Socioeconomic Disparities and In-Hospital Mortality from Infectious Diseases: Evidence from a Tertiary Center in Senegal

Background: Socioeconomic disparities are a major determinant of health outcomes, especially in low- and middle-income countries. While infectious diseases remain a leading cause of hospitalization and mortality in sub-Saharan Africa, the role of socio-professional status—a key proxy for social vulnerability—on in-hospital outcomes is underexplored. Methods: We conducted a retrospective observational study of 610 adult patients hospitalized for infectious diseases over a two-year period (2021-2022) in a tertiary hospital in Senegal. Patients were categorized by socio-professional status (formal employment, informal sector, unemployed) based on self-reported occupation. The primary outcome was in-hospital mortality. A multivariable logistic regression model was used to assess the independent association between socio-professional status and mortality, adjusting for age, sex, and clinical severity at admission (organ involvement). While over one-third of patients were excluded due to unclassified occupational data, sensitivity analyses confirmed the robustness of our findings (Supplementary Material). Results: Overall in-hospital mortality was 20.2%. Mortality was highest among unemployed patients (27.0%) compared to those in the informal sector (19.6%) and formal employment (7.7%). In adjusted analysis, unemployment was significantly associated with higher odds of in-hospital death (adjusted odds ratio [aOR] 1.85, 95% CI: 1.08 - 3.19, *p* = 0.026). Male sex, increasing age, and neurological or multisystem involvement were also significant predictors of mortality. Informal sector workers had elevated but non-significant odds of death (aOR 1.44, *p* = 0.188). Conclusion: Socio-professional status, particularly unemployment, is an independent predictor of in-hospital mortality among patients with infectious diseases in Senegal. These findings underscore the need to incorporate socioeconomic vulnerability into hospital triage, social support systems, and health equity interventions in low-resource settings.