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 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 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 Uncomplicated Severe Acute Malnutrition Among 6–59 Months Children From the Outpatient Therapeutic Feeding Program in North Shewa Zone of Oromia Region, Ethiopia. A Prospective Follow-Up Study.

2021 ◽  
Author(s):  
Amare Bekalu Taye ◽  
Degemu Sahlu Asebe ◽  
Addisu Walelign Tadesse
Keyword(s):  
Food Security ◽  
Median Time ◽  
Acute Malnutrition ◽  
Household Food Security ◽  
Health Post ◽  
Follow Up Study ◽  
Household Food ◽  
Correct Dose ◽  
Food Security Status

Abstract Introduction: Community-based management of acute malnutrition is implementing in Ethiopia. But there is scarce information in our study set up regarding the time to recovery and its predictors of SAM among 6-59 months children, so this study aimed to assess the time to recovery and its predictors of uncomplicated SAM among 6-59children managed at the OTP in north Shewa zone, Ethiopia.Methods: A health post-based prospective follow-up study had conducted on 6-59months children from November 20/2020 – February 20/2021. A total of 423 children had included in the study. A structured interviewer-administered questionnaire had used. The median time to recovery had calculated using the Kaplan Meier (KM) curve. The predictors of time to recovery were determined using both bi-variable and multi-variable Cox regression models with a 95% confidence interval (CI). Finally, the variable that had a p-value < 0.05 in the multi-variable analysis was declared as the predictors of time to recovery. Proportional hazard assumption was checked graphically and using Schoenfeld residual test.Result: From the total 423 Children, 327 (77.3%) recovered. The median time to recovery was 42 + IQR of 14 days. Children from food secure households; AHR= 9.6 with 95% CI (8.1-18.5), mild food insecure; AHR= 6.5 with 95% CI (3.1, 13.8), moderate food insecure; AHR= 2.5 with 95% CI (1.2-5.3). Mothers who traveled less than 2 hours walking distance to the health post; AHR=2.6 with 95% CI (1.8-18.7). Children who received the correct dose of the RUTF AHR=1.6 with 95% CI (1.1-2.3), children who measured their weight weekly AHR= 1.5 with 95% CI (1.1-2.0), and children treated by health extension worker who took the Nutrition-related training AHR= 2.1 with 95% CI (1.0-4.5) were predictors of time to recovery. Conclusion and recommendation: The median time to recovery was within the acceptable range of the Ethiopian protocol for the management of uncomplicated SAM in the Outpatient setup. Household food security status, the distance between home and health posts, the correct dose of RUTF, weekly weight measurement per protocol, and HEWs nutrition-related training status were the significant predictors of time to recovery. It is advisable to improve the household food security status, and the Health extension worker's (HEWs) nutrition-related training.

scholarly journals Time to Cure and Predictors of Recovery among Children Aged 6-59 Months with Severe Acute Malnutrition Admitted in Jimma University Medical Center, Southwest Ethiopia

2020 ◽  
Author(s):  
Robel Kabthymer ◽  
Getu Gizaw ◽  
Tefera Belachew
Keyword(s):  
Median Time ◽  
Severe Acute Malnutrition ◽  
Average Length ◽  
Medical Center ◽  
Survival Curve ◽  
Acute Malnutrition ◽  
Rank Test ◽  
Co Morbidity ◽  
Wide Range ◽  
Jimma University

Background: Treatment at stabilization center is an important intervention to avert the huge burden of mortality for children with complicated severe acute malnutrition (SAM). Recent reviews indicated a wide range in recovery rate (34-88%) due to several context-specific factors. This study aimed to estimate time to recovery and to determine predictors of time to recovery among children aged 6-59 month with severe acute malnutrition. Method: Retrospective cohort study was used among 375 children aged 6-59 months admitted in Jimma university medical center, from September 2015 to September 2017. Kaplan Meir estimate and survival curve was used to compare the time to recovery using log-rank test among different characteristics. Cox Proportional Hazard Model was used to identify significant predictors of time to recovery. Results: Median time of recovery for cohort of SAM children&rsquo;s was 19 days (95%CI: 17.95-20.05). Independent predictors of time to recovery were: Play stimulation, vaccination status, Tuberculosis, malaria, use of amoxicillin, deworming and shock. Conclusion: The findings of this study showed that the average length of stay on treatment and median time for recovery are within the sphere standard. Psychosocial stimulation, appropriate provision of routine medication and management of medical co-morbidity are needed to promote fast recovery.

scholarly journals Effect of Isoniazid Preventive Therapy on the Incidence of Tuberculosis among Seropositive Children Attending HIV/AIDS Care in Two General Hospitals, Northwest Ethiopia, 2021

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Fassikaw Kebede ◽  
Birhanu Kebede ◽  
Tsehay Kebede ◽  
Melaku Agmasu
Keyword(s):  
Cox Regression ◽  
Data Entry ◽  
Concomitant Administration ◽  
Preventive Therapy ◽  
Northwest Ethiopia ◽  
Isoniazid Preventive Therapy ◽  
Categorical Variables ◽  
P Value ◽  
Human Immune Deficiency Virus

The human immune deficiency virus (HIV) is the strongest risk factor for the incidence of tuberculosis (TB) by way of reactivation of latent or new infection. The provision of isoniazid preventive therapy (IPT) is one of the public health interventions for the prevention of TB. To date, there have been limited clinical data regarding the effectiveness of isoniazid preventive therapy (IPT) on TB incidence. This study aimed to assess the effect of isoniazid preventive therapy on the incidence of tuberculosis for seropositive children in Northwest Ethiopia. Methods. A facility-based retrospective follow-up was employed for reviewing 421 files from 1 January 2015 up to 30 December 2019. EpiData version 3.2 and Stata/14 software were used for data entry and analysis, respectively. Categorical variables at bivariable Cox regression were assessed for candidates transferred at P value <0.25 for multivariable Cox regression to claiming predictors associated with TB incidence rate at 95% CI at P < 0.005 . Result. The overall incidence of TB was found to be 4.99 cases per 100 person-years at 95% CI (3.89–6.53). Missed IPT (AHR = 7.45, 95% CI: 2.96, 18.74, P < 0.001 ), missed cotrimoxazole preventive therapy (CPT) (AHR = 2.4, 95% CI: 1.84–4.74, P < 0.022 ), age ≥ 11 years (AHR = 4.2, 95% CI: 1.04–7.03, P < 0.048 ), MUAC ≤ 11.5 cm (AHR = 4.36, 95% CI: 1.97–9.97, P < 0.001 ), WHO stages III and IV (AHR = 2.04, 95% CI: 1.12–3.74, P < 0.022 ), and CD4 count ≤100 cells/μl (AHR = 3.96, 95% CI: 1.52–10.34, P < 0.005 ) were significantly associated with TB incidence. Conclusion. Concomitant administration of ART with IPT had demoted more than ninety-six percent of new TB incidences for this report. Undertaking in-depth TB screening and frequent follow-up among all these children is critical in order to prevent and control tuberculosis.

scholarly journals Recovery rate of children with moderate acute malnutrition treated with ready-to-use supplementary food (RUSF) or improved corn–soya blend (CSB+): a randomized controlled trial

2015 ◽  
Vol 19 (2) ◽  
pp. 363-370 ◽  
Author(s):  
Gabriel Nama Medoua ◽  
Patricia M Ntsama ◽  
Anne Christine A Ndzana ◽  
Véronique J Essa’a ◽  
Julie Judith T Tsafack ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Recovery Rate ◽  
Energy Requirement ◽  
Controlled Trial ◽  
Acute Malnutrition ◽  
Rank Test ◽  
Supplementary Food ◽  
Significant Difference ◽  
Moderate Acute Malnutrition

AbstractObjectiveTo compare an improved corn–soya blend (CSB+) with a ready-to-use supplementary food (RUSF) to test the hypothesis that satisfactory recovery rate will be achieved with CSB+ or RUSF when these foods provide 50 % of the child’s energy requirement, the 50 % remaining coming from usual diet.DesignA comparative efficacy trial study was conducted with moderately wasted children, using a controlled randomized design, with parallel assignment for RUSF or CSB+. Every child received a daily ration of 167 kJ (40 kcal)/kg body weight during 56 d with a follow-up performed every 14 d. Every caregiver received nutrition counselling at enrolment and at each follow-up visit.SettingHealth districts of Mvog-Beti and Evodoula in the Centre region of Cameroon.SubjectsEight hundred and thirty-three children aged 6–59 months were screened and eighty-one malnourished children (weight-for-height Z-score between −3 and −2) aged 25–59 months were selected.ResultsOf children treated with CSB+ and RUSF, 73 % (95 % CI 59 %, 87 %) and 85 % (95 % CI 73 %, 97 %), respectively, recovered from moderate acute malnutrition, with no significant difference between groups. The mean duration of treatment required to achieve recovery was 44 d in the RUSF group and 51 d in the CSB+ group (log-rank test, P=0·0048).ConclusionsThere was no significant difference in recovery rate between the groups. Both CSB+ and RUSF were relatively successful for the treatment of moderate acute malnutrition in children. Despite the relatively low ration size provided, the recovery rates observed for both groups were comparable to or higher than those reported in previous studies, a probable effect of nutrition education.

Association between Attention-Deficit Hyperactivity Disorder in childhood and schizophrenia later in adulthood

2014 ◽  
Vol 29 (4) ◽  
pp. 259-263 ◽  
Author(s):  
S. Dalsgaard ◽  
P.B. Mortensen ◽  
M. Frydenberg ◽  
C.M. Maibing ◽  
M. Nordentoft ◽  
...  
Keyword(s):  
Cox Regression ◽  
Normal Population ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Follow Up Study ◽  
Background Population ◽  
Hazard Ratios ◽  
Central Register ◽  
Risk Ratios

AbstractPurpose:To estimate the risk of schizophrenia in adulthood among children and adolescents with ADHD compared to the background population.Subjects/materials and methods:Two hundred and eight youths with ADHD (183 boys; 25 girls) were followed prospectively. Diagnoses of schizophrenia were obtained from The Danish Psychiatric Central Register. The relative risk (RR) of schizophrenia for cases with ADHD, compared to the normal population, was calculated as risk ratios. Hazard ratios (HR's) by Cox regression were calculated in the predictor analyses.Results:Mean age for ADHD cases at follow-up was 31.1 years. Schizophrenia diagnoses were given to 3.8% of these cases. Compared to the general population, RR of schizophrenia in cases with ADHD was 4.3 (95% CI 1.9–8.57).Discussion and conclusion:This prospective follow-up study found children with ADHD to be at higher risk of later schizophrenia than controls. If replicated, these results warrant increased focus on the possible emergence symptoms of schizophrenia or schizophreniform psychosis during clinical follow-up of patients with ADHD.

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