Factors associated with paediatric ward abscondment in four district hospitals in Malawi

Abstract

Abscondment from hospital poses risks to patients. The epidemiology of abscondment from hospitals remains unclear in Malawi and other sub-Saharan African settings. This case-control study used data from a hospital surveillance of the Malaria Vaccine Implementation Program in four district hospitals in Malawi to describe factors associated with abscondment among paediatric inpatients. The cases and controls (1:1 match) were children aged 1–59 months hospitalised with an acute medical illness. The cases were children who absconded from the hospital. Controls were children admitted within ± 7 days of the admission date of the corresponding cases who did not abscond, residing in the same geographical cluster. Baseline characteristics between cases and controls were compared using the chi-squared test of independence or Fisher’s Exact test. Over the period of analysis, 2.17% (454/20925) of admitted patients absconded. Severe anaemia was more prevalent in cases than controls (17.54% (50/285) vs. 8.91% (27/303), p < 0.01). Hospital stay longer than three days was more prevalent in cases than controls (42.22% (141/334) vs. 25.40% (112/441), p < 0.01). In this analysis, hospital stay for > 3 days and severe anaemia showed possible trends towards increased odds of abscondment, hence may warrant further investigation as potential indicators for the prevention of abscondment.