scholarly journals Survival and predictors of mortality among severe acute malnourished under-five children admitted at Felege-Hiwot comprehensive specialized hospital, northwest, Ethiopia: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amare Kassaw ◽  
Desalegne Amare ◽  
Minyichil Birhanu ◽  
Aragaw Tesfaw ◽  
Shegaw Zeleke ◽  
...  
Keyword(s):  
Public Health ◽  
Oxygen Saturation ◽  
Retrospective Cohort ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Altered Consciousness ◽  
Time To Death ◽  
Under Five ◽  
Predictors Of Mortality ◽  
Malnourished Children

Abstract Background Malnutrition is still a global public health problem contributing for under-five morbidity and mortality. The case is similar in Ethiopia in which severe acute malnutrition is the major contributor to mortality being an underlying cause for nearly 45% of under-five deaths. However, there is no recent evidence that shows the time to death and public health importance of oxygen saturation and chest in drawing in the study area. Therefore, estimated time to death and its predictors can provide an input for program planners and decision-makers. Methods A facility -based retrospective cohort study was conducted among 488 severe acute malnourished under-five children admitted from the 1st of January 2016 to the 30th of December 2019. The study participants were selected by using simple random sampling technique. Data were entered in to Epi-Data version 3.1 and exported to STATA version15 statistical software for further analysis. The Kaplan Meier was used to estimate cumulative survival probability and a log-rank test was used to compare the survival time between different categories of explanatory variables. The Cox-proportional hazard regression model was fitted to identify predictors of mortality. P-value< 0.05 was used to declare statistical significance. Results Out of the total 488 randomly selected charts of children with severe acute malnutrition, 476 records were included in the final analysis. A total of 54(11.34%) children died with an incidence rate of 9.1death /1000 person- days. Failed appetite test (AHR: 2.4; 95%CI: 1.26, 4.67), altered consciousness level at admission (AHR: 2.4; 95%CI: 1.08, 4.67), oxygen saturation below 90% (AHR: 3.3; 95%CI: 1.40, 7.87), edema (AHR 2.9; 95%CI: 1.45, 5.66) and HIV infection (AHR: 2.8; 95%CI: 1.24, 6.36) were predictors of mortality for children diagnosed with severe acute malnutrition. Conclusion The overall survival status of severe acute malnourished children was low as compared to national sphere standards and previous reports in the literature. The major predictors of mortality were oxygen saturation below 90%, altered consciousness, HIV infection, edema and failed appetite test. Therefore, early screening of complications, close follow up and regular monitoring of sever acute malnourished children might improve child survival rate.

scholarly journals Survival and Predictors of Mortality among Severe Acute Malnourished under-five children admitted at Felege-Hiwot Comprehensive Specialized Hospital, Northwest, Ethiopia: A retrospective cohort study

2020 ◽  
Author(s):  
Amare Kassaw ◽  
Desalegne Amare ◽  
Minyichil Birhanu ◽  
Aragaw Tesfaw ◽  
Shegaw Zeleke ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Retrospective Cohort ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Altered Consciousness ◽  
Time To Death ◽  
Under Five ◽  
Predictors Of Mortality ◽  
Malnourished Children ◽  
Specialized Hospital

Abstract Background Malnutrition is still a global public health problem contributing for under-five morbidity and mortality. Specifically, childhood mortality attributable to malnutrition is high at Felege-Hiwot Comprehensive Specialized Hospital. However, there is no recent evidence that shows the time to death and public health importance of oxygen saturation and chest in drawing in the hospital. Therefore, estimated time to death and its predictors can provide an input for program planners and decision-makers in the study area.Methods An institutional-based retrospective cohort study was conducted among 488 severe acute malnourished under-five children admitted from the 1st of January 2016 to the 30th of December 2019. The study participants were selected by using simple random sampling technique. Data were entered in to Epi-Data version 3.1 and exported to STATA version15 statistical software for further analysis. The Kaplan Meir was used to estimate cumulative survival probability and a log-rank test was used to compare the survival time between different categories of explanatory variables. The Cox-proportional hazard regression model was fitted to identify predictors of mortality. P-value < 0.05 was used to declare statistical significance.Results Out of the total 488 randomly selected charts of children with severe acute malnutrition, 476 records were included in the final analysis. A total of 54(11.34%) children died with an incidence rate of 9.1death /1000 person- days. Failed appetite test (AHR: 2.4; 95%CI: 1.26, 4.67), altered consciousness level at admission (AHR: 2.4; 95%CI: 1.08, 4.67), oxygen saturation below 90% (AHR: 3.3; 95%CI: 1.40, 7.87), edema (AHR 2.9; 95%CI: 1.45, 5.66) and HIV infection (AHR: 2.8; 95%CI: 1.24, 6.36) were predictors of mortality for children diagnosed with severe acute malnutrition.Conclusion The overall survival status of severe acute malnourished children was low as compared to national sphere standards and previous reports in the literature. The major predictors of mortality were oxygen saturation below 90%, altered consciousness, HIV infection, edema and failed appetite test. Therefore, early screening of complications, close follow up and regular monitoring of sever acute malnourished children might improve child survival rate.

scholarly journals SURVIVAL ANALYSIS OF UNDER-FIVE CHILDREN WITH SEVERE ACUTE MALNUTRITION IN WOLDIA HOSPITAL: RETROSPECTIVE COHORT STUDY

2021 ◽  
Vol 2 (1) ◽  
pp. 1-13
Author(s):  
Aragaw Asfaw
Keyword(s):  
Cohort Study ◽  
Survival Analysis ◽  
Survival Time ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Time To Death ◽  
Under Five ◽  
Under Five Children

Abstract Background: Globally, 52 million children of age under five years were affected by acute malnutrition from which 17 million were severely wasted. In Ethiopia every month over 25,000 children with severe acute malnutrition are admitted to hospitals, if not identified early and treated properly, these children could die. Therefore this study aimed to assess the determinants of time to death of under-five children with SAM admitted to inpatient therapeutic feeding center in Woldia General Hospital.   Methods: A retrospective cohort study was conducted. The study population were children with severe acute malnutrition aged from 0 to 59 months who have been admitted to woldia general hospital from September 2017 to August 2019.The sample was 150 that fulfils the inclusion criteria were included. Non parametric survival analysis was used to estimate survival time to death and Cox PH model was carried out to determine independent predictors.   Results: The accounted proportion of death of under-five children in the study period was 10%. And the estimated mean survival time of the patient was 4.48 weeks. Both estimates was almost on the recommended Sphere standard which should < 10% and <4 weeks respectively. In the estimated model HR for age groups (24-35 months) is 0.000 with 95% CI [0.000-4.591], wasting  is 0.010 with 95% CI [0.000-0.065], referred from is 0.000 with 95% CI [0.000-0.061], cough 133.04 with 95% CI [3.596-4922.83], HIV is 1209.61 with 95% CI [1.137-1286998.42], Iv antibiotic treatment is 0.000 with 95% CI [0.000-0.037] and amoxicillin is 0.001 with 95% CI [0.000-0.736] were significant predictors for time to death of under-five children with SAM.   Conclusions: From the fitted model, age of the children, admission criteria, children referred from,cough, HIV, IV antibiotic treatment and Amoxicillin are the covariates that have significant effect on time to death of under five children by SAM at 5% level of significance. Early identifying cases and giving special attention for children with co morbidities such as HIV and cough is vital for decrease child mortality Ethiopia.    Keywords: Severe acute malnutrition, inpatient, semi parametric, non parametric, death

scholarly journals Post-Discharge survival status and predictors of mortality among severely acute malnourished children <5 years of age admitted to Minia University Maternity and Children Hospital

2019 ◽  
Author(s):  
Eman Ghazawy ◽  
Gihan Bebars ◽  
Ehab Salah Eshak
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Treatment Programs ◽  
Cumulative Probability ◽  
Post Discharge ◽  
Under Five ◽  
Survival Status ◽  
Probability Of Survival ◽  
Malnourished Children ◽  
Nutrition Rehabilitation

Abstract Background: Though effective treatment programs for severely malnourished children are available, but little is known about long-term outcomes and potential predictors of post-discharge mortality. The aim of this study was to assess the post-discharge survival status and predictors for post-discharge mortality in severely malnourished children admitted to Minia University Maternity and Children Hospital Methods: A retrospective cohort study which included 135 children under five years of age who were admitted to the nutrition rehabilitation ward with severe acute malnutrition (SAM) during the period from January to December 2018. Data were collected from the inpatients hospital records and children’s parents/guardians were interviewed using a detailed structured questionnaire that inquired about demographic and socioeconomic variables. Results: A total of 135 children were enrolled into the study. Death rate during hospitalization was 9.6%. The cumulative probability of survival beyond eight weeks and at least for 24 weeks after discharge was 89.3% with a cumulative probability of post-discharge mortality of 10.7% and all deaths occurred within eight weeks after discharge. The main predictors for post-discharge mortality were illiteracy of mothers and the presence of edema at admission; the multivariable HRs (95%CIs) were 7.10 (1.58-31.93; p=0.01) and 6.96 (0.84-357.85; p=0.07), respectively. Conclusions: Mothers’ education and edema at admission are independent predictors for post-discharge mortality in under-five children with SAM. The identification of predictors for post-discharge mortality is an important preliminary step for interventions aiming to reduce morbidity and mortality following discharge.

scholarly journals Predictors for a Cure Rate of Severe Acute Malnutrition 6-59 Month Children in Stabilizing Center at Pawe General Hospital, Northwest Ethiopia: Retrospective Cohort Study

2021 ◽  
Vol 10 (1) ◽  
pp. 34-43
Author(s):  
Fassikaw Kebede ◽  
◽  
Nemera Eticha ◽  
Belete Negese ◽  
Mastewal Giza ◽  
...  
Keyword(s):  
Cohort Study ◽  
General Hospital ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Severe Acute Malnutrition ◽  
Northwest Ethiopia ◽  
Acute Malnutrition ◽  
Cure Rate ◽  
Under Five ◽  
Under Five Children

Malnutrition (over and undernutrition) is a major public health problem across the globe, especially undernutrition is responsible for one-third of the death of children in underprivileged populations. Each year more than 25 to 35 million under-five children have suffered from Severe Acute Malnutrition (SAM). The sub-Saharan African countries account for the lion's share of this case fatality rate. The case in Ethiopia is not different from other countries. This study's main aim is to assess predictors for the cure rate of Severe Acute Malnutrition in 6-59 month Children in stabilizing center at Pawe General Hospital, Northwest Ethiopia. A retrospective cohort study. Methods: Hospital-based retrospective cohort study was employed among 454 admitted under-five SAM children from Januarys1st 2015-to December 30, 2019. Data were cleaned, coded, and entered into Epi-Data 3.1; then exported to STATA/SE- 14/R for analysis. Survival analysis was used to check each variable's proportional hazard assumption and no variable Schoenfield test <0.05. Variable with AHR at 95 % CI at P-value less than 0.05 considered as significant. Final model adequacy was checked by Nelson Alana and Cox Snell residual plot test. Result: Totally 454 (90.4%) individual data were included for final analysis; Sixty-five percent of 65.4% (95%CI: 50.1- 69.2) admitted children declared as cured, 16.52 % of them defaulted and 11.5% of children reported as dead. The median age and median cure time of SAM children were found at 2.2 years and 13 days (±7), respectively. Children diagnosed marasmus (AHR=1.56: 95% CI 1.08--2.2, p<0.018), with No nasal-gastric intubation (NGT) during admission (AHR= 1.31: 95%CI (1.04 --1.67, P<0.029) and taking F-100 milk (AHR=5.42 95% CI (2.92--9.85, p<0.001) were associated with treatment cure rate. The conclusions: The overall treatment cure rate of this study was remaining low at 65.4% compared to the sphere standard sets reference (i.e., >75-77.9 %). Concerning associated factors addressing F-100 milk, making SAM under-five children with no NGT and increased treatment cure rate was independently associated with treatment cure rate.

scholarly journals Post-Discharge survival status and predictors of mortality among severely malnourished children <5 years of age admitted to Minia University Maternity and Children Hospital

2020 ◽  
Author(s):  
Eman Ghazawy ◽  
Gihan Bebars ◽  
Ehab Salah Eshak
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Treatment Programs ◽  
Cumulative Probability ◽  
Post Discharge ◽  
Under Five ◽  
Survival Status ◽  
Probability Of Survival ◽  
Malnourished Children ◽  
Nutrition Rehabilitation

Abstract Background: Though effective treatment programs for severely malnourished children are available, little is known about long-term outcomes and potential predictors of post-discharge mortality. The aim of this study was to assess the post-discharge survival status and predictors for post-discharge mortality in severely malnourished children admitted to Minia University Maternity and Children HospitalMethods: A retrospective cohort study which included 135 children under five years of age who were admitted to the nutrition rehabilitation ward with severe acute malnutrition (SAM) during the period from January to December 2018. Data were collected from the inpatient’s hospital records and the children’s parents/guardians were interviewed using a detailed structured questionnaire that inquired about demographic and socioeconomic variables. The Cox proportional hazard model was used to assess the factors associated with the SAM’s post-discharge mortality.Results: A total of 135 children were enrolled into the study. Death rate during hospitalization was 9.6%. The cumulative probability of survival beyond eight weeks and at least for 24 weeks after discharge was 89.3% with a cumulative probability of post-discharge mortality of 10.7% and all deaths occurred within eight weeks after discharge. The main predictor for the SAM’s post-discharge mortality was illiteracy of mothers; the multivariable HR (95%CI) was 7.10 (1.58-31.93; p=0.01).Conclusions: Mothers’ education and edema at admission are independent predictors for post-discharge mortality in under-five children with SAM. The identification of predictors for post-discharge mortality is an important preliminary step for interventions aiming to reduce morbidity and mortality following discharge.

Trends of severe acute malnutrition morbidity and mortality (2014-2017), Bale Zone, Oromia Region, Ethiopia, 2018

2019 ◽  
Author(s):  
Mohammed Hasen Badeso ◽  
Henok Asefa Ferede ◽  
Naod Berhanu Bogale ◽  
Falaho Sani Kalil
Keyword(s):  
Public Health ◽  
Death Rate ◽  
Severe Acute Malnutrition ◽  
Age Groups ◽  
Public Health Problem ◽  
Acute Malnutrition ◽  
Important Public Health Problem ◽  
Under Five ◽  
Annual Prevalence ◽  
Bale Zone

Abstract Background Malnutrition is a serious disease and remains an important public health problem in many developing countries including Ethiopia. Malnutrition is one of the diseases under the surveillance system which is reported weekly and monthly. In the Bale zone, malnutrition is one of the major public health problems. Therefore, this trend analysis of severe acute malnutrition was to describe the magnitude, trends, disease outcome and geographical distribution of the severe acute malnutrition in Bale Zone from 2014-2017.Methods A descriptive cross-sectional study was conducted on April 2018. Data was extracted from Bale zone monthly malnutrition report database and checked for completeness and consistency then four years’ trends of severe acute malnutrition were analyzed. The prevalence and trend of severe acute malnutrition by Woreda, year and age were analyzed using Microsoft office excel and SPSS version 20 then summarized using text, table, and figure.Result A total of 37,678 severe acute malnutrition cases registered over four years (2014-2017). Of these, 31,642(84%) cured, 52(0.14%) died, 641(1.7%) defaulters, 66(0.18%) non-respondents. Among registered cases, 98.2% are 6-59months age groups. The average annual prevalence of severe acute malnutrition high among under-five children was 3.3%. Prevalence rate per 1000 population of severe acute malnutrition in 2014, 2015,2016 and 2017 are 3.6, 4.5, 7.5 and 4.7 respectively and death rate are 0.21%, 0.26%, 0.1% and 0.08% respectively. Among the Woreda, the highest prevalence at Delomena (2.45%) and lowest at Sinana woreda (0.1%). The death rate is high among 6-59months age groups (0.13%) and followed by less than 6months age group (0.008%).Conclusion Cases of severe acute malnutrition increased during the year 2014 to 2016 then decreased during 2017. The prevalence of severe acute malnutrition high in under-five age groups children at Bale zone during the study period and Delomena Woreda has the highest average annual prevalence of severe acute malnutrition. We recommend further research on why some district has a high prevalence of severe acute malnutrition.

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