Survival Status and Its Determinants among Under-Five Children with Severe Acute Malnutrition Admitted to Inpatient Therapeutic Feeding Centers in South Wollo Zone, Amhara Region, Ethiopia

Abstract

Background. Under nutrition is one of the leading causes of morbidity and mortality in under-five children in developing countries including Ethiopia. In Ethiopia, many children with severe acute malnutrition (SAM) are treated at inpatient therapeutic feeding centers. However, the survival status and its determinants are not well understood. Therefore, the aim of this study was to estimate the survival status and its determinants among under-five children with severe acute malnutrition admitted to inpatient therapeutic feeding centers (ITFCs). Methods. A record review was conducted on 414 under-five children who were admitted with severe acute malnutrition to ITFCs in South Wollo Zone, northeast Ethiopia, between September 11, 2014, and January 9, 2016. Data were entered into Epi-Info version 7.2 and analyzed using SPSS version 20. Life table analysis was used to estimate cumulative proportion of survival. The relationship between time to recovery and covariates was determined using Cox-proportional hazards regression model. p<0.05 was used to declare presence of significant association between recovery time and covariates. Results. Of the total children recorded, 75.4% of children were recovered and discharged, 10.3% were defaulters, 3.4% died, 7.4% were nonresponders, and 3.4% were unknown. The mean (±standard deviation) time to recovery was 12 (±5.26) days, whereas the median time to recovery was 11 (interquartile range of 8–15) days. Children’s breastfeeding status at admission (AHR: 1.42, 95% CI: 1.10, 1.83) and children without comorbidities at admission (AHR: 1.44, 95% CI: 1.03, 2.00) had statistically significant effect on time to recovery from SAM. Conclusion. All treatment responses in this study were within the recommended and acceptable range of global standards. Policy makers, health facilities, and care providers may need to focus on the importance of breastfeeding especially for those under two years of age and give emphasis for cases with comorbidities.

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

“…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.…”

“…It is significantly higher than that of Ayder hospital (11) other similar studies from Bahirdar [13,35], Ghana [20] and Yemen [36]. Nevertheless, it is by greater margin below the minimum international standards [15], in comparison with other study findings in Ethiopia [1,8,24,25,[27][28][29][30][31][32] and similar reports from India, Malawi and Uganda [34,[37][38][39] as well. 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.…”

Recovery rate and its predictors among children with severe acute malnutrition in Addis Ababa, Ethiopia: A retrospective cohort study

“…This is in-line with a study done by Fikrie et al [24]. The median duration of recovery in this study was higher than the median duration of recovery of other Ethiopian studies [16,17,20,26,27,36], but lower than some other studies done at the various stabilization centers in the country [25,30,31]. These variations could be due to differences in…”

Predictors of undesirable treatment outcome of severe acute malnutrition inpatient children in Addis Ababa, Ethiopia: a retrospective cohort study

“…This is consistent with the minimum international standard set for management of severe acute malnutrition which is <15%. This is also consistent with other similar studies in Ethiopia (21,24) The average length of hospital stay was found out to be 16 days which is consistent with the minimum international standard set for management of severe acute malnutrition (SPHERE standard). The standard recommends an average length of stay of less than 30 days (9) .The finding of the study in this regard is also in line with other analogous studies conducted in Ethiopia (11,18,21).…”