Three Years of Paediatric Morbidity and Mortality at the National Hospital in Dili, East Timor

Aim The aim of this study was to undertake a retrospective review of admissions and discharges to the neonatal unit at the National Hospital Guido Valadares, Dili, in order to gain insight into the epidemiology of hospitalised neonates in East Timor, as the information cannot be obtained from the hospital health management information system. Method Data were sourced from unit registers for 3 years, 2008-2010 inclusive. Demographic characteristics and diagnoses were related to the risk of dying using stepwise multivariate logistic regression and adjusting for potential confounders of age, sex and weight. Results Two thousand eighty-eight babies were admitted to the unit over the study period. Over a quarter of babies weighed <2.5kg on admission. Almost half were admitted from emergency or outpatient departments and only 27% were admitted within their first week of life. The most common reasons for admission were sepsis and respiratory disease (38 and 22%, respectively). Overall mortality was 11.4%, mainly attributed to prematurity (28%), infection (26%) and asphyxia (24%). Home birth, male gender, very low weight, young age and a short duration of hospitalisation were independently associated with an increased risk of death. Half of all babies weighing <1.5kg died. Two-thirds of deaths occurred within 2 days of admission. Conclusions The study provides, for the first time, an insight into the admissions and outcomes of the largest neonatal unit in East Timor. It is a baseline from which improvements to the quality of clinical care and data collection can be made.