Factors Associated with Treatment Outcomes of Under-five Children with Severe Acute Malnutrition Admitted to Therapeutic Feeding Unit of Yirgalem Hospital

Kabeta, Alemneh; Bekele, Gezahegn

doi:10.4172/2090-7214.1000261

Cited by 20 publications

(22 citation statements)

References 11 publications

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“…The relatively short nutritional recovery times found in India and Zambia may be due to socioeconomic status, as well as treatment and caring practices, and the longer recovery time in the present study compared to other settings in Ethiopia might be because in this study setting, complicated cases may be referred, potentially prolonging the recovery time. In contrast, the nutritional recovery time in the present study was shorter than those found in studies conducted in Gambia, in the Gedeo Zone of Ethiopia, and at Ayder Referral Hospital [20,39,40]. Regarding predictors of nutritional recovery time, of all the sociodemographic characteristics examined in this study, age was the only factor to have a significant impact.…”

Section: Discussioncontrasting

confidence: 93%

Recovery time from severe acute malnutrition and associated factors among under-5 children in Yekatit 12 Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

Adimasu¹,

Sebsibie

Abebe

et al. 2020

Epidemiol Health

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OBJECTIVES: Recovery time from severe acute malnutrition (SAM) is often a neglected topic despite its clinical impact. Although a few studies have examined nutritional recovery time, the length of hospitalization in those studies varied greatly. Therefore, the aim of this study was to determine the recovery time from SAM and to identify predictors of length of hospitalization among under-5 children.METHODS: A retrospective cohort study was conducted among 423 under-5 children with SAM who had been admitted to Yekatit 12 Hospital. Kaplan-Meier analysis was used to estimate time to nutritional recovery, and Cox proportional hazard regression analysis was performed to determine independent predictors.RESULTS: The nutritional recovery rate was 81.3%, and the median recovery time was 15.00 days (95% confidence interval [CI], 13.61 to 16.39). Age, daily weight gain per kilogram of body weight, vaccination status, and the existence of at least 1 comorbidity (e.g., pneumonia, stunting, shock, and deworming) were found to be significant independent predictors of nutritional recovery time. The adjusted hazard ratio (aHR) for nutritional recovery decreased by 1.9% for every 1-month increase in child age (aHR, 0.98; 95% CI, 0.97 to 0.99).CONCLUSIONS: The overall nutritional recovery time in this study was within the Sphere standards. However, approximately 13.0% of children stayed in the hospital for more than 28.00 days, which is an unacceptably large proportion. Daily weight gain of ≥8 g/kg, full vaccination, and deworming with albendazole or mebendazole reduced nutritional recovery time. Conversely, older age, pneumonia, stunting, and shock increased nutritional recovery time.

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Section: Discussioncontrasting

confidence: 93%

Recovery time from severe acute malnutrition and associated factors among under-5 children in Yekatit 12 Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

Adimasu¹,

Sebsibie

Abebe

et al. 2020

Epidemiol Health

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“…At admission, 64.4% of participants showed up with other co-morbidities on top of SAM. Majority of children (64.9%) were hospitalized with marasmus (non-edematous) type of SAM, similar with some recent studies in Ethiopia [1,13,[25][26][27][28][29][30][31] but in contrary to that of Jimma [32], Hadiya, Ethiopia [33] and Uganda [34], which reported edematous type of SAM was highly encountered. This variation might be attributable to the multi-faceted causes of SAM all over the world.…”

Section: Discussionsupporting

confidence: 86%

“…This might be due to the relatively higher rate of transfer out to nearby health facility, which probably would be to prevent patient overload since one of the study area (AKU-CSH) is the only referral hospital in this particular study area. Almost a quarter (22.2%) of patients were transferred out to nearby health facility that is above other recently reported study findings in Ethiopia [1,13,25,27,35] Ghana [20], Uganda [34] and Yemen [36].…”

Section: Discussionsupporting

confidence: 44%

Length of stay to recover from severe acute malnutrition and associated factors among under-five years children admitted to public hospitals in Aksum, Ethiopia

Tesfay¹,

Abay

Hintsa

et al. 2020

PLoS ONE

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Background Severe acute malnutrition is defined by <70% weight for length/height, by visible severe wasting, by the presence of pitting edema, and in children 6 to 59 months of age, mid upper arm circumference <110 mm. Severe acute malnutrition remains to be a worldwide problem, claiming lives of millions of children, especially in sub-Saharan Africa and south Asia. Though the Ethiopian national guideline states the total length of stay in therapeutic feeding units should not be more than four weeks, there is huge difference, varying from 8 to 47 days of stay. Therefore, the objective of this study was to assess length of stay to recover from severe acute malnutrition and associated factors among under five children hospitalized to the public hospitals in Aksum Town. Methods Sample size was calculated using STATA version 12.0. A retrospective cohort study was conducted using pretested questionnaire in the public hospitals in Aksum on children aged 0-59 months. Cleaned data was entered to Epi info version 7.1.4 and then exported into SPSS version 21 for analysis. Bivariable and multivariable analyses were performed using Kaplan Meier and Cox regression models. During bivariable analysis, variables with p-value < 0.05 were selected for multivariable analysis to identify independent factors associated with length of stay. Results A total of 564 participants enrolled to the study. The rate of recovery was 56% with median length of stay of 15 days (95% CI: 14.1, 15.9). The independent predictors of length of stay to recovery were presence of diarrhea at admission (AHR = 0.573, 95% CI: 0.415-0.793), being HIV positive (AHR = 0.391, 95% CI: 0.194-0.788), palmar pallor (AHR = 0.575, 95% CI: 0.416-0.794), presence of other co-morbidities at admission (AHR = 0.415, 95% CI: 0.302-0.570) and not being treated with plumpy nut (AHR = 0.368, 95% CI: 0.262-0.518).

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“…The median recovery time of 14 days (95% CI: 13, 15) was within the acceptable minimum international standard set for therapeutic feeding centers which is less than 28 days [22]. The finding is in line with those of studies conducted in Woliso and Gedeo zones [13,23], but it was lower than that in Tigray (21days) [11], Yirgalem (18.6 days) [24], Jimma (21 days) [14], Bahir Dar (16 days) [20], and Karat referral hospitals (26 days) [25]. The discrepancy could be due to differences in the study setting as the latter studies were conducted in referral and specialized hospitals where children with the most severe SAM cases are referred.…”

Section: Discussionsupporting

confidence: 79%

“…Besides, other medical complications also exacerbate time to recovery [27,28]. Similar to other studies reported elsewhere [9,24,29], children without TB infection at admission were 2.03 times more likely to recover from SAM as compared to those with TB infection at baseline. This could be explained by the fact that the presence of malnutrition facilitates the progress of TB infection to an active disease due to its immunosuppressive effects.…”

supporting

confidence: 67%

Time to Recovery from Severe Acute Malnutrition and Its Predictors among Admitted Children Aged 6-59 Months at the Therapeutic Feeding Center of Pawi General Hospital, Northwest Ethiopia: A Retrospective Follow-Up Study

Wondim

Tigabu

Mekonnen

2020

International Journal of Pediatrics

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Background. Ethiopia is one of the countries in sub-Saharan Africa with the highest rates of severe acute malnutrition. Early recovery is a performance indicator for severe acute malnourished children for the therapeutic feeding. Despite the available interventions to tackle nutritional problems, there is scarce information on time to recovery and its determinants among children with SAM in Ethiopia. Objective. The study is aimed at assessing time to recovery from severe acute malnutrition and its predictors among admitted children aged 6-59 months at the therapeutic feeding center of Pawi General Hospital, northwest Ethiopia, from January 2013 to December 2017. Methods. An institution-based retrospective follow-up study was conducted among 398 children aged 6-59 months. The data were collected by using data extraction sheet. The data were cleaned and entered using EpiData version 4.2.0.0 and exported to Stata version 14 statistical software for further analysis. Kaplan-Meier survival curve was used to estimate median nutritional recovery time after initiation of inpatient treatment, and log-rank test was used to compare time to recovery between groups. The Cox proportional regression model was used to identify the predictors of recovery time. Adjusted hazard rate with its 95% CI was reported to show strength of relationship. Results. The recovery rate was 5.3 per 100 person-day observations, and the median recovery time was 14 days (95% CI: 13–15). The lower chance of early recovery was found among children who were not fully vaccinated (AHR: 0.73 (95% CI: 0.56, 0.96)), while high chance of recovery was found among children who had no anemia (AHR: 1.66 (95% CI: 1.23, 2.23)), TB (AHR: 2.03 (95% CI: 1.11, 3.71)), and malaria infection (AHR: 1.54 (95% CI: 1.09, 2.17)) at admission. Conclusion and Recommendation. The overall nutritional recovery rate was below the accepted minimum standard. Children not fully vaccinated and children without malaria, anemia, and TB comorbidities at admission had a higher chance of recovering early from severe acute malnutrition. Hence, treating comorbidities is vital for prompt nutritional recovery.

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Factors Associated with Treatment Outcomes of Under-five Children with Severe Acute Malnutrition Admitted to Therapeutic Feeding Unit of Yirgalem Hospital

Cited by 20 publications

References 11 publications

Recovery time from severe acute malnutrition and associated factors among under-5 children in Yekatit 12 Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

Recovery time from severe acute malnutrition and associated factors among under-5 children in Yekatit 12 Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

Length of stay to recover from severe acute malnutrition and associated factors among under-five years children admitted to public hospitals in Aksum, Ethiopia

Time to Recovery from Severe Acute Malnutrition and Its Predictors among Admitted Children Aged 6-59 Months at the Therapeutic Feeding Center of Pawi General Hospital, Northwest Ethiopia: A Retrospective Follow-Up Study

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