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

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034583
Author(s):  
Adhanom Gebreegziabher Baraki ◽  
Temesgen Yihunie Akalu ◽  
Haileab Fekadu Wolde ◽  
Wubet Worku Takele ◽  
Worku Nigussu Mamo ◽  
...  
Keyword(s):  
Vitamin A ◽  
Severe Acute Malnutrition ◽  
Female Gender ◽  
Acute Malnutrition ◽  
Amhara Region ◽  
North West ◽  
Follow Up Study ◽  
Health Institutions ◽  
Using Data

ObjectivesThis study aimed to determine the time to recovery from severe acute malnutrition (SAM) and its predictors in selected public health institutions in Amhara Regional State, Ethiopia.DesignAn institution-based retrospective follow-up study was conducted using data extracted from 1690 patient cards from September 2012 to November 2016.SettingSelected government health institutions in the Amhara region, Ethiopia.ParticipantsChildren treated in therapeutic feeding units for SAM were included.Outcome measuresTime to recovery from SAM.ResultsOne thousand and fifty children have recovered from SAM, 62.13% (95% CI 59.8% to 64.5%). The median time to recovery was 16 days (IQR=11–28). Female gender (adjusted HR (AHR)=0.81, 95% CI 0.67 to 0.98), oedematous malnutrition (AHR=0.74 95% CI 0.59 to 0.93), pneumonia (AHR=0.66, 95% CI 0.53 to 0.83), tuberculosis (AHR=0.53, 95% CI 0.36 to 0.77), HIV/AIDS (AHR=0.47, 95% CI 0.28 to 0.79), anaemia (AHR=0.73, 95% CI 0.60 to 0.89) and receiving vitamin A (AHR=1.43, 95% CI 1.12 to 1.82) were notably associated with time to recovery.ConclusionsThe time to recovery in this study was acceptable but the proportion of recovery was far below the minimum standard. Special emphasis should be given to the prevention and treatment of comorbidities besides the therapeutic feeding. Supplementing vitamin A would also help to improve the recovery rate.

scholarly journals Time to recovery and determinants of severe acute malnutrition among 6–59 months children treated at outpatient therapeutic programme in North Gondar zone, Northwest Ethiopia: a prospective follow up study

2019 ◽  
Vol 45 (1) ◽  
Author(s):  
Worku Nigussu Mamo ◽  
Terefe Derso ◽  
Kassahun Alemu Gelaye ◽  
Temesgen Yihunie Akalu
Keyword(s):  
Median Time ◽  
Cox Regression ◽  
Severe Acute Malnutrition ◽  
Northwest Ethiopia ◽  
Acute Malnutrition ◽  
Rank Test ◽  
Follow Up Study ◽  
Therapeutic Programme ◽  
North Gondar Zone

Abstract Background Despite the available interventions to tackle nutritional problems, there is scarce information on time to recovery and its determinants among children with SAM in Ethiopia. Objective This study was aimed at finding the time to recovery and determinants among 6–59 months children with severe acute malnutrition treated at an outpatient therapeutic programme in North Gondar zone, northwest Ethiopia. Methods Facility based prospective follow up study was conducted from March 24 to May 24, 2017. A total of 408 children with the age of 6–59 months were included in the study. Structured interviewer administered questionnaire was used. Anthropometric measurements were conducted every week. The median time of recovery, Kaplan Meier (KM) curve, and log rank test were computed. Both bi-variable and multivariable Cox regression model was fitted. To establish an association between time to recovery and its determinants 95% confidence interval (CI) and p-value < 0.05 were used. Proportional hazard assumption was checked graphically and using Schoenfeld residual test. Results Out of 389 children, 254 (65.3%) recovered. The median time to recovery was 38.5 ± IQR of 14 days. Children with diarrhoea AHR = 0.81 with 95% CI (0.73, 0.99), children taken amoxicillin AHR = 2.304 with 95% CI (1.68–3.161), and had vomiting at admission AHR = 0.430 with 95% CI (0.205, 0.904) were significant predictors of time to recovery. Conclusions and recommendations The overall time to recovery has not met the minimum sphere international standard which was lower than 75%. It is advisable to give emphasis to patients with diarrhoea and vomiting.

scholarly journals Factors associated with child survival in children admitted to outpatient therapeutic program at public health institutions in Afar Regional State, Ethiopia: a prospective cohort study

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Misgan Legesse Liben ◽  
Abel Gebre Wuneh ◽  
Reda Shamie ◽  
Kiros G/her
Keyword(s):  
Public Health ◽  
Vitamin A ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Vitamin A Supplementation ◽  
Therapeutic Program ◽  
Regional State ◽  
Public Health Institutions ◽  
Health Institutions ◽  
Outpatient Therapeutic Program

Abstract Introduction About 20 million children suffer from severe acute malnutrition each year. The World Health Organization recommends the outpatient therapeutic program as a standard treatment protocol for the management of uncomplicated severe acute malnutrition and for children who are transferred from inpatient cares after recovery. This study aimed to assess the treatment outcome of severe acute malnutrition and determinants of survival in children admitted to outpatient therapeutic program at public health institutions, Afar Regional State. Methods Institution-based prospective cohort study was conducted on 286 children aged 6–59 months admitted to the outpatient therapeutic program, from April to September 2017, at selected public health institutions in Afar Regional State. For the comparison of time to recovery among the different groups of children on the outpatient therapeutic program, Kaplan-Meir curve was used and significance test for these differences was assessed by the log-rank test. Then, a proportional hazard in the Cox model was used to identify independent predictors of survival. p value < 0.05 was considered significant. Results Of 286 children, 238 (83.2%; 95% CI (79, 88)), 18 (6.3%), 14 (4.9%), 8 (2.8%), and 8 (2.8%) cases were cured, defaulters, non-responder, died, and transfer to inpatient care, respectively. The overall mean rate of weight gain was 10.5(± 3.45) g/kg/day, and mean length of stay was 44.15(± 8.77) days. The recovery rate of children whose mothers travel less than 2 h to the health institution was about three times (AHR, 2.91; 95% CI (2.18, 3.88)) higher than children whose mothers travel 2 h and above. Compared with children who received vitamin A supplementation, children who lack supplementation were less likely (AHR, 0.39; 95% CI (0.25, 0.59)) to be cured. Moreover, the rate of recovery from outpatient therapeutic program among children who received antibiotics was about 1.4 times (AHR, 1.38; 95% CI (1.01, 1.89)) higher compared with children who did not receive of antibiotics. Conclusion This study showed that nearly eight children in every ten had recovered from severe acute malnutrition. Therefore, considering the distance of health facility from children’s residence, improving vitamin A supplementation and antibiotics are vital in improving the rate of recovery. Further research is also required to identify and address barriers to the provision of antibiotics and vitamin A supplementation.

scholarly journals Time to Recovery from Severe Acute Malnutrition and Its Predictors among Admitted Children Aged 6-59 Months at the Therapeutic Feeding Center of Pawi General Hospital, Northwest Ethiopia: A Retrospective Follow-Up Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Amare Wondim ◽  
Bethelihem Tigabu ◽  
Mengistu Mekonnen Kelkay
Keyword(s):  
Recovery Rate ◽  
Recovery Time ◽  
Severe Acute Malnutrition ◽  
Northwest Ethiopia ◽  
Acute Malnutrition ◽  
Early Recovery ◽  
Follow Up Study ◽  
Nutritional Recovery ◽  
Feeding Center

Background. Ethiopia is one of the countries in sub-Saharan Africa with the highest rates of severe acute malnutrition. Early recovery is a performance indicator for severe acute malnourished children for the therapeutic feeding. Despite the available interventions to tackle nutritional problems, there is scarce information on time to recovery and its determinants among children with SAM in Ethiopia. Objective. The study is aimed at assessing time to recovery from severe acute malnutrition and its predictors among admitted children aged 6-59 months at the therapeutic feeding center of Pawi General Hospital, northwest Ethiopia, from January 2013 to December 2017. Methods. An institution-based retrospective follow-up study was conducted among 398 children aged 6-59 months. The data were collected by using data extraction sheet. The data were cleaned and entered using EpiData version 4.2.0.0 and exported to Stata version 14 statistical software for further analysis. Kaplan-Meier survival curve was used to estimate median nutritional recovery time after initiation of inpatient treatment, and log-rank test was used to compare time to recovery between groups. The Cox proportional regression model was used to identify the predictors of recovery time. Adjusted hazard rate with its 95% CI was reported to show strength of relationship. Results. The recovery rate was 5.3 per 100 person-day observations, and the median recovery time was 14 days (95% CI: 13–15). The lower chance of early recovery was found among children who were not fully vaccinated (AHR: 0.73 (95% CI: 0.56, 0.96)), while high chance of recovery was found among children who had no anemia (AHR: 1.66 (95% CI: 1.23, 2.23)), TB (AHR: 2.03 (95% CI: 1.11, 3.71)), and malaria infection (AHR: 1.54 (95% CI: 1.09, 2.17)) at admission. Conclusion and Recommendation. The overall nutritional recovery rate was below the accepted minimum standard. Children not fully vaccinated and children without malaria, anemia, and TB comorbidities at admission had a higher chance of recovering early from severe acute malnutrition. Hence, treating comorbidities is vital for prompt nutritional recovery.

scholarly journals Nutrient and Anti-nutrient Profile of a Local Formula from Sorghum, Peanut, Honey and Ghee (Metu2) for Treatment of Severe Acute Malnutrition

2018 ◽  
Vol 7 (2) ◽  
pp. 25
Author(s):  
Amegovu K. Andrew ◽  
Peter Yiga ◽  
Kuorwel K. Kuorwel ◽  
Timothy Chewere
Keyword(s):  
Vitamin A ◽  
Energy Content ◽  
Severe Acute Malnutrition ◽  
Essential Fatty Acids ◽  
High Energy ◽  
Acute Malnutrition ◽  
World Health ◽  
Home Based ◽  
North Eastern ◽  
Eastern Uganda

World over, we are still struggling with persistent acute malnutrition levels; an estimated 17 million preschool children suffer from SAM, roughly the same figures as reported in 2013, a trend depicting insufficient progress towards the 2025 World Health Assembly. One such affected area is Karamoja Region in North Eastern Uganda. Partly, the trend could be attributed to unsustainable interventions like RUTF. Formulas from locally available foods could provide not only an affordable but also a culturally acceptable and effective home based solution.   Locally available sorghum, peanut, honey and ghee in North Eastern Uganda, is such a potential local formula. The nutritional and anti-nutritional profile of this local formula(metu2) was compared to plumpy-nut. Standard official analytical methods were used. Proximate composition was comparable and within the WHO recommendations for therapeutic formulas. Local formula(metu2) had a comparatively high energy content, 528kcal/100g to 509kcal in plumpynut. Vitamin A and K contents were below the WHO recommendations in local formula while Na, Mg and essential fatty acids were comparable and within the contents needed for SAM recovery. Zn was comparatively higher in plumpy-nut but levels in both formulas were below the recommendations. Trypsin inhibitors, phytates and condensed tannins were higher in local formula while aflatoxins were within the limits but not for plumpynut. Though lacking in critical K, Zn and Vitamin A, local formula(metu2) was comparable to plumpy-nut and its efficacy to sustain recovery from SAM needs to be studied. 

scholarly journals Follow-up of a historic cohort of children treated for severe acute malnutrition between 1988 and 2007 in Eastern Democratic Republic of Congo

PLoS ONE ◽  
2020 ◽  
Vol 15 (3) ◽  
pp. e0229675 ◽  
Author(s):  
Pacifique Mwene-Batu ◽  
Ghislain Bisimwa ◽  
Gaylord Ngaboyeka ◽  
Michelle Dramaix ◽  
Jean Macq ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Republic Of Congo ◽  
Historic Cohort

scholarly journals Study to determine gender variation in severe acute malnutrition at nutrition rehabilitation centre

2019 ◽  
Vol 6 (2) ◽  
pp. 602
Author(s):  
Suguna S. ◽  
Vidyasagar V.
Keyword(s):  
Weight Gain ◽  
District Hospital ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Rehabilitation Centre ◽  
Gender Variation ◽  
Nutrition Rehabilitation ◽  
Time Of Admission ◽  
Discharge Criteria

Background: The objective of this study is to know the gender variation in number of admissions, severity of malnutrition at the time of admission, gaining of weight and adherence to follow up in children admitted to nutrition rehabilitation center and during follow up.Methods: This is a retrospective study involving the review of existing programme records. Children who were admitted to nutrition rehabilitation centre, district hospital, Chamarajanagar, Karnataka, India, between January 2017 to December 2017 with severe acute malnutrition were involved in the study. The programme included 2 weeks of in-patient care, and four follow-up visits to the NRC subsequently as follows; 1st visit at 7 days, 2nd at 14 days, 3rd at 1 month and 4th at 2 months after discharge.Results: Among 57 children who admitted to NRC females were 30 (52.6%) and males 27 47.4%). 25 among 57 children (43.9%) could sustain weight gain of >5grams/kg/day as per one of the discharge criteria. 13 (52%) were females and 12 (48%) were males. 32(56%) among 57 admitted children to NRC, could achieve <-1SD during entire programmed. 15(46.8%) were females and 17 (53.1%) were males.Conclusions: There was no gender variation in either number of admission or severity of malnutrition at the time of admission or weight gain during NRC programme.

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