Acute severe malnutrition treatment outcomes in children ages 6–59 months admitted to Singa Hospital, Sudan

2020 ◽  
Vol 114 (8) ◽  
pp. 612-617
Author(s):  
Jalal Ali Bilal ◽  
Hatim G Eltahir ◽  
Abdullah Al-Nafeesah ◽  
Osama Al-Wutayd ◽  
Ishag Adam

Abstract Background Acute malnutrition threatens the lives of 50.5 million children <5 y of age. Consequences of malnutrition include death, among other short-term sequelae. This study was conducted from April to October 2018 to determine the outcomes of children 6–59 months of age with acute severe malnutrition admitted to Singa Hospital in central Sudan. Methods Clinical information for children with a mid-upper arm circumference (MUAC) <115 mm were collected. We measured children's weight and height and calculated weight-for-height z-scores. Treatment was offered according to World Health Organization (WHO) guidelines. Outcomes were recorded as recovered, discharged against medical advice or died. Results This study included 376 malnourished children. The median age was 18 months (interquartile range [IQR] 12−24). The male:female ratio was 1:1. Among children with weight-for-height Z-scores of −4 and −3, 103 (27.3%) had oedematous malnutrition. There were 131 (34.8%) children with malaria parasites, 33 (8.7%) with pyuria and 24 (6.3%) with intestinal parasites. The recovery rate was 89.1%. The case fatality rate was 3.7%. Mortality was significantly increased with diarrhoea and dermatoses. There were no significant differences in the median of age (17.5 months [IQR 6−24] vs 18 [6−24], p = 0.595), MUAC (110 mm [IQR 104–111] vs 110 [100–111], p = 0.741) or sex (p = 0.991) between children who died and those who recovered. Conclusions The case fatality rate was 3.7% and it was associated with diarrhoea and dermatoses.

2020 ◽  
Author(s):  
Ahmed Youssef Kada

BACKGROUND Covid-19 is an emerging infectious disease like viral zoonosis caused by new coronavirus SARS CoV 2. On December 31, 2019, Wuhan Municipal Health Commission in Hubei province (China) reported cases of pneumonia, the origin of which is a new coronavirus. Rapidly extendable around the world, the World Health Organization (WHO) declares it pandemic on March 11, 2020. This pandemic reaches Algeria on February 25, 2020, date on which the Algerian minister of health, announced the first case of Covid-19, a foreign citizen. From March 1, a cluster is formed in Blida and becomes the epicentre of the coronavirus epidemic in Algeria, its total quarantine is established on March 24, 2020, it will be smoothly alleviated on April 24. A therapeutic protocol based on hydroxychloroquine and azithromycin was put in place on March 23, for complicated cases, it was extended to all the cases confirmed on April 06. OBJECTIVE This study aimed to demonstrate the effectiveness of hydroxychloroquin/azithromycin protocol in Algeria, in particular after its extension to all patients diagnosed COVID-19 positive on RT-PCR test. We were able to illustrate this fact graphically, but not to prove it statistically because the design of our study, indeed in the 7 days which followed generalization of therapeutic protocol, case fatality rate decrease and doubling time increase, thus confirming the impact of wide and early prescription of hydroxychloroquin/azithromycin protocol. METHODS We have analyzed the data collected from press releases and follow-ups published daily by the Ministry of Health, we have studied the possible correlations of these data with certain events or decisions having a possible impact on their development, such as confinement at home and its reduction, the prescription of hydroxychloroquine/azithromycin combination for serious patients and its extension to all positive COVID subjects. Results are presented in graphics, the data collection was closed on 31/05/2020. RESULTS Covid-19 pandemic spreads from February 25, 2020, when a foreign citizen is tested positive, on March 1 a cluster is formed in the city of Blida where sixteen members of the same family are infected during a wedding party. Wilaya of Blida becomes the epicentre of coronavirus epidemic in Algeria and lockdown measures taken, while the number of national cases diagnosed begins to increases In any event, the association of early containment measures combined with a generalized initial treatment for all positive cases, whatever their degree of severity, will have contributed to a reduction in the fatality rate of COVID 19 and a slowing down of its doubling time. CONCLUSIONS In Algeria, the rapid combination of rigorous containment measure at home and early generalized treatment with hydroxychloroquin have demonstrated their effectiveness in terms of morbidity and mortality, the classic measures of social distancing and hygiene will make it possible to perpetuate these results by reducing viral transmission, the only unknown, the reopening procedure which can only be started after being surrounded by precautions aimed at ensuring the understanding of the population. CLINICALTRIAL Algeria, Covid-19, pandemic, hydroxychloroquin, azithromycin, case fatality rate


2020 ◽  
pp. 147332502097329
Author(s):  
Hamed Mortazavi

As the number of patients infected with the 2019 novel coronavirus disease (nCOVID-19) increases, the number of deaths has also been increasing. According to World Health Organization (WHO), as of 4 October 2020, 34,804,348 cases had tested positive for nCOVID-19 globally, which among them, 1,030,738 confirmed deaths had occurred, equivalent to a case-fatality rate of 2.96%. However, in comparison with global statistics, the incidence and mortality of the nCOVID-19 infection are higher in Iran. As reported by the National Committee on COVID-19 Epidemiology of Ministry of Health of Iran, the total number of patients with confirmed COVID-19 infection has reached 468,119, of which 26,746 have died, equivalent to a case-fatality rate of 5.71%. Currently, there is solid evidence that older adults are at a higher risk of severe disease following infection from COVID-19.


2021 ◽  
Vol 33 (8) ◽  
pp. 1718-1722
Author(s):  
Alberto Boretti

This work summarizes the available evidence of the use of chloroquine/hydroxychloroquine (CQ/HCQ) in SARS-CoV-2 infection. Most of the published works indicate CQ/HCQ is likely effective against SARS-CoV-2 infection, almost 100% in prophylaxis and mild-medium severity cases and 60% in late infection cases. The percentage of positive works is larger if those works conducted under a probable conflict of interest are excluded from the list. Despite this overwhelming evidence from independent studies, the use of CQ/HCQ is currently limited or prevented in many western countries, based on a very singular examination of the science. The case of a work published in late May 2020, despite being openly defective and then retracted, prompted the World Health Organization (WHO) to ban the use of CQ/HCQ. This position has not yet rectified, thanks to the results of the not less questionable RECOVERY trial, where very sick patients were administered more than double the dose, over more than double the time, recommended for asymptomatic patients in current protocols of other countries, where CQ/HCQ are used for asymptomatic and mild but not severe pneumonia critically ill patients. While the case fatality rate does not depend only on therapies, it is finally shown based on the number of cases and fatalities per million and the case fatality rate as the western countries enforcing the ban on CQ/HCQ did not perform better, but much worse, than other countries, also because of therapies.


2017 ◽  
Vol 9 (6) ◽  
pp. 374-378 ◽  
Author(s):  
Villa Watch ◽  
Jimmy Aipit ◽  
Tina Kote-Yarong ◽  
Allanie Rero ◽  
John W Bolnga ◽  
...  

Abstract Background In Papua New Guinea, TB is considered to be a major public health problem, but little is known about the prevalence and prognosis of presumed TB in children. Methods As part of a prospective hospital-based surveillance on the northern coast of mainland Papua New Guinea, the authors investigated the admission prevalence and case fatality rate associated with presumed TB over a 6-year period (2011–2016). All children admitted who were diagnosed with TB were followed-up until discharge or death. Results Of 8992 paediatric admissions, 734 patients (8.2%) were diagnosed with presumed TB and there were 825 deaths, with TB accounting for 102 (12.4%). Extrapulmonary TB was the final diagnosis in 384 admissions {prevalence 4.3% [384/8992 (95% CI 3.9–4.7)]} with a case fatality rate of 21.4% [82/384 (95% CI 17.4–25.9)]. TB meningitis, disseminated TB and pericardial TB had high case fatality rates of 29.0% (53/183), 28.9% (11/38) and 25% (4/16), respectively. Severe malnutrition was more common in patients with pulmonary compared with extrapulmonary TB (25.4% vs 15.6%; p<0.01). Conclusions Improved community-based case detection strategies, routine BCG vaccinations and other effective forms of TB control need revitalization and sustainability to reduce the high case fatality rates associated with childhood TB in Papua New Guinea.


2021 ◽  
Author(s):  
William A. Barletta

AbstractBackgroundDuring 2021 several new variants of the SARS-CoV-2 virus appeared with both increased levels of transmissibility and virulence with respect to the original wild variant. The Delta (B.1.617.2) variation, first seen in India, dominates COVID-19 infections in several large countries including the United States and India. Most recently, the Lambda variant of interest with increased resistance to vaccines has spread through much of South America.ObjectiveThis research explores the degree to which new variants of concern 1) generate spikes and waves of fluctuations in the daily case fatality rates (CFR) across countries in several regions in the face of increasing levels of vaccination of national populations and 2) may increase the vulnerability of persons with certain comorbidities.MethodsThis study uses new, openly available, epidemiological statistics reported to the relevant national and international authorities for countries across the Americas, Europe, Africa, Asia and the Middle East. Daily CFRs and correlations of fatal COVID-19 infections with potential cofactors are computed for the first half of 2021 that has been dominated by the wide spread of several “variants of concern” as denoted by the World Health Organization.ResultsThe analysis yields a new quantitative measure of the temporal dynamics of mortality due to SARS-CoV-2 infections in the form of variations of a proxy case fatality rate compared on a country to-country basis in the same region. It also finds minimal variation of correlation between the cofactors based on WHO data and on the average apparent case fatality rate.


2016 ◽  
Vol 1 (1) ◽  
pp. 41 ◽  
Author(s):  
S. Bharathi ◽  
K. Anuradha ◽  
J. Venkateshwar Rao

<p><em>Objectives:<strong> </strong></em><em>To study the outcome indicators of a nutritional rehabilitation center and to assess its performance.</em></p><p><em>Design: </em><em>Retrospective case study.</em></p><p><em>Period:</em><em> One year period from Jan 2014 to Dec 2014.</em></p><p><em>Methods:<strong> </strong></em><em>Data of 254 children aged between 6-59</em><em> </em><em>months with severe acute malnutrition admitted in nutritional rehabilitation center at department of pediatrics, Gandhi hospital, was</em><em> </em><em>analyzed retrospectively. Identification and treatment of severe acute malnutrition was done according to world health organization recommendations.</em></p><p><em>Results:<strong> </strong></em><em>The recovery rate, death rate, defaulter rate, mean (SD) weight gain &amp; mean (SD) duration of stay in the nutritional rehabilitation center were 51.42%, 3.54%, 28.57%, 8g/kg/day, 14.2 days respectively.</em></p><p><em>Conclusions:<strong> </strong></em><em>Nutritional rehabilitation centers are effective in management of severe malnutrition and also in decreasing the case fatality rates.</em></p>


2020 ◽  
Vol 5 (1) ◽  
pp. e05-e05
Author(s):  
Khatereh Anbari ◽  
Seyyed Amir Yasin Ahmadi ◽  
Mitra Elmi

Introduction: One of the unusual aspects in coronavirus disease 2019 (COVID-19) pandemic is changing case fatality rate (CFR) in different time series. Many researchers are trying to find the reasons of this variability. Objectives: This study aimed to present a model for a 30-day trend of CFR in any infectious disease epidemic using the example of COVID-19 in Iran. Patients and Methods: As a case study, we tried to use statistical mining of scientific databases. A descriptive approach with quantitative tools was conducted. The World Health Organization (WHO) database was used to access daily reports of CFR. Funnel plot and Z score were used to study and graph the trend. Results: During this period of time, a total of 20610 cases were confirmed based on real-time polymerase chain reaction (PCR). Among them, 1556 individuals died. Therefore, CFR was calculated as 7.549% (95% confidence intervals 7.189%-7.910%). This frequency was considered as the pooled frequency. Daily CFR with 95% CI was compared with the pooled frequency. Conclusion: In our case, the epidemic was started from high CFR due to low number of cases and testing only highly suspicious individuals. Then, the CFR was reduced due to increased number of patients and improvement in screening. Finally, CFR went back to its moderate rate due to the addition of the death numbers related to the cases of previous days.


2021 ◽  
Author(s):  
WURI RATNA HIDAYANI

Kasus pneumonia misterius yang belum diketahui etiologinya dilaporkan pada akhir Desember 2019 di Tiongkok. Terjadi lonjakan kasus dalam waktu relative singkat pasien pneumonia berjumlah 44 pasien dan terus meningkat menjadi ribuan kasus. Kasus ini kemudian diidentifikasikan ke dalam kasus Novel Corona Virus Diseases 19 (COVID 19) (Perhimpunan Dokter Paru Indonesia, 2020). Menurut World Health Organization (WHO) menyatakan bahwa hasil diagnosis tes Polymerase Chain Reaction (PCR) negative dengan tanda klinis infeksi COVID 19 di Kazakhstan dikelompokkan ke dalam perhitungan total COVID 19, pernyataan ini disiarkan sejak tanggal 1 Agustus 2020 dengan laporan adanya kasus pneumonia dengan gejala klinis COVID 19 sebanyak 13.121 kasus dengan kematian sebanyak 152 kematian sehingga Case Fatality Rate (CFR) sebesar 1,16% (Xinshua, 2020). Pada Tahun 2015 di dunia kasus pneumonia mencapai 920.000 jiwa setiap tahunnya dengan arti bahwa ada 2 balita meninggal setiap menitnya. Menurut WHO (2017) menyatakan bahwa terdapat 25.481 kematian karena pernafasan akut atau 17% dari seluruh kematian dunia dan Indonesia merupakan peringkat 7 dunia pada kasus pneumonia (Newswire, 2019).


2021 ◽  
Vol 5 (1) ◽  
pp. 713
Author(s):  
Evi Diliana Rospia ◽  
Dwi Kartika Cahyaningtyas ◽  
Desi Rofita ◽  
Cahaya Indah Lestari ◽  
Ni Wayan Ari Adi Putri ◽  
...  

ABSTRAKNovel coronavirus 2019 atau virus corona sindrom pernafasan akut parah yang disebut COVID-19. Gejala klinis utama yang muncul yaitu demam, batuk dan kesulitan bernapas. World Health Organization (WHO) melaporkan 11.84.226 kasus konfirmasi dengan 545.481 kematian di seluruh dunia (Case Fatality Rate/CFR 4,6%). Di Indonesia kasus meningkat dan menyebar dengan cepat, kasus pertama pada tanggal 2 Maret 2020, pada tanggal 9 Juli 2020 Kementerian Kesehatan melaporkan 70.736 kasus konfirmasi COVID-19 dengan 3.417 kasus meninggal (CFR 4,8%). Kegiatan vaksinasi masal ini bertujuan terbentuknya herd immunity (kekebalan kelompok) dan berkurangnya angka kematian akibat COVID-19 pada masyarakat. Kegiatan vaksinasi masal dilaksanakan di Universitas Muhammadiyah Mataram Kota Mataram Nusa Tenggara Barat, dan jenis vaksin yang digunakan pada kegiatan vaksinasi masal ini adalah Sinovac. Jumlah responden yang mengikuti kegiatan ini sebanyak 1.000 orang. Hasil pengabdian didapatkan jumlah yang melakukan vaksinasi sebanyak 1000 orang yang terdiri dari masyarakat umum dan karyawan Universitas Muhammadiyah Mataram. Kata kunci: vaksinasi; covid-19; komunitas; indonesia. ABSTRACTNovel coronavirus 2019 or severe acute respiratory syndrome coronavirus called COVID-19. The main symptoms that appear are fever, cough and difficulty breathing. The World Health Organization (WHO) reports 11,84,226 confirmed cases with 545,481 deaths worldwide (Case Fatality Rate/CFR 4.6%) In Indonesia cases are increasing and spreading rapidly, the first case on March 2, 2020, on July 9 2020 The Ministry of Health reported 70,736 confirmed cases of COVID-19 with 3,417 deaths (CFR 4.8%). This mass vaccination activity aims to form herd immunity and reduce the death rate due to COVID-19 in the community. The mass vaccination activity was carried out at the Muhammadiyah University of Mataram, and the type of vaccine used in this mass vaccination activity was Sinovac. The number of respondents who participated in this activity was 1,000 people. The results of the service found that the number of people who vaccinated was 1000 people consisting of the general public and employees of the Muhammadiyah University of Mataram. Keywords: vaccination; covid-19; community; indonesia. 


Author(s):  
Daniel Martin Simadibrata ◽  
Cleopas Martin Rumende ◽  
Rahmad Mulyadi ◽  
Marcellus Simadibrata

Coronavirus disease 2019 (COVID-19) is an emerging infectious disease officially declared as a pandemic on 11 March 2020 by the World Health Organization (WHO). Indonesia’s COVID-19 case fatality rate remain consistently high, approximately twice the global case fatality rate available. Patients typically present with fever, dry cough and dyspnea. However, there were reports of atypical COVID-19 symptoms such as myalgia, fatigue, diarrhea, nausea, and vomiting. These atypical presentations were suggested to indicate a more severe COVID-19. Here, we present a case of COVID-19 patient presenting with gastrointestinal-specific symptoms in Indonesia.


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