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The most common final ED diagnoses were pneumonia in 23 (41%), severe anemia, classified according to the World Health Organization definition as a hemoglobin measurement of less than 7?g/dL [17], in 20 (36%), and upper GI bleeding in 20 (36%). Bronchitis was the least common final ED Diagnosis (Table 3). Table 3 Final ED diagnoses. The most common final hospital discharge diagnoses were pneumonia in 23 patients (44%), upper GI bleeding in 24 patients (46%), Malaria in 22 patients (42%), HIV in 11 patients (21%), and severe anemia and malnutrition in 10 patients (19%). As was seen with the ED diagnoses, bronchitis was the least common hospital discharge diagnosis (Table 4). Table 4 Final hospital diagnoses. Treatment included intravenous antibiotics for 35 patients (63%, 95% CI: 49�C75%), blood transfusions for 11 (20%, 95% CI: 10�C32%), and surgical interventions for 3 (5%, 95% CI: 1�C15%); these surgical interventions included suture ligation for hemostasis, packing, and electrical cauterization to achieve hemostasis. Four patients (7%, 95% CI: 2�C17%) died in the ED and the rest were admitted to the hospital: 42 (75%) to the general pediatric ward, 7 (13%) to the pediatric intensive care unit, and 3 (5%) to the pediatric surgical service. Eight of the admitted patients died in the hospital for a total mortality of 12 (21%, 95% CI: 12�C34%) among the study cohort (Table 5). By comparison, 498 (9%, 95% CI: 8�C10%) of the 5484 children with complete data who presented to the ED for reasons not related to complications of uvulectomy died (p = 0.003). Table 5 Disposition. 4. Discussion Our investigation found that 1% of children presenting to the MNH ED in the year 2012 had complaints related to a recent traditional uvulectomy and nearly all were under the age of 5 years. These findings are similar to those seen in other African countries [9, 12], where the procedure is predominantly performed in the early years of life due to the belief that the elongated uvula is responsible for myriad potential maladies, including sleep disturbances, respiratory infections, and even suffocation of children in their sleep [18]. The predominant symptoms at ED presentation in our cohort were cough, difficulty in breathing, fever, and hematemesis. All the children had at least one abnormal physical finding or vital sign at the time of presentation to the emergency medicine department, with more than half of the patients presenting with fever. Other observed abnormalities included tachypnea, tachycardia, and hypoxia. We were not able to establish with certainty that the presenting symptoms of our cohort were due to complications of the procedure or from preexisting Alpelisib manufacturer medical conditions that prompted the procedure. Regardless, the observed mortality was more than twice that of all other children presenting to the ED during the study period.