Treatment cure rate and its predictors among children with severe acute malnutrition in northwest Ethiopia: A retrospective record review
Fasil Wagnewa✉, Getiye Dejenu Kibreta, Setegn Eshetieb, Animut Alebela, Wubet Worku Takeleb, Amanuel Alemu Abajobirc
- aCollege of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- bCollege of Health Sciences, University of Gondar, Gondar, Ethiopia
- cFaculty of Medicine, The University of Queensland, Brisbane, Australia
- ✉Corresponding author
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Abstract
BACKGROUND: More than 29 million that is an estimated 5%, under-five children suffer from severe acute malnutrition (SAM) globally, with a nine times higher risk of mortality than that of well-nourished children. However, little is known regarding outcomes and predictors of SAM in Ethiopia. Therefore, this study aims to determine treatment cure rate and its predictors among children aged 6-59 months with SAM admitted to a stabilization center. METHODOLOGY: A retrospective record review was employed in SAM children at the University of Gondar Comprehensive Specialized Hospital (UOGCSH) from 2014 to 2016. SAM defined as weight for height below -3 z scores of the median World Health Organization (WHO) growth standards or presence of bilateral edema or mid upper arm circumference < 115mm for a child ≥6months age. All SAM patients with medical complication(s) or failure to pass appetite test are admitted to the malnutrition treatment center for inpatient follow-up. Data were extracted from a randomly selected records after getting ethical clearance. Data were cleaned, coded and entered to Epi-info version-7, and analyzed using STATA/se version-14. Descriptive statistics and analytic analyses schemes including bivariable and multivariable Cox proportional hazards model were conducted. RESULT: Among a total of 416 records recruited for this study, 288 (69.2%) SAM children were cured at the end of the follow up, with a median cure time of 11 days. Kwash-dermatosis (AHR (Adjusted Hazard Ratio): 1.48(95% CI: 1.01, 2.16)), anemia (AHR: 1.36(95% CI: 1.07, 1.74)), tuberculosis (AHR: 1.6(95% CI: 1.04, 2.43)) and altered body temperature at admission (AHR: 1.58(95% CI: 1.04, 2.4) were independent predictors of time to cure. CONCLUSION: The cure rate in SAM children was low relative to sphere standard guideline. Prognosis of SAM largely depends on the presence of other comorbidities at admission. Available intervention modalities need to address coexisting morbidities to achieve better outcomes in SAM children.
TL;DRThe cure rate in SAM children in Ethiopia was low relative to sphere standard guideline, and prognosis largely depends on the presence of other comorbidities at admission, which needs to be addressed to achieve better outcomes. (Semantic Scholar)