Abstract
Sever acute malnutrition (SAM) remains a major public health problem contributing to morbidity and mortality among children aged 0-59 months. However, little is known about the survival status and determinants of mortality among children admitted to stabilization centers (SC) in Ethiopia particularly in study setting. The objective: to assess the survival status and determinants of mortality among severely malnourished children aged 0-59 months admitted to SC in Jinka general hospital from September 1, 2014 to August 30, 2018. Hospital based retrospective cohort study design was used among 588 severely malnourished children aged 0-59 months admitted to SC of Jinka general hospital from March 20-30, 2019. Simple random sampling method was used to select medical records of the study participants. Proportional hazard assumption over time was checked by Schoenfeld’s global test. The Kaplan-Meier survival curve with log-rank test was used to compare survival across groups. Bivariable and multivariable Cox proportional hazard regression was used to assess the association between each independent variable and the outcome variable. Level of statistical significance was declared at p less than 0.05. Among cohort of children studied, nearly 11% of children were died during follow up. The overall mean survival time was 38 days, 95% CI :( 36.3, 39.7).Urban residence [AHR=2.24, 95% CI: (1.17, 4.30)], presence of dehydration [AHR =3.94, 95% CI:(1.89, 8.22)], presence of shock [AHR=4.15, 95% CI:(2.01, 8.55)], altered body temperature [AHR= 2.01, 95% CI:(1.01, 3.91)], failure to take F100 formula milk [AHR= 4.87, 95%CI:(2.75, 8.63)] and oral antibiotics [AHR=3.57, 95%CI:(1.88,6.77)] were identified to be the independent determinants of mortality The mortality rate for severely undernourished children was higher than global sphere standard and national protocol.Societal and individual level determinants of mortality were identified. Therefore, interventions to reduce mortality should focus on altered clinical conditions and comorbidities/ infections.
Patient navigation to improve diabetes outpatient care at a safety-net hospital: a retrospective cohort study
