Objective:

To estimate postdischarge mortality over three months and identify associated factors among children aged 5–14 years discharged from three Tanzanian tertiary hospitals.

Approach:

• Design and setting: Prospective observational cohort conducted over 10 months at Muhimbili National Hospital, Jakaya Kikwete Cardiac Institute, and Muhimbili Orthopedic Institute.
• Participants and follow-up: Enrolled 786 children aged 5–14 years; follow-up by telephone was conducted at 1, 2, and 3 months after discharge.
• Analysis: Cox proportional hazards regression assessed associated factors, Kaplan-Meier methods estimated survival, and verbal autopsy was used to determine probable causes of death.

Key Findings:

• Three-month outcomes were known for 744 participants; 22 (2.9%) died after discharge.
• Reported associations with postdischarge death included HIV infection (HR 9.83; 95% CI 2.3–41.5), chronic kidney disease (HR 18.26; 95% CI 1.3–39.26), symptoms lasting more than two weeks (HR 4.7; 95% CI 1.5–14.73), leukocytosis (HR 7.94; 95% CI 1.97–32.03), a…
• More than half of deaths occurred within one month of discharge; 13 (59.1%) occurred at home.
• Pneumonia and malignancies were each identified as the probable cause in 18.2% of deaths.

Interpretation:

The authors report that overall postdischarge mortality was relatively low, with higher mortality among children with chronic illness or discharged against medical advice. Most deaths occurred within one month of discharge.

Limitations:

• Postdischarge outcomes were unavailable for 42 of the 786 enrolled participants.
• The supplied context does not provide further study-specific limitations.