Treatment outcomes and factors affecting time-to-recovery from severe acute malnutrition in 6–59 months old children admitted to a stabilization center in Southern Ethiopia: A retrospective cohort study

Abstract Background Despite improving access to Severe Acute Malnutrition (SAM) management, information on the quality of the service, as measured by timely recovery, is scare. This study is designed to assess treatment outcomes and factors affecting time-to-recovery from SAM in children 6–59 months...

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Bibliographic Details
Main Authors: Anteneh Fikrie, Akalewold Alemayehu, Samson Gebremedhin
Format: Article
Language:English
Published: BMC 2019-04-01
Series:Italian Journal of Pediatrics
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13052-019-0642-x
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Summary:Abstract Background Despite improving access to Severe Acute Malnutrition (SAM) management, information on the quality of the service, as measured by timely recovery, is scare. This study is designed to assess treatment outcomes and factors affecting time-to-recovery from SAM in children 6–59 months admitted to a stabilizing center in Hawassa University Comprehensive Specialized Hospital (HU-CSH), Southern Ethiopia. Methods Institutional-based retrospective cohort study was conducted on 420 randomly selected children aged 6–59 months. The children were managed at the hospital from July, 2015 to June, 2017. Pre-tested structured questionnaire was used to extract data from medical records. Data were analyzed using Kaplan Meir (KM) curve, Log rank test and Cox-Proportional hazards model. The outputs of the bivariable and multivariable Cox model are presented using Adjusted Hazard Ratio (AHR) with the respective 95% Confidence Intervals (CIs). Results After a maximum of 59 days treatment 69.3% of the children recovered and 10.8% died. The mean (±SD) weight gain rates was 12.7 (±8.9) g/kg/days. The overall incidence density rate of recovery was 3.8 per 100 person-days. The overall median (IQR) time of recovery was 17(10, 24) days. F-100 intake (AHR = 0.502, 95%, CI: 0.29–0.86), Tuberculosis infection (AHR = 1.38, 95% CI: 1.00–1.91) and provision of special medication (IV fluid, IV antibiotic and blood transfusion) (AHR = 0.72, 95% CI: 0.52–0.99) at admission were found to be significant predictors of time-to-recovery from SAM. Conclusion The overall recovery from complicated SAM children admitted at HU-CSH after a maximum of 59 days treatment was low (69.4%) and a very high proportion of children (10.8%) end up in death. Therefore, HU-CSH should give special focus for those children present with medical comorbidities during admission.
ISSN:1824-7288