Post discharge morbidities and mortalities among children with severe acute malnutrition who did not undergo nutrition rehabilitation

2019 ◽  
Author(s):  
Eman Ghazawy ◽  
Gihan Bebars ◽  
Ehab Salah Eshak

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.


2020 ◽  
Author(s):  
Eman Ghazawy ◽  
Gihan Bebars ◽  
Ehab Salah Eshak

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.


2013 ◽  
Vol 51 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Karanveer Singh ◽  
N. Badgaiyan ◽  
A. Ranjan ◽  
H. O. Dixit ◽  
A. Kaushik ◽  
...  

Author(s):  
Deepthi Pagali ◽  
Suneetha Bollipo ◽  
Harsha B. Korrapolu ◽  
Mohammed Abdul Rahman

Background: Nutrition rehabilitation centre (NRC) is a unit in a district health facility, where children with severe acute malnutrition are admitted and provided with nutritional and therapeutic care.Methods: Analysis of nutritional data of all the children admitted to NRC at Krishna district from January 2017 to July 2018. Statistical analysis was done using SPSS.Results: A total of 200 children were included in the study. The overall mean weight at admission was found to be 8.30 kg with a standard deviation of 2.35 kg and the mean weight at the time of discharge is 9.57 kg with a standard deviation of 2.61 kg. There is a statistically significant difference in weight and mid arm circumference at admission and discharge. Mean duration of hospital stay is around 18.67±5.4 days. Target weight is achieved in 71% of the study group.Conclusions: Present study reflects that NRCs have been playing a key role to cope up with the problem of severe acute malnutrition as demonstrated by a high rate of weight gain at discharge as well as during follow ups. 


Author(s):  
Rajesh Kumar Sinha ◽  
Asha Kiran ◽  
Vivek Kashyap ◽  
Praveen Kumar

Background: Children with severe acute malnutrition (SAM) having medical complications require immediate care at malnutrition treatment centers (MTC). Thus, it becomes important to assess the effect and treatment cost of such children in these facilities. Hence, the present study was done with these aims in two MTCs in Jharkhand, India.Methods: A retrospective record review was done of the children admitted to these two MTCs between 1st April 2017 and 31st March 2018. A predesigned proforma was used to collect child related information. The data collected was entered in Microsoft excel sheet and analysed.Results: Majority of the admitted children (90.6%) were in 6-23 months age group. 358 (51.5%) children were females. Only, 194 (27.9%) children admitted were SAM had any medical complication. 690 (99.3%) children were discharged of whom 499 (72.3%) were discharged after achieving the target weight. The average weight gain during their stay was 8.1±2.4 g/kg/day and average length of stay was 16.7±3.2 days. Post discharge follow up rates were found to be low and only 130 (18.8%) children completed all three follow ups. Average cost per SAM child treated was Rs. 18,599 (US$ 272) and per SAM child cured was Rs. 25,904 (US$ 379).Conclusions: MTCs are effective in managing medically complicated SAM children. However, improvements are necessary to ensure that more such children should be treated at facility level, complimented with a community based programme for managing uncomplicated SAM children to improve coverage and ensure continuum of care.


2019 ◽  
Vol 6 (2) ◽  
pp. 602
Author(s):  
Suguna S. ◽  
Vidyasagar V.

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.


2021 ◽  
Vol 29 (01) ◽  
pp. 116-120
Author(s):  
Saadia Khan ◽  
Waqas Imran Khan ◽  
Ayesha Fayyaz ◽  
Ibad Ali ◽  
Asad Abbas ◽  
...  

Objective: To determine the percentage of Hypothyroidism in children with severe acute malnutrition. Study Design: Cross Sectional study. Setting: Nutrition Rehabilitation Center, Children’s Hospital and Institute of Child Health Multan. Period: January 2019 to December 2019. Material & Methods: A total of 255 malnourished patients (as per inclusion criteria) were included in current study. A written Performa was designed to collect history, anthropometric measurements and systemic examination. Taking aseptic measures venous blood was sent for baseline tests as well as for T3, T4 and TSH, total serum protein albumin and total ferritin levels to hospital laboratory. Correlation between serum thyroid concentrations and total protein, albumin, hemoglobin and serum ferritin were estimated by using t-test and p-vlaue less than 0.05 was considered as significant. Total collected data was entered and analyzed in SPSS version 21.0. Results: A total of 255 malnourished children were included in this study. Majority of studied subjects were male (52.5%) with 83.92%, 3-5 years of age. Amongst the 255 children mean values of T3 in MAM and SAM patients were 105.4 ng/dl and 89.7 ng/dl respectively. There was a statistically significant (p <0.001) association between decreased T3 and type of malnutrition. Similarly, mean values of T4 in MAM and SAM patients were 6.3 ug/dl and 5.7 ug/dl respectively that was statistically significant (p <0.05). Lower values of T4 were higher among SAM children in 1 to 3 years age group compared to respective MAM children with p value .0.05 and high T4 value in 3-5 years age group of MAM children were both statistically insignificant. Higher mean Values of TSH was found in SAM compared to MAM children both age groups. Conclusion: Severe acute malnutrition (SAM) is associated with reduction in T3 and T4 levels and higher levels of TSH in SAM children as compared to MAM. The altered thyroid hormone status in children with PEM is perhaps a protective phenomenon to limit protein catabolism and lower energy requirements.


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