Time to recovery from severe acute malnutrition and its predictors: a multicentre retrospective follow-up study in Amhara region, north-west Ethiopia

Baraki, Adhanom Gebreegziabher; Akalu, Temesgen Yihunie; Wolde, Haileab Fekadu; Takele, Wubet Worku; Mamo, Worku; Derseh, Behailu Tariku; Desyibelew, Hanna Demelash; Dadi, Abel Fekadu

doi:10.1136/bmjopen-2019-034583

Cited by 18 publications

(22 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Besides, children with marasmic kwashiorkor recovered early compared to those diagnosed with pure kwashiorkor. This is supported by existing pieces of evidence from the Amhara Region [29]. This might be due to marked physiological intracellular electrolyte disturbance.…”

Section: Plos Onesupporting

confidence: 70%

“…of Gonder comprehensive specialized hospital)27l 69.2% [3], and in selected health institutions of Amhara region 62.13 [29]. Moreover, the finding is lower than the study finding from Yekatit 12 Hospital in Ethiopia 81.3% [30], SNNP of Ethiopia 87% [8], Addis Ababa, 79%, [24], East Amhara Hospitals 74.49% [10], Meta-analysis in Ethiopia 70.5% [31] and Shebedino, Southern Ethiopia 79.6% [32].…”

Section: Plos Onementioning

confidence: 83%

See 1 more Smart Citation

Time to recovery from severe acute malnutrition and its predictors among children aged 6–59 months at Asosa general hospital, Northwest Ethiopia. A retrospective follow up study

Kebede

Tolossa²,

Bekonjo³

2022

PLoS ONE

View full text Add to dashboard Cite

Background Severe Acute Malnutrition (SAM) has become a major public health challenge in developing countries including Ethiopia, especially among the underprivileged population. Ethiopia is among the developing countries with the highest burden of acute malnutrition among under-five children. Though, plenty of studies were done on the magnitude of acute malnutrition among under-five children in Ethiopia, there is a limited evidence on time to recovery from SAM and its predictors among children aged 6–59 months in Ethiopia, particularly in the study area. Objectives The study was aimed to assess the time to recovery from SAM and its predictors among children aged 6–59 months at Asosa general hospital (AGH), Benishangul Gumuz, Ethiopia. Methods A Five years retrospective follow-up study design was employed among 454 children admitted with SAM in AGH from January 2015 to December 2019. The data were extracted from the patient medical records using checklist. The data were coded and entered into Epi-Data 3.1; then exported to STATA/SE-14 for analysis. Proportional Cox regression was performed to identify predictors of recovery time. A proportional hazard assumption was checked. Variables with AHR at 95% CI and P-value less than 0.05 in the multivariable Cox proportional regression was considered as significant predictors of recovery time. Findings Among the 454 included records of children with SAM, 65.4% (95%CI: 50.1, 69.2) of them were recovered at the end of the follow-up with a median recovery time of 15 IQR(11–18)days. The incidence rate of recovery was 5.28 per 100 child days’ observations. Being HIV Negative (AHR = 2.19: 95% CI 1.28, 3.73), Marasmic (AHR = 1.69: 95% CI 1.18, 2.42), and marasmic-kwashiorkor child (AHR = 1.60: 95% CI (1.09, 2.37) independently predicted recovery time. Conclusions Though the time to recovery from severe acute malnutrition was in the acceptable range, the proportion of recovery was found to be low in the study area compared to sphere standard. The prognosis of children with severe acute malnutrition was determined by the HIV status of the child and the type of malnutrition experienced. Further strengthening of malnutrition therapeutic centers and routine checkup of the nutritional status of HIV positive children should be emphasized to reduce child mortality and morbidity from under-nutrition.

show abstract

Section: Plos Onesupporting

confidence: 70%

Section: Plos Onementioning

confidence: 83%

Time to recovery from severe acute malnutrition and its predictors among children aged 6–59 months at Asosa general hospital, Northwest Ethiopia. A retrospective follow up study

Kebede

Tolossa²,

Bekonjo³

2022

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Anaemia at admission was associated with faster recovery. This is in contrast to previous studies in inpatient settings reporting slower recovery rates among children with anaemia at admission [ 24 , 25 , 30 , 45 ]. It could be that children admitted to inpatient care because of medical complications and in addition presenting with anaemia have a different pathophysiologic profile to children in outpatient care with anaemia but who don’t present medical complications and that would explain a slower response to treatment.…”

Section: Discussioncontrasting

confidence: 99%

“…Illness at admission were associated with faster recovery, contrary to results from most previous studies showing slower recovery in inpatient [ 24 , 25 , 28 – 30 , 45 , 48 ] and outpatient settings [ 14 ] among those admitted with co-morbidity. Interestingly however, one study from Gambia showed that higher cortisol at admission (indicating acute illness) predicted higher WAZ gain during treatment [ 49 ].…”

Section: Discussioncontrasting

confidence: 98%

“…The mean time to recovery was longer than reported by most previous studies conducted in outpatient settings [ 14 , 15 , 27 , 31 , 32 , 34 , 43 , 44 ]. Most of the variability in length of stay in treatment between different studies and contexts can probably be ascribed to differences in discharge criteria: in many studies recovery was declared when children reached a weight-for height >85% of WHO median growth reference regardless of being admitted with low WHZ or MUAC [ 14 , 24 – 26 , 30 – 32 , 43 , 45 ]. Additionally, often the recommendation [ 6 ] of presenting the anthropometric recovery criteria for at least 2 weeks is not followed [ 14 , 24 – 26 , 30 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Predictors of time to recovery and non-response during outpatient treatment of severe acute malnutrition

et al. 2022

View full text Add to dashboard Cite

Background Every year, over 4 million children are treated for severe acute malnutrition with varying program performance. This study sought to explore the predictors of time to recovery from and non-response to outpatient treatment of SAM. Methods Children with weight-for-height z-score (WHZ) <-3 and/or mid-upper arm circumference (MUAC) <115 mm, without medical complications were enrolled in a trial (called MANGO) from outpatient clinics in Burkina Faso. Treatment included a weekly ration of ready-to-use therapeutic foods. Recovery was declared with WHZ ≥-2 and/or MUAC ≥125 mm, for two weeks without illness. Children not recovered by 16 weeks were considered as non-response to treatment. Predictors studied included admission characteristics, morbidity and compliance during treatment and household characteristics. Cox proportional hazard models were fitted and restricted mean time to recovery calculated. Logistic regression was used to analyse non-response to treatment. Results Fifty-five percent of children recovered and mean time to recovery was eight weeks while 13% ended as non-response to treatment. Independent predictors of longer time to recovery or non-response included low age, being admitted with WHZ <-3, no illness nor anaemia at admission, illness episodes during treatment, skipped or missed visits, low maternal age and not practising open defecation. Eighty-four percent of children had at least one and 59% at least two illness episodes during treatment. This increased treatment duration by 1 to 4 weeks. Thirty-five percent of children missed at least one treatment visit. One missed visit predicted 3 weeks longer and two or more missed visits 5 weeks longer treatment duration. Conclusions Both longer time to recovery and higher non-response to treatment seem most strongly associated with illness episodes and missed visits during treatment. This indicates that prevention of illnesses would be key to shortening the treatment duration and that there is a need to seek ways to facilitate adherence.

show abstract

Occurrence of mycotoxins, phytoestrogens and other fungal metabolites in Ready-to-Use Therapeutic Foods for severely and acutely malnourished children

Ezekiel,

Ogbonna,

Williams

et al. 2024

Food Control

View full text Add to dashboard Cite

Time to recovery from severe acute malnutrition and its predictors: a multicentre retrospective follow-up study in Amhara region, north-west Ethiopia

Cited by 18 publications

References 19 publications

Time to recovery from severe acute malnutrition and its predictors among children aged 6–59 months at Asosa general hospital, Northwest Ethiopia. A retrospective follow up study

Time to recovery from severe acute malnutrition and its predictors among children aged 6–59 months at Asosa general hospital, Northwest Ethiopia. A retrospective follow up study

Predictors of time to recovery and non-response during outpatient treatment of severe acute malnutrition

Occurrence of mycotoxins, phytoestrogens and other fungal metabolites in Ready-to-Use Therapeutic Foods for severely and acutely malnourished children

Contact Info

Product

Resources

About