Time to Recovery and Its Predictors among Children 6–59 Months Admitted with Severe Acute Malnutrition to East Amhara Hospitals, Northeast Ethiopia: A Multicenter Prospective Cohort Study

Background. Malnutrition has been among the most common public health problems in the world, especially in developing countries including Ethiopia. Even though the Ethiopian government launched stabilization centers in different hospitals, there are limited data on how long children will stay in treatment centers to recover from severe acute malnutrition. This study aimed to assess the time to recovery and its predictors among children 6–59 months with severe acute malnutrition admitted to public hospitals in East Amhara, Northeast Ethiopia. Methods. Institution-based, prospective cohort study was conducted in seven public hospitals in East Amhara and a total of 341 children were included in the study. The results were determined by Kaplan–Meier procedure, log-rank test, and Cox-regression to predict the time to recovery and to identify the predictors of recovery time. Variables having P value ≤0.2 during binary analysis were entered into multivarable Cox proportional hazards regression analysis. P value <0.05 was considered statistically significant. Results. The nutritional recovery rate was 6.9 per 100 person-days with a median nutritional recovery time of 11 days (an interquartile range of 6). The independent predictors like using NG tube for feeding (AHR = 0.44, 95% CI: 0.27–0.71), not entering phase 2 on day 10 (AHR = 0.19, 95% CI: 0.12–0.29), and being admitted to referral hospitals (AHR = 0.52 95% CI: 0.37–0.73) were associated with longer periods of nutritional recovery time. Conclusion. Both the recovery rate and the recovery time were within the acceptable minimum standards. But, special attention has to be given to children who failed to enter phase 2 on day 10, for those who needed NG tube for feeding, and for those admitted to referral hospitals during inpatient management.

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Predictors of nutritional recovery time and survival status among children with severe acute malnutrition who have been managed in therapeutic feeding centers, Southern Ethiopia: retrospective cohort study

BMC Public Health ◽

10.1186/s12889-015-2593-5 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 27

Author(s):

Delelegn Yilma Gebremichael

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Recovery Time ◽

Retrospective Cohort ◽

Severe Acute Malnutrition ◽

Acute Malnutrition ◽

Southern Ethiopia ◽

Survival Status ◽

Nutritional Recovery

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Recovery time from severe acute malnutrition and associated factors among under-5 children in Yekatit 12 Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

Epidemiology and Health ◽

10.4178/epih.e2020003 ◽

2020 ◽

Vol 42 ◽

pp. e2020003 ◽

Cited By ~ 2

Author(s):

Mekonen Adimasu ◽

Girum Sebsibie ◽

Fikrtemariam Abebe ◽

Getaneh Baye ◽

Kerebih Abere

Keyword(s):

Cohort Study ◽

Weight Gain ◽

Retrospective Cohort Study ◽

Recovery Time ◽

Retrospective Cohort ◽

Severe Acute Malnutrition ◽

Acute Malnutrition ◽

Daily Weight Gain ◽

Nutritional Recovery ◽

Length Of Hospitalization

OBJECTIVES: Recovery time from severe acute malnutrition (SAM) is often a neglected topic despite its clinical impact. Although a few studies have examined nutritional recovery time, the length of hospitalization in those studies varied greatly. Therefore, the aim of this study was to determine the recovery time from SAM and to identify predictors of length of hospitalization among under-5 children.METHODS: A retrospective cohort study was conducted among 423 under-5 children with SAM who had been admitted to Yekatit 12 Hospital. Kaplan-Meier analysis was used to estimate time to nutritional recovery, and Cox proportional hazard regression analysis was performed to determine independent predictors.RESULTS: The nutritional recovery rate was 81.3%, and the median recovery time was 15.00 days (95% confidence interval [CI], 13.61 to 16.39). Age, daily weight gain per kilogram of body weight, vaccination status, and the existence of at least 1 comorbidity (e.g., pneumonia, stunting, shock, and deworming) were found to be significant independent predictors of nutritional recovery time. The adjusted hazard ratio (aHR) for nutritional recovery decreased by 1.9% for every 1-month increase in child age (aHR, 0.98; 95% CI, 0.97 to 0.99).CONCLUSIONS: The overall nutritional recovery time in this study was within the Sphere standards. However, approximately 13.0% of children stayed in the hospital for more than 28.00 days, which is an unacceptably large proportion. Daily weight gain of ≥8 g/kg, full vaccination, and deworming with albendazole or mebendazole reduced nutritional recovery time. Conversely, older age, pneumonia, stunting, and shock increased nutritional recovery time.

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Time-to-recovery from severe acute malnutrition in children 6–59 months of age enrolled in the outpatient treatment program in Shebedino, Southern Ethiopia: a prospective cohort study

BMC Pediatrics ◽

10.1186/s12887-019-1407-9 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 6

Author(s):

Genene Teshome ◽

Tafese Bosha ◽

Samson Gebremedhin

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Treatment Program ◽

Outpatient Treatment ◽

Prospective Cohort ◽

Severe Acute Malnutrition ◽

Acute Malnutrition ◽

Southern Ethiopia

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Diarrhea, Dehydration, and the Associated Mortality in Children with Complicated Severe Acute Malnutrition: A Prospective Cohort Study in Uganda

The Journal of Pediatrics ◽

10.1016/j.jpeds.2019.03.014 ◽

2019 ◽

Vol 210 ◽

pp. 26-33.e3 ◽

Cited By ~ 2

Author(s):

Benedikte Grenov ◽

Betty Lanyero ◽

Nicolette Nabukeera-Barungi ◽

Hanifa Namusoke ◽

Christian Ritz ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Severe Acute Malnutrition ◽

Acute Malnutrition

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Recovery time and associated factors of severe acute malnutrition among children in Bahir Dar city, Northwest Ethiopia: an institution based retrospective cohort study

BMC Nutrition ◽

10.1186/s40795-018-0224-0 ◽

2018 ◽

Vol 4 (1) ◽

Cited By ~ 11

Author(s):

Degnet Teferi Asres ◽

Reddy P. C. J. Prasad ◽

Tadesse Awoke Ayele

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Recovery Time ◽

Retrospective Cohort ◽

Associated Factors ◽

Severe Acute Malnutrition ◽

Northwest Ethiopia ◽

Acute Malnutrition ◽

Bahir Dar

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Determinants of treatment outcomes of severe acute malnutrition among under-5 children in Yekatit 12 Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

10.21203/rs.3.rs-30080/v1 ◽

2020 ◽

Author(s):

Mekonen Adimasu Kebede ◽

Girum Sebsbie Teshome ◽

Fkirtemariam Abebe Fenta ◽

Melaku Bimerew Getahun

Keyword(s):

Cohort Study ◽

Treatment Outcomes ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Severe Acute Malnutrition ◽

Vaccination Status ◽

Acute Malnutrition ◽

Nutritional Recovery ◽

Default Rates ◽

Hiv Aids

Abstract Background Devastatingly, the number of children with SAM is still growing globally. Severe acute malnutrition is the third most common contributing factor to the deaths of under-5 children worldwide. According to the World Health Organization, severe acute malnutrition causes 1 million deaths annually via increased susceptibility to death from severe infection. Ethiopia is one of the countries with highest under-5 child mortality rate, with malnutrition underlying to 28% of all children deaths. In Ethiopia, some studies reported an alarming death and default rates which indicate the need for further study to assess contributing factors to the treatment outcomes of severe acute malnutrition. Therefore, the intention of this research is to determine the treatment outcomes of severe acute malnutrition and identify predictors of nutritional recovery. Method: A retrospective cohort study was conducted among 423 under-5 children with severe acute malnutrition. Logistic regression analysis was performed and an adjusted odd ratio with 95%CI was used to determine independent predictors. Result The overall recovery, death and default rates were 81.3%, 11.1% and 7.6% respectively. Age, vaccination status, HIV/AIDS, pneumonia, diarrhea and stunting were found to be significant independent predictors of treatment outcomes. The adjusted odd ratio (AOR) for nutritional recovery increased by 14.6% for every 1-month increase in child age (AOR = 1.146; 95%CI: 1.052–1.249). Regarding vaccination status, those under-5 children who were fully vaccinated for their age were about 4 time more likely to recover than their counterparts (AOR = 4.242; 95%CI: 1.566–11.491) Conclusion In conclusion, the overall nutritional recovery and default rate in this study were in the acceptable range of international standard even though the death rate was higher. Age and full vaccination were proven to increase nutritional recovery. Conversely, the presence of HIV/AIDS, pneumonia, diarrhea and stunting were proven to decrease nutritional recovery.

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