scholarly journals Predictors for time to recovery from sever acute malnutrition among under-five children admitted to therapeutic feeding unit at Dubti referral hospital, Afar region, Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Awoke Seyoum Tegegne ◽  
Denekew Bitew Belay
Keyword(s):  
At Risk ◽  
Drinking Water ◽  
Recovery Time ◽  
Severe Acute Malnutrition ◽  
Referral Hospital ◽  
Acute Malnutrition ◽  
Cooking Fuel ◽  
Average Recovery ◽  
Under Five ◽  
Afar Region

Abstract Background Currently, about 165 million children are categorized under malnutrition and 51.5 million suffering from acute malnutrition in world wide. Hence, the objective of current study was to assess the recovery time and its predictors of children under five from severe acute malnutrition admitted to Therapeutic Feeding Unit at Dubti Referral Hospital, Afar region, Eastern Ethiopia. Methods Institutional based retrospective cohort study was conducted on 650 inpatient children with SAM admitted for therapeutic feeding unit whose treatment was from March to April/2017. Results The result in current investigation indicates that the average recovery time from SAM was found to be 21 days (95% CI; 21.23–25.77), p-value = 0.035). A Cox proportional hazard regression model revealed that Weight of a child at birth, gestational age of a child, working status of a child at admission birth order of a child, mother’s BMI, mother’s level of education, mother’s stature, mother’s occupation, mother’s age, mother’s marital status, mother’s nutritional status, house hold income in ETB, family size in HH, number of under-five children, the type of toilet used in HH, source of improved drinking water, type of cooking fuel, ownership of livestock, age and weight of a child at admission had statistically significant association with the variation of average recovery time of children from SAM. Conclusion Male children under severe acute malnutrition, rural children, children with different additional diseases and children who did not get mothers’ breast milk at least in the first six months after birth and children who did not get vaccination are groups at risk and needs intervention and special attention to be recovered with short period of time. Children from low income family, who did not get improved drinking water, without moderate cooking fuel and a child from larger families were groups at risk in recovery time from SAM.

scholarly journals Comorbidities and Factors Associated with Mortality among Children under Five Years Admitted with Severe Acute Malnutrition in the Nutritional Unit of Jinja Regional Referral Hospital, Eastern Uganda

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Desire Banga ◽  
Melvis Baren ◽  
Namale Vivian Ssonko ◽  
Franck Katembo Sikakulya ◽  
Yves Tibamwenda ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Referral Hospital ◽  
Acute Malnutrition ◽  
Health Concern ◽  
Regional Referral Hospital ◽  
Children Under Five ◽  
Under Five ◽  
Factors Associated ◽  
Eastern Uganda ◽  
Children Under 5

Background. Mortality among children with severe acute malnutrition remains an immense health concern in the hospitals in developing countries, but its attributes are not completely assessed in various hospital settings. The aim of this study was to determine the proportion of mortality, the comorbidities, and factors associated with in-hospital mortality among children under five years of age admitted with severe acute malnutrition at Jinja Regional Referral Hospital, Eastern Uganda. Methods. This was a hospital-based analytical and descriptive prospective cohort study conducted in the nutritional unit of Jinja Regional Referral Hospital. A total of 338 children and their caretakers who met the criteria were consecutively enrolled into the study. Descriptive statistics were used to each of the independent factors, and comorbidities were subjected to chi-squared test followed by logistic regression analysis to assess its association incidence of mortality among children. All independent variables with p values ≤ 0.05 were entered into a multivariate model for factors and comorbidities independently. Factors and comorbidities with p values ≤ 0.05 were considered as associates of mortality among children. Results. Of the 338 children under 5 years of age enrolled, 49 (14.5%) died, although the majority of children were diagnosed with dehydration, 128 (37.9%); pneumonia, 127(37.6%); and malaria, 87(25.7%). Anemia ( aRR = 2.9 , 95% CI: 1.23-6.62, p = 0.01 ), bacteremia ( aRR = 10.0 , 95% CI: 3.62-29.01, p = 0.01 ), HIV ( aRR = 4.8 , 95% CI: 1.42-16.30, p < 0.01 ), TB ( aRR = 4.3 , 95% CI: 1.28-14.49, p < 0.02 ), and shock ( aRR = 60.9 , 95% CI: 9.05-410.28, p < 0.01 ) were the comorbidities significantly associated with a likelihood of mortality. Conclusions. The mortality among children under 5 years of age admitted with severe acute malnutrition is still high (14.5% versus 5%). The comorbidities are significantly associated with mortality. The clinicians are recommended to follow-up closely patients with severe acute malnutrition and to focus on the critical comorbidities identified.

scholarly journals PO 8430 A GEOSPATIAL APPROACH TO PREDICTING DIARRHEA PREVALENCE IN NIGERIA

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A36.3-A37
Author(s):  
Oluwasegun Adetunde
Keyword(s):  
Drinking Water ◽  
Severe Acute Malnutrition ◽  
Oral Rehydration Salt ◽  
Acute Malnutrition ◽  
National Bureau ◽  
Water Access ◽  
Mortality Pattern ◽  
Under Five ◽  
Improved Sanitation ◽  
Diarrhea Prevalence

BackgroundNigeria ranks second globally only behind India in under-five mortality prevalence. In Nigeria, 108.8 children die per 1000 live births before their 5th birthday. It is of note that diarrhoea (15.3% prevalence) is the second leading cause of under-five mortality in Nigeria after pneumonia. General poor hygiene and nutritional status are contributory factors to diarrhea.MethodsData was collected for severe acute malnutrition (SAM) using the weight for height z-value (WHZ) and/or oedema criteria. In addition, data on diarrhoea prevalence, oral rehydration salt therapy (ORST), improved source of drinking water and improved sanitation were collected. These were obtained for 36 states and federal capital territory (FCT) from the National Bureau of Statistics headquarters in FCT, Abuja for 2015. Correlation analysis was first carried out to determine relationships followed by geographically weighted regression analysis (GWR). GWR was used to predict under-five mortality pattern and accuracy mapped.ResultsObserved correlation coefficients to diarrhoea prevalence were 0.59,–0.49, −0.35 and −0.63 for SAM, ORST, improved drinking water access, and improved sanitation, respectively. R2 varied across states, though positive, from 0.29 in Akwa Ibom to 0.95 in Kebbi states. Standard deviation of residuals in the regression model ranged from −3.89 to 3.33 in Borno and Gombe states respectively, while Sokoto and Bauchi had 0.006 and 0.024 respectively, thus having the best accuracy in predictions across all states in the country. Both correlation and GWR were at p<0.05.ConclusionThe results obtained support literature, confirming the inverse relationship between ORST prevalence, improved drinking water access and improved sanitation to diarrhea prevalence. It also supports the already confirmed positive relationship between poor nutrition of children and susceptibility to diarrhoea. The study however expanded knowledge by incorporating geocomputation to predict diarrhoea prevalence.

Retrospective Assessment of Malnutrition among Under-five Children in Ayder Referral Hospital, Tigray Ethiopia

2015 ◽  
Vol 4 (2) ◽  
pp. 71
Author(s):  
Teklemariam Gultie ◽  
Desta Mebrahtu ◽  
Girum Sebsibie
Keyword(s):  
Breast Feeding ◽  
Severe Acute Malnutrition ◽  
Age Groups ◽  
Referral Hospital ◽  
Acute Malnutrition ◽  
Cross Sectional ◽  
Timely Initiation ◽  
Under Five ◽  
Under Five Children ◽  
Ayder Referral Hospital

Currently worldwide there are about 60 million children with moderate acute and 13 million with severe acute malnutrition. About 9% of sub-Saharan African and 15%of south Asian children have moderate acute malnutrition and about 2% of children in developing countries have severe acute malnutrition. The objective of aim the study was<strong> </strong>to assess the magnitude of malnutrition in under five children in Ayder referral hospital using a retrospective cross-sectional study design. This study showed that male children, 168(58.1%), were higher than female, 121(41.9%).. Majority, 133(46%), were in the age group b/n 12 to 24 months .More than half, 186(64.4%) were rural dwellers.  The types of malnutrition identified were Marasmus, kwashiorkor, Marasmic kwash and underweight which account for 116(40.1%), 69(23.9%), 54(18.7%) and 50(17.5%) respectively. Marasmus was the predominant type of malnutrition in all age groups of under five malnourished children with prevalence of 40.1% where as underweight was the prevalent type of malnutrition (17.3%). More over the infant feeding practices such as exclusive breast feeding, timely initiation of complementary feeding, and having history of breast feeding once in their life during infancy were relatively higher among the children as compared with other studies.

scholarly journals Retrospective Assessment of Malnutrition among Under-five Children in Ayder Referral Hospital, Tigray Ethiopia

2015 ◽  
Vol 4 (2) ◽  
pp. 71
Author(s):  
Teklemariam Gultie ◽  
Desta Mebrahtu ◽  
Girum Sebsibie
Keyword(s):  
Breast Feeding ◽  
Severe Acute Malnutrition ◽  
Age Groups ◽  
Referral Hospital ◽  
Acute Malnutrition ◽  
Cross Sectional ◽  
Timely Initiation ◽  
Under Five ◽  
Under Five Children ◽  
Ayder Referral Hospital

Currently worldwide there are about 60 million children with moderate acute and 13 million with severe acute malnutrition. About 9% of sub-Saharan African and 15%of south Asian children have moderate acute malnutrition and about 2% of children in developing countries have severe acute malnutrition. The objective of aim the study was<strong> </strong>to assess the magnitude of malnutrition in under five children in Ayder referral hospital using a retrospective cross-sectional study design. This study showed that male children, 168(58.1%), were higher than female, 121(41.9%).. Majority, 133(46%), were in the age group b/n 12 to 24 months .More than half, 186(64.4%) were rural dwellers.  The types of malnutrition identified were Marasmus, kwashiorkor, Marasmic kwash and underweight which account for 116(40.1%), 69(23.9%), 54(18.7%) and 50(17.5%) respectively. Marasmus was the predominant type of malnutrition in all age groups of under five malnourished children with prevalence of 40.1% where as underweight was the prevalent type of malnutrition (17.3%). More over the infant feeding practices such as exclusive breast feeding, timely initiation of complementary feeding, and having history of breast feeding once in their life during infancy were relatively higher among the children as compared with other studies.

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 Effectiveness of Breastfeeding Support Packages in Low- and Middle-Income Countries for Infants under Six Months: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 681
Author(s):  
Ritu Rana ◽  
Marie McGrath ◽  
Ekta Sharma ◽  
Paridhi Gupta ◽  
Marko Kerac
Keyword(s):  
At Risk ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
World Health ◽  
Cochrane Library ◽  
Breastfeeding Support ◽  
Middle Income ◽  
Middle Income Countries ◽  
Breastfeeding Practices ◽  
Low And Middle Income

Small and nutritionally at-risk infants under six months, defined as those with wasting, underweight, or other forms of growth failure, are at high-risk of mortality and morbidity. The World Health Organisation 2013 guidelines on severe acute malnutrition highlight the need to effectively manage this vulnerable group, but programmatic challenges are widely reported. This review aims to inform future management strategies for small and nutritionally at-risk infants under six months in low- and middle-income countries (LMICs) by synthesising evidence on existing breastfeeding support packages for all infants under six months. We searched PubMed, CINAHL, Cochrane Library, EMBASE, and Global Health databases from inception to 18 July 2018. Intervention of interest were breastfeeding support packages. Studies reporting breastfeeding practices and/or caregivers’/healthcare staffs’ knowledge/skills/practices for infants under six months from LMICs were included. Study quality was assessed using NICE quality appraisal checklist for intervention studies. A narrative data synthesis using the Synthesis Without Meta-analysis (SWiM) reporting guideline was conducted and key features of successful programmes identified. Of 15,256 studies initially identified, 41 were eligible for inclusion. They were geographically diverse, representing 22 LMICs. Interventions were mainly targeted at mother–infant pairs and only 7% (n = 3) studies included at-risk infants. Studies were rated to be of good or adequate quality. Twenty studies focused on hospital-based interventions, another 20 on community-based and one study compared both. Among all interventions, breastfeeding counselling (n = 6) and education (n = 6) support packages showed the most positive effect on breastfeeding practices followed by breastfeeding training (n = 4), promotion (n = 4) and peer support (n = 3). Breastfeeding education support (n = 3) also improved caregivers’ knowledge/skills/practices. Identified breastfeeding support packages can serve as "primary prevention" interventions for all infants under six months in LMICs. For at-risk infants, these packages need to be adapted and formally tested in future studies. Future work should also examine impacts of breastfeeding support on anthropometry and morbidity outcomes. The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO 2018 CRD42018102795).

Time To Relapse of Severe Acute Malnutrition And Its Determinants Among Children Treated In The Health Posts of Hadiya Zone, Southern Ethiopia.

2021 ◽  
Author(s):  
Abera Lambebo ◽  
Desselegn Temiru ◽  
Tefera Belachew
Keyword(s):  
Severe Acute Malnutrition ◽  
Statistical Significance ◽  
Acute Malnutrition ◽  
Southern Ethiopia ◽  
Under Five ◽  
Back Ground ◽  
Relapse Time ◽  
The Mean ◽  
Time To Relapse ◽  
Hadiya Zone

Abstract Back ground: In developing countries including Ethiopia, children under five years old are likely to suffer from repeated bouts of SAM. There is lack of study that documented time to relapse of SAM and its determinants. Objective: This study aimed to identify time of relapse and its determinants among children discharged after treatment for SAM in health facilities of Hadiya Zone, South, Ethiopia Methods: An institution based retrospective cohort study was carried out from data spanning from 2014/2015 to 2019/2020. After checking all the assumptions, multivariable CPH model was fitted to isolate independent determinants of time to relapse. All tests were two sided and statistical significance at P values <0.05. Result: The mean(±SD) time for relapse of SAM among under five children was 22(±9.9) weeks from discharge to relapse time. On multivariable CPH model, the hazard of relapse for SAM was significantly higher for children who had edema (AHR =2.02 ,95%, CI: 1.17-3.50), age of 6-11 months (AHR = 5.2, 95%, CI:1.95-13.87), had discharge low MUAC (AHR = 12,95%, CI: 7.90-19.52)Concussion: The finding showed that children discharged from SAM are likely to have relapse in 3 weeks.

scholarly journals An Overview on Acute Malnutrition and Food Insecurity among Children during the Conflict in Yemen

Children ◽  
2019 ◽  
Vol 6 (6) ◽  
pp. 77 ◽  
Author(s):  
Fekri Dureab ◽  
Eshraq Al-Falahi ◽  
Osan Ismail ◽  
Lina Al-Marhali ◽  
Ayoub Al Jawaldeh ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Severe Acute Malnutrition ◽  
Public Health Problem ◽  
Acute Malnutrition ◽  
Nutrition Status ◽  
Surveillance Program ◽  
Children Under Five ◽  
Under Five ◽  
Community Needs ◽  
Moderate Acute Malnutrition

Background: This study aims to describe malnutrition among children under five and to describe the food insecurity status during the current conflict in Yemen. Methods: Data were obtained from a Yemeni nutrition surveillance program (pilot phase) targeting 4142 households with 5276 children under five from two governorates (Ibb and Sana’a). Results: Global acute malnutrition was found in 13.3% of overall screened children, while 4.9% had severe acute malnutrition (SAM) and 8.4% had moderate acute malnutrition. One-fifth of the children under six months of age were acutely malnourished, followed by children under two years at 18.5% based on weight-for-height z scores. Significant associations between malnutrition and other diseases included suspected measles at three times higher rates (4.5%, p < 0.00) among SAM cases than other children. Diarrhea, fever, and cough were significantly higher among the SAM group (p < 0.05). Most households depended on market food purchases in the month preceding this survey (84.7%). Household coping mechanisms to secure daily meals included borrowing food to survive, changing types and quality of food, and decreasing the number of meals per day; some families sent their children to live with relatives. Conclusion: Malnutrition is a serious public health problem. The humanitarian community needs to adopt alternative strategies to improve food security and the nutrition status in Yemen.

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