Abstract
BackgroundMalnutrition is still a global public health problem contributing for under-five morbidity and mortality. The case is similar in Ethiopia in which severe acute malnutrition is the major contributor to mortality being an underlying cause for nearly 45% of under-five deaths. However, there is no recent evidence that shows the time to death and public health importance of oxygen saturation and chest in drawing in the study area. Therefore, estimated time to death and its predictors can provide an input for program planners and decision-makers.MethodsA facility -based retrospective cohort study was conducted among 488 severe acute malnourished under-five children admitted from the 1st of January 2016 to the 30th of December 2019. The study participants were selected by using simple random sampling technique. Data were entered in to Epi-Data version 3.1 and exported to STATA version15 statistical software for further analysis. The Kaplan Meier was used to estimate cumulative survival probability and a log-rank test was used to compare the survival time between different categories of explanatory variables. The Cox-proportional hazard regression model was fitted to identify predictors of mortality. P-value< 0.05 was used to declare statistical significance.ResultsOut of the total 488 randomly selected charts of children with severe acute malnutrition, 476 records were included in the final analysis. A total of 54(11.34%) children died with an incidence rate of 9.1death /1000 person- days. Failed appetite test (AHR: 2.4; 95%CI: 1.26, 4.67), altered consciousness level at admission (AHR: 2.4; 95%CI: 1.08, 4.67), oxygen saturation below 90% (AHR: 3.3; 95%CI: 1.40, 7.87), edema (AHR 2.9; 95%CI: 1.45, 5.66) and HIV infection (AHR: 2.8; 95%CI: 1.24, 6.36) were predictors of mortality for children diagnosed with severe acute malnutrition.ConclusionThe overall survival status of severe acute malnourished children was low as compared to national sphere standards and previous reports in the literature. The major predictors of mortality were oxygen saturation below 90%, altered consciousness, HIV infection, edema and failed appetite test. Therefore, early screening of complications, close follow up and regular monitoring of sever acute malnourished children might improve child survival rate.
Highlights
Malnutrition is still a global public health problem contributing for under-five morbidity and mortality
The overall survival status of severe acute malnourished children was low as compared to national sphere standards and previous reports in the literature
Socio-demographic characteristics Out of the total 488 randomly selected charts of Severe Acute Malnutrition (SAM) children, 476(97.5%) records were fulfilling enrollment criteria in the final analysis; and the remaining 12(2.5%) were excluded (8 incomplete data and 4 charts were lost during data collection)
Summary
Malnutrition is still a global public health problem contributing for under-five morbidity and mortality. Malnutrition refers to all deviations from adequate nutrition and jeopardizes children’s survival, health, growth and development. It exists in two forms; over nutrition and undernutrition of macronutrients and micronutrients [1, 2]. In the developing world undernutrition or protein-energy malnutrition is the common problem in acute or chronic form that profoundly affects children’s survival [3]. The status of the world’s children 2019 report showed that nearly half of all death in children under-5 years attributed to undernutrition; it puts children at greater risk of dying from common infections, increases the frequency, severity of such infections and delays recovery time. Children with severe acute malnutrition are nearly 12 times more likely to die than healthy children [3]
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