Abstract
BackgroundMalnutrition remains to be one of the most common causes of morbidity and mortality among children in developing countries. The prevalence of wasting in Ethiopia remained about 10 % for the past ten years. Mortality rate of children with severe acute malnutrition treated in inpatient set ups has remained unacceptably high.MethodsA retrospective cohort study was conducted in Southern Ethiopia. The study population were children with severe acute malnutrition aged from 6 to 59 months who have been managed at Karat and Fasha stabilization centers between September 30, 2013, and Sep. 29, 2014. The total sample size was 420 and pretested questionnaire was used. Kaplan Meier analysis was used to estimate time to nutritional recovery and Cox proportional-hazard regression analysis was carried out to determine independent predictors.ResultsNutritional recovery rate was 3.61 per 100 person day observations. Median nutritional recovery time was 22 and 29 days for edematous malnourished and severely wasted children respectively. The independent predictors of nutritional recovery rate were: stabilization center (AHR = 1.4, 95 % CI: 1.1–1.7), malnutrition status (AHR = 1.8, 95 % CI: 1.3–2.4), weight (AHR = 1.5, 95 % CI: 1.2–1.9), mid- upper arm circumference (AHR = 1.4, 95 % CI: 1.1–1.9), inpatient complications (AHR = 2.2, 95 % CI: 1.4–3.5) and did not lose edema within four days of inpatient treatment (AHR = 2.3, 95 % CI: 1.1–4.8).ConclusionsThe findings of this study confirm the probability of surviving gets slimmer with inpatient complications and staying longer in stabilization centers. So, to prevent complications and enhance recovery rate due emphasis should be given in improving early detection and treatment of severely malnourished children in Ethiopia.
Highlights
Malnutrition remains to be one of the most common causes of morbidity and mortality among children in developing countries
This study revealed that nutritional recovery rate of Severe acute malnutrition (SAM) children at Karat and Fasha Therapeutic feeding center (TFC) was above the national minimum standards of cure rate greater than 75 % [10, 20]
This study revealed that SAM children who did not develop complications at TFCs had significantly higher nutritional recovery rate than their counter parts
Summary
Malnutrition remains to be one of the most common causes of morbidity and mortality among children in developing countries. Mortality rate of children with severe acute malnutrition treated in inpatient set ups has remained unacceptably high. Mortality rate of children with SAM treated in inpatient set ups has remained unacceptably high [12]. Such high mortality in inpatient units has been attributed to either co-morbidities [13], or to poor adherence to WHO therapeutic guidelines [14]. Still there is high prevalence of malnutrition in Ethiopia, despite the availability of treatment for children with SAM in TFCs. So, this study intended to estimate nutritional recovery time, determine the contextual factors of nutritional recovery rate and assess effectiveness of TFCs compared to minimum international standard set for management of SAM
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