Abstract
BackgroundIn spite of the availability of guidelines for the management of severe acute malnutrition (SAM) in Ethiopia, high comorbidity and poor treatment outcomes are still observed in therapeutic feeding centers among under -five children with SAM. The aim of this study was to assess comorbidity, treatment outcomes and factors affecting the recovery rate of children aged 1–59 months with SAM admitted into Therapeutic Feeding Centers (TFCs).MethodsA total of 413 records of children with SAM admitted in three selected hospitals from July 2013 to July 2015 G.C were retrospectively reviewed. Descriptive analysis was used to compare performance indicator values with SPHERE project reference standards (the minimum standard to be attained during nutritional therapy). Cox-proportional hazard regression analysis was performed to estimate the predictors of recovery rate at p-value < 0.05.ResultThe mean age of children was 16 months (95% CI, 15.0, 17.0). Out of 413 children with SAM, 231 (55.9%) recovered, 24 (5.8%) died and 16.3% were defaulted from TFCs. The mean weight gain (in gram per weight of kilogram per day) for recovered children was 15.61 g/kg/day (95% CI, 14.15, 17.07). The overall median recovery time for these children was 12 days (95% CI, 11.22, 12.78). Moreover, most (77.5%) of children admitted with SAM were marasmic followed by Kwash (16%). Pneumonia (54.8%), diarrhea (41.8%) and rickets (21.4%) were co-morbidities which affected SAM children. A child being admitted at Mehal Meda Hospital (Adjusted Hazard Ratio (AHR) = 2.01; 95% CI: 1.34, 2.91), edematous form of malnutrition (AHR = 0.59; 95% CI: 0.39, 0.90) and being a child infected with pneumonia (AHR = 0.71; 95% CI: 0.51, 0.98) were predictors of nutritional recovery rate.ConclusionUnder five pneumonia, diarrhea and rickets were co-morbidities that should be prevented. Recovery rate was poor when compared to SPHERE project reference value (which is > 75%). Predictors, namely presence of pneumonia and edematous form of malnutrition reduced nutritional recovery rate. Whereas, being admitted at Mehal Meda Hospital improved recovery rate. Therefore, hospitals should work in collaboration with health extension workers to prevent co-morbidities and strengthen screening and referral of malnutrition cases at community level. Moreover, Zonal Health Department and District Health Offices should facilitate experience sharing among health facilities.
Highlights
Malnutrition is an abnormal physiological condition caused by deficiencies or imbalances in energy, protein and/or other nutrients
Socio -demographic characteristics of severe acute malnutrition (SAM) children Out of 413 children with SAM, 229 (56%) were males and the majority (70.8%) of these children was in the age group of 6 to 24 months with the mean age of 16 months
The majority (71.7%) of participants was from Debre Berhan Referral Hospital and 93.7% were Amhara in Ethnicity
Summary
Malnutrition is an abnormal physiological condition caused by deficiencies or imbalances in energy, protein and/or other nutrients. According to World Health Organization, Severe Acute Malnutrition (SAM) is defined as a Weight-for-Height value < − 3 Z scores or Middle Upper Arm Circumference (MUAC) < 115 mm or children having bilateral pitting edema. According to 2017 global nutrition report, 52 million children are wasted (SAM) and it is the main challenge to achieve the sustainable development goals [4]. It is a risk factor for more than 50% of 11 million deaths annually and the number-one driver of the global burden of disease [5, 6]. The aim of this study was to assess comorbidity, treatment outcomes and factors affecting the recovery rate of children aged 1–59 months with SAM admitted into Therapeutic Feeding Centers (TFCs)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.