn, Joy E

Published
2022
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2. Neurodevelopmental and growth outcomes after invasive Group B Streptococcus in early infancy: A multi-country matched cohort study in South Africa, Mozambique, India, Kenya, and Argentina

Author

Madhi, Shabir A., Dangor, Ziyaad, Leahy, Shannon, Harden, Lois, Ghoor, Azra, Mbatha, Sibongile, Lowick, Sarah, Laughton, Barbara, Jaye, Tamara, Lala, Sanjay G, Sithole, Pamela, Msayi, Jacqueline, Kumalo, Ntombifuthi, Msibi, Tshepiso Nompumelelo, Santhanam, Sridhar, John, Hima B., Arumugam, Asha, Murugesan, Nandhini, Rajendraprasad, Nandhini, Priya, Mohana, Abubakar, Amina, Nasambu, Carophine, Adan, Adam Mabrouk, Katana, Patrick Vidzo, Mwangome, Eva, Newton, Charles R., Bassat, Quique, Bardají, Azucena, Bramugy, Justina, Mucasse, Humberto, Aerts, Celine, Massora, Sergio, Libster, Romina, Yanotti, Clara Sánchez, Medina, Valeria, Rojas, Andrea, Amado, Daniel, Llapur, Conrado J., Hossain, A.K.M. Tanvir, Sadeq-ur Rahman, Qazi, Paul, Proma, Chandna, Jaya, Procter, Simon R., Seedat, Farah, Horváth-Puhó, Erzsébet, Jit, Mark, Milner, Kate, Gonçalves, Bronner P., and Lawn, Joy E.

Published
2022
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3. Klebsiella spp. cause severe and fatal disease in Mozambican children: antimicrobial resistance profile and molecular characterization

Author

Massinga, Arsénia J., Garrine, Marcelino, Messa, Jr, Augusto, Nobela, Nélio A., Boisen, Nadia, Massora, Sergio, Cossa, Anélsio, Varo, Rosauro, Sitoe, António, Hurtado, Juan Carlos, Ordi, Jaume, Mucavele, Hélio, Nhampossa, Tacilta, Breiman, Robert F., Whitney, Cynthia G., Blau, Dianna M., Bassat, Quique, and Mandomando, Inácio

Published
2021
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4. Can long-term COVID-19 vaccination be improved by serological surveillance?: a modeling study for Mozambique

Author

Liu, Carol Y, primary, Shioda, Kayoko, additional, Kraay, Alicia, additional, Massora, Sergio, additional, de Jesus, Auria, additional, Massinga, Arsenia, additional, Monjane, Celso, additional, Omer, Saad B, additional, Jenness, Samuel M, additional, Nelson, Kristin, additional, Flasche, Stefan Y, additional, Mandomando, Inacio, additional, and Lopman, Benjamin A, additional

Published
2023
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6. Infectious cause of death determination using minimally invasive autopsies in developing countries

Author

Martínez, Miguel J., Massora, Sergio, Mandomando, Inácio, Ussene, Esperança, Jordao, Dercio, Lovane, Lucilia, Muñoz-Almagro, Carmen, Castillo, Paola, Mayor, Alfredo, Rodriguez, Cristina, Lopez-Villanueva, Miriam, Ismail, Mamudo R., Carrilho, Carla, Lorenzoni, Cesaltina, Lacerda, Marcus V.G., Bassat, Quique, Menéndez, Clara, Ordi, Jaume, and Vila, Jordi

Published
2016
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9. Group B streptococcus infection during pregnancy and infancy: estimates of regional and global burden

Author

Gonçalves, Bronner P, primary, Procter, Simon R, additional, Paul, Proma, additional, Chandna, Jaya, additional, Lewin, Alexandra, additional, Seedat, Farah, additional, Koukounari, Artemis, additional, Dangor, Ziyaad, additional, Leahy, Shannon, additional, Santhanam, Sridhar, additional, John, Hima B, additional, Bramugy, Justina, additional, Bardají, Azucena, additional, Abubakar, Amina, additional, Nasambu, Carophine, additional, Libster, Romina, additional, Sánchez Yanotti, Clara, additional, Horváth-Puhó, Erzsébet, additional, Sørensen, Henrik T, additional, van de Beek, Diederik, additional, Bijlsma, Merijn W, additional, Gardner, William M, additional, Kassebaum, Nicholas, additional, Trotter, Caroline, additional, Bassat, Quique, additional, Madhi, Shabir A, additional, Lambach, Philipp, additional, Jit, Mark, additional, Lawn, Joy E, additional, Søgaard, Kirstine K., additional, van Kassel, Merel N., additional, Snoek, Linde, additional, de Gier, Brechje, additional, van der Ende, Arie, additional, Hahné, Susan J M, additional, Harden, Lois M., additional, Ghoor, Azra, additional, Mbatha, Sibongile, additional, Lowick, Sarah, additional, Laughton, Barbara, additional, Jaye, Tamara, additional, Lala, Sanjay G, additional, Sithole, Pamela, additional, Msayi, Jacqueline, additional, Kumalo, Ntombifuthi, additional, Msibi, Tshepiso Nompumelelo, additional, Arumugam, Asha, additional, Murugesan, Nandhini, additional, Rajendraprasad, Nandhini, additional, Priya, Mohana, additional, Mabrouk, Adam, additional, Katana, Patrick Vidzo, additional, Mwangome, Eva, additional, Newton, Charles R., additional, Mucasse, Humberto, additional, Aerts, Celine, additional, Massora, Sergio, additional, Medina, Valeria, additional, Rojas, Andrea, additional, Amado, Daniel, additional, Llapur, Conrado J., additional, Hossain, A. K. M. Tanvir, additional, Rahman, Qazi Sadeq-ur, additional, Ip, Margaret, additional, Seale, Anna, additional, Heath, Paul T., additional, Le Doare, Kirsty, additional, Khalil, Asma, additional, Schrag, Stephanie J., additional, Sobanjo-ter Meulen, Ajoke, additional, Mason, Elizabeth, additional, Blau, Dianna M, additional, El Arifeen, Shams, additional, Assefa, Nega, additional, Onyango, Dickens, additional, Sow, Samba O., additional, Mandomando, Inacio, additional, Ogbuanu, Ikechukwu, additional, Kotloff, Karen L., additional, Scott, J. Anthony G., additional, Gurley, Emily S., additional, Barr, Beth A. Tippet, additional, and Mahtab, Sana, additional

Published
2022
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10. Neurodevelopmental and growth outcomes after invasive Group B Streptococcus in early infancy: A multi-country matched cohort study in South Africa, Mozambique, India, Kenya, and Argentina

Author

Paul, Proma, primary, Chandna, Jaya, additional, Procter, Simon R., additional, Dangor, Ziyaad, additional, Leahy, Shannon, additional, Santhanam, Sridhar, additional, John, Hima B., additional, Bassat, Quique, additional, Bramugy, Justina, additional, Bardají, Azucena, additional, Abubakar, Amina, additional, Nasambu, Carophine, additional, Libster, Romina, additional, Yanotti, Clara Sánchez, additional, Seedat, Farah, additional, Horváth-Puhó, Erzsébet, additional, Hossain, A.K.M. Tanvir, additional, Sadeq-ur Rahman, Qazi, additional, Jit, Mark, additional, Newton, Charles R., additional, Milner, Kate, additional, Gonçalves, Bronner P., additional, Lawn, Joy E., additional, Madhi, Shabir A., additional, Harden, Lois, additional, Ghoor, Azra, additional, Mbatha, Sibongile, additional, Lowick, Sarah, additional, Laughton, Barbara, additional, Jaye, Tamara, additional, Lala, Sanjay G, additional, Sithole, Pamela, additional, Msayi, Jacqueline, additional, Kumalo, Ntombifuthi, additional, Msibi, Tshepiso Nompumelelo, additional, Arumugam, Asha, additional, Murugesan, Nandhini, additional, Rajendraprasad, Nandhini, additional, Priya, Mohana, additional, Adan, Adam Mabrouk, additional, Katana, Patrick Vidzo, additional, Mwangome, Eva, additional, Mucasse, Humberto, additional, Aerts, Celine, additional, Massora, Sergio, additional, Medina, Valeria, additional, Rojas, Andrea, additional, Amado, Daniel, additional, and Llapur, Conrado J., additional

Published
2022
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11. Short- and Long-term Outcomes of Group B Streptococcus Invasive Disease in Mozambican Children: Results of a Matched Cohort and Retrospective Observational Study and Implications for Future Vaccine Introduction

Author

Bramugy, Justina, primary, Mucasse, Humberto, additional, Massora, Sergio, additional, Vitorino, Pio, additional, Aerts, Céline, additional, Mandomando, Inacio, additional, Paul, Proma, additional, Chandna, Jaya, additional, Seedat, Farah, additional, Lawn, Joy E, additional, Bardají, Azucena, additional, and Bassat, Quique, additional

Published
2021
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12. Effect of 10-Valent Pneumococcal Conjugate Vaccine on Streptococcus pneumoniae Nasopharyngeal Carriage Among Children Less Than 5 Years Old: 3 Years Post-10-Valent Pneumococcal Conjugate Vaccine Introduction in Mozambique

Author

Valenciano, Sandra J, primary, Moiane, Benild, additional, Lessa, Fernanda C, additional, Chaúque, Alberto, additional, Massora, Sergio, additional, Pimenta, Fabiana C, additional, Mucavele, Helio, additional, Verani, Jennifer R, additional, da Gloria Carvalho, Maria, additional, Whitney, Cynthia G, additional, Tembe, Nelson, additional, and Sigaúque, Betuel, additional

Published
2020
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13. Escherichia coli ST131 clones harbouring AggR and AAF/V fimbriae causing bacteremia in Mozambican children: Emergence of new variant of fimH27 subclone

Author

Mandomando, Inácio, primary, Vubil, Delfino, additional, Boisen, Nadia, additional, Quintó, Llorenç, additional, Ruiz, Joaquim, additional, Sigaúque, Betuel, additional, Nhampossa, Tacilta, additional, Garrine, Marcelino, additional, Massora, Sergio, additional, Aide, Pedro, additional, Nhacolo, Ariel, additional, Pons, Maria J., additional, Bassat, Quique, additional, Vila, Jordi, additional, Macete, Eusébio, additional, Scheutz, Flemming, additional, Levine, Myron M., additional, Ruiz-Perez, Fernando, additional, Nataro, James P., additional, and Alonso, Pedro L., additional

Published
2020
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14. Short- and Long-term Outcomes of Group B Streptococcus Invasive Disease in Mozambican Children: Results of a Matched Cohort and Retrospective Observational Study and Implications for Future Vaccine Introduction.

Author

Bramugy, Justina, Mucasse, Humberto, Massora, Sergio, Vitorino, Pio, Aerts, Céline, Mandomando, Inacio, Paul, Proma, Chandna, Jaya, Seedat, Farah, Lawn, Joy E, Bardají, Azucena, and Bassat, Quique

Subjects
STREPTOCOCCAL disease prevention, EVALUATION of medical care, PUBLIC health surveillance, SCIENTIFIC observation, CONFIDENCE intervals, RURAL conditions, ENDOSCOPIC surgery, STREPTOCOCCAL diseases, RETROSPECTIVE studies, PAIRED comparisons (Mathematics), CHILD psychopathology, SURVIVAL analysis (Biometry), ODDS ratio, BACTERIAL vaccines, LONGITUDINAL method, CHILDREN
Abstract

Background Invasive group B Streptococcus disease (iGBS) in infancy, including meningitis or sepsis, carries a high risk of mortality and neurodevelopmental impairment (NDI). We present data on iGBS from 2 decades of surveillance in Manhiça, Mozambique, with a focus on NDI. Methods Morbidity surveillance databases in a rural Mozambican district hospital were screened for iGBS cases. From February 2020 to March 2021, surviving iGBS patients (n = 39) plus age- and sex-matched children without iGBS (n = 119) were assessed for neurocognitive development, vision, and hearing. The role of GBS in stillbirths and infant deaths was investigated using minimally invasive tissue sampling (MITS). Results Ninety iGBS cases were included, with most children being <3 months of age (85/90). The in-hospital case fatality rate was 14.4% (13/90), increasing to 17.8% (3 additional deaths) when considering mortality during the 6 months postdiagnosis. Fifty percent of the iGBS exposed infants and 10% of those unexposed showed any NDI. Surviving GBS conferred a 11-fold increased adjusted odds of moderate/severe NDI (odds ratio, 2.8 [95% confidence interval,.92–129.74]; P  = .06) in children aged 0–5 years. For older children (6–18 years), no differences in NDI were found between exposed and unexposed. Motor domain was the most affected among young GBS survivors. Three stillbirths and 4 early neonatal deaths (of the 179 MITS performed) were attributed to iGBS. Conclusions In absence of preventive strategies, such as intrapartum antibiotics, iGBS remains a significant cause of perinatal and infant disease and death. GBS also causes major longer-term neurodevelopmental sequelae, altogether justifying the need for maternal GBS vaccination strategies to increase perinatal and infant survival. [ABSTRACT FROM AUTHOR]

Published
2022
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15. Postdischarge Mortality Prediction in Sub-Saharan Africa

Author

Madrid, Lola, Casellas, Aina, Sacoor, Charfudin, Quintó, Llorenç, Sitoe, Antonio, Varo, Rosauro, Acácio, Sozinho, Nhampossa, Tacilta, Massora, Sergio, Sigaúque, Betuel, Mandomando, Inacio, Cousens, Simon, Menéndez, Clara, Alonso, Pedro, Macete, Eusebio, and Bassat, Quique

Abstract

BACKGROUND: Although the burden of postdischarge mortality (PDM) in low-income settings appears to be significant, no clear recommendations have been proposed in relation to follow-up care after hospitalization. We aimed to determine the burden of pediatric PDM and develop predictive models to identify children who are at risk for dying after discharge. METHODS: Deaths after hospital discharge among children aged

Published
2019

17. Effect of 10-Valent Pneumococcal Conjugate Vaccine on Streptococcus pneumoniae Nasopharyngeal Carriage Among Children Less Than 5 Years Old: 3 Years Post-10-Valent Pneumococcal Conjugate Vaccine Introduction in Mozambique.

Author

Valenciano, Sandra J, Moiane, Benild, Lessa, Fernanda C, Chaúque, Alberto, Massora, Sergio, Pimenta, Fabiana C, Mucavele, Helio, Verani, Jennifer R, Carvalho, Maria da Gloria, Whitney, Cynthia G, Tembe, Nelson, and Sigaúque, Betuel

Subjects
STREPTOCOCCAL disease prevention, NASOPHARYNX microbiology, CLINICAL trials, CONFIDENCE intervals, CROSS-sectional method, PNEUMOCOCCAL vaccines, ANTI-infective agents, REGRESSION analysis, STREPTOCOCCUS, DISEASE prevalence, DESCRIPTIVE statistics, CARRIER state (Communicable diseases), DRUG resistance in microorganisms, PHARMACODYNAMICS, CHILDREN
Abstract

Background Mozambique introduced 10-valent pneumococcal conjugate vaccine (PCV10) in 2013 with doses at ages 2, 3, and 4 months and no catch-up or booster dose. We evaluated PCV10 impact on the carriage of vaccine-type (VT), non-VT, and antimicrobial non-susceptible pneumococci 3 years after introduction. Methods We conducted cross-sectional carriage surveys among HIV-infected and HIV-uninfected children aged 6 weeks to 59 months: 1 pre-PCV10 (2012–2013 [Baseline]) and 2 post-PCV10 introductions (2014–2015 [Post1] and 2015–2016 [Post2]). Pneumococci isolated from nasopharyngeal swabs underwent Quellung serotyping and antimicrobial susceptibility testing. Non-susceptible isolates (intermediate or resistant) were defined using Clinical and Laboratory Standards Institute 2018 breakpoints. We used log-binomial regression to estimate changes in the pneumococcal carriage between survey periods. We compared proportions of non-susceptible pneumococci between Baseline and Post2. Results We enrolled 720 children at Baseline, 911 at Post1, and 1208 at Post2. Baseline VT carriage was similar for HIV-uninfected (36.0%, 110/306) and HIV-infected children (34.8%, 144/414). VT carriage was 36% (95% confidence interval [CI]: 19%–49%) and 27% (95% CI: 11%–41%) lower in Post1 vs baseline among HIV-uninfected and HIV-infected children, respectively. VT carriage prevalence declined in Post2 vs Post1 for HIV-uninfected but remained stable for HIV-infected children. VT carriage prevalence 3 years after PCV10 introduction was 14.5% in HIV-uninfected and 21.0% in HIV-infected children. Pneumococcal isolates non-susceptible to penicillin declined from 66.0% to 56.2% (P =.0281) among HIV-infected children. Conclusions VT and antimicrobial non-susceptible pneumococci carriage dropped after PCV10 introduction, especially in HIV-uninfected children. However, VT carriage remained common, indicating ongoing VT pneumococci transmission. [ABSTRACT FROM AUTHOR]

Published
2021
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19. Su1183 - Association of Intestinal-Damage Biomarkers with HIV Progression in a Sub Saharan African Cohort of Mozambican Adults

Author

Langhorst, Jost, primary, Pastor, Lucia, additional, Schröder, Dorit, additional, Casellas, Aina, additional, Rueffer, Andreas, additional, Carillo, Jorge, additional, Urrea, Victor, additional, Parker, Erica, additional, de la Fuente Soro, Laura, additional, Massora, Sergio, additional, Mandomando, Inacio, additional, Blanco, Julian, additional, and Naniche, Denise, additional

Published
2018
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20. Effect of 10-Valent Pneumococcal Conjugate Vaccine on Streptococcus pneumoniaeNasopharyngeal Carriage Among Children Less Than 5 Years Old: 3 Years Post-10-Valent Pneumococcal Conjugate Vaccine Introduction in Mozambique

Author

Valenciano, Sandra J, Moiane, Benild, Lessa, Fernanda C, Chaúque, Alberto, Massora, Sergio, Pimenta, Fabiana C, Mucavele, Helio, Verani, Jennifer R, da Gloria Carvalho, Maria, Whitney, Cynthia G, Tembe, Nelson, and Sigaúque, Betuel

Abstract

Carriage of vaccine-type (VT) and antimicrobial non-susceptible pneumococci in Mozambique dropped quickly after 10-valent pneumococcal conjugate vaccine (PCV10) introduction, especially in HIV-uninfected children. However, VT carriage remained common among both HIV-uninfected and HIV-infected children 3 years after PCV10 introduction, indicating ongoing community transmission.

Published
2021
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21. Carriage prevalence of Salmonella enterica serotype Typhi in gallbladders of adult autopsy cases from Mozambique

Author

Lovane, Lucilia, primary, Martinez, Miguel J, additional, Massora, Sergio, additional, Mandomando, Inacio, additional, Ussene, Esperança, additional, Jordao, Dercio, additional, Castillo, Paola, additional, Ismail, Mamudo R, additional, Lorenzoni, Cesaltina, additional, Carrilho, Carla, additional, Bassat, Quique, additional, Menendez, Clara, additional, Ordi, Jaume, additional, Vila, Jordi, additional, and Soto, Sara Maria, additional

Published
2016
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23. The Challenge of Diagnosing and TreatingStaphylococcus aureusInvasive Infections in a Resource-limited Sub-Saharan Africa Setting: A Case Report

Author

Rovira, Gemma, primary, Cooke, Elisa F., additional, Mucavele, Helio, additional, Sitoe, Antonio, additional, Madrid, Lola, additional, Nhampossa, Tacilta, additional, Garrine, Marcelino, additional, Massora, Sergio, additional, Cossa, Anelsio, additional, Mandomando, Inacio, additional, and Bassat, Quique, additional

Published
2015
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24. The Challenge of Diagnosing and Treating Staphylococcus aureus Invasive Infections in a Resource-limited Sub-Saharan Africa Setting: A Case Report.

Author

Rovira, Gemma, Cooke, Elisa F., Mucavele, Helio, Sitoe, Antonio, Madrid, Lola, Nhampossa, Tacilta, Garrine, Marcelino, Massora, Sergio, Cossa, Anelsio, Mandomando, Inacio, and Bassat, Quique

Abstract

Background: Community-acquired methicillin-sensitive Staphylococcus aureus (CA-MSSA) is responsible for the majority of skin and soft-tissue infections. CA-MSSA can also cause life-threatening infections, possibly in relation to particular virulence factors, including Panton-Valentine leukocidin (PVL).Methods: We describe a severe CA-MSSA necrotizing pneumonia complicated with multifocal osteomyelitis, pericardial effusion and endocarditis in a 6-year-old boy admitted to a Mozambican hospital. Staphylococcus aureus isolation and antibiotic susceptibility testing were performed by conventional microbiology. Additionally, microarray assay was used for molecular characterization.Results: Blood culture confirmed the presence of S. aureus susceptible to most antimicrobial agents, including methicillin. Molecular characterization confirmed the presence of PVL, together with alpha and beta haemolysin genes.Conclusions: To our knowledge, this is the first reported case of disseminated CA-MSSA disease with confirmed PVL exotoxin in sub-Saharan Africa. PVL-positive CA-MSSA should be considered in the differential diagnosis of community-acquired pneumonia, making laboratory testing a higher priority. [ABSTRACT FROM AUTHOR]

Published
2015
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25. Postdischarge Mortality Prediction in Sub-Saharan Africa.

Author

Madrid L, Casellas A, Sacoor C, Quintó L, Sitoe A, Varo R, Acácio S, Nhampossa T, Massora S, Sigaúque B, Mandomando I, Cousens S, Menéndez C, Alonso P, Macete E, and Bassat Q

Subjects
Adolescent, Africa South of the Sahara epidemiology, Child, Child, Preschool, Cohort Studies, Female, Forecasting, Humans, Infant, Infant, Newborn, Male, Mortality trends, Mozambique epidemiology, Retrospective Studies, Child Mortality trends, Infant Mortality trends, Patient Discharge trends
Abstract

Background: Although the burden of postdischarge mortality (PDM) in low-income settings appears to be significant, no clear recommendations have been proposed in relation to follow-up care after hospitalization. We aimed to determine the burden of pediatric PDM and develop predictive models to identify children who are at risk for dying after discharge., Methods: Deaths after hospital discharge among children aged <15 years in the last 17 years were reviewed in an area under demographic and morbidity surveillance in Southern Mozambique. We determined PDM over time (up to 90 days) and derived predictive models of PDM using easily collected variables on admission., Results: Overall PDM was high (3.6%), with half of the deaths occurring in the first 30 days. One primary predictive model for all ages included young age, moderate or severe malnutrition, a history of diarrhea, clinical pneumonia symptoms, prostration, bacteremia, having a positive HIV status, the rainy season, and transfer or absconding, with an area under the curve of 0.79 (0.75-0.82) at day 90 after discharge. Alternative models for all ages including simplified clinical predictors had a similar performance. A model specific to infants <3 months old was used to identify as predictors being a neonate, having a low weight-for-age z score, having breathing difficulties, having hypothermia or fever, having oral candidiasis, and having a history of absconding or transfer to another hospital, with an area under the curve of 0.76 (0.72-0.91) at day 90 of follow-up., Conclusions: Death after discharge is an important although poorly recognized contributor to child mortality. A simple predictive algorithm based on easily recognizable variables could readily be used to identify most infants and children who are at a high risk of dying after discharge., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2019 by the American Academy of Pediatrics.)

Published
2019
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