Patterns and predictors of Abscondment from the Paediatric Wards of Four District Hospitals in Malawi

Absconding from hospital poses risks to patients. The epidemiology of absconding from hospital remains unclear in Malawi and other sub-Saharan African settings. This case-control study used data from a hospital surveillance component of the Malaria Vaccine Implementation Program in four district hospitals in Malawi to describe the patterns and determinants of absconding among paediatric patients. The cases and controls (1:1 match) were children aged 1–59 months who were hospitalized with a medical illness. Cases were children who absconded from the hospital. Controls were children admitted within ± 7 days of admission date of the corresponding cases who did not abscond, residing in the same study cluster. Baseline characteristics between cases and controls were compared using chi-squared test of independence or Fisher’s Exact test. Over the period of analysis 2.2% (454/20925) of the admitted patients absconded. Severe anemia was associated with abscondment (18.6% (53/285) vs 10.6% (32/303), p = 0.006). The hospital stay of > 3 days was more prevalent in cases of abscondment (42.2% (141/454) vs 25.4% (112/454), p = < 0.001). In the setting of this analysis, strategies to reduce abscondment should target guardians whose children have stayed in the hospital for > 3 days and those with severe anemia.