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 Relapsing Time to Severe Acute Malnutrition and Hazards Among Children Treated in the Health Posts.

2021 ◽  
Author(s):  
Abera Lambebo ◽  
Desselegn Temiru ◽  
Tefera Belachew
Keyword(s):  
Negative Binomial ◽  
Severe Acute Malnutrition ◽  
Statistical Significance ◽  
Acute Malnutrition ◽  
Negative Binomial Regression Model ◽  
Under Five ◽  
Under Five Children ◽  
The Mean ◽  
Time To Relapse ◽  
Mean Time

Abstract Background: Malnutrition has many unpleasant results on child health during illness and after discharge. However, in Ethiopia there is luck of study that address either time to relapse or post discharge statusObjective: To identify time of relapse and associated factors among children discharged after undergoing treatment for SAM in South, Ethiopia Methods: An institution Retrospective cohort study was done among children admitted to health posts for treatment of SAM from 2014/2015-2019/2020 under-five children after discharge. After checking all the assumptions finally multivariable Cox regression has been used. All tests were two sided and P values <0.05 were used to declare statistical significance. Results: The mean time for relapse of severe acute malnutrition among under five children was determined us 22 at 95% CI, (20.69-24.82) week from discharge to relapse time.On multivariable negative binomial regression model, after adjusting for background variables time for relapse of severe acute undernutrition was significantly associated with edema during admission (AHR,2.02 ,95%, CI: 1.17-3.50), age group of 6-11 months (AHR 5.2,95%, CI:1.95-13.87), less discharge MUAC for first admission increase hazard of relapse (AHR 12,95%, CI: 7.90-19.52). Conclusion: The mean time was 22 week and edema, Age and MUAC was associated time to relapse.

scholarly journals Time to Relapse of Severe Acute Malnutrition and Associated Factors Among Under Five Children  in Hadiya Zone, Southern Ethiopia.

2021 ◽  
Author(s):  
ABERA LAMBEBO TEMAMO ◽  
Deselegn Temiru ◽  
Tefera Belachew
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Severe Acute Malnutrition ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Acute Malnutrition ◽  
Southern Ethiopia ◽  
Under Five ◽  
Under Five Children ◽  
Hadiya Zone

Abstract BackgroundIn developing countries including Ethiopia, children under five years old are likely to suffer from repeated bouts of severe acute malnutrition as home level drivers are not mostly improved although the child is discharged after clinical and anthropometric cure. There is lack of study that documented time to relapse of severe acute malnutrition and its determinants.ObjectiveTo identify time of relapse and its determinants among children discharged after undergoing treatment for SAM in health facilities of Hadiya Zone, South, Ethiopia MethodsAn institution based retrospective cohort study was carried out in Hadiya Zone, of Southern Ethiopia among under-five children admitted to health posts for treatment of SAM in the past five years spanning from 2014/2015 to 2019/2020 and discharged after cure. Both first admission data and relapse data were abstracted from the records of the SAM children from Aguste 1 – 30 /2020 Using a data collection format. Data were coded and edited manually, then doubly entered into Epi-Data statistical software version 3.1 and then exported to SPSS for windows version 26. After checking all the assumptions, multivariable Cox Proportional Hazards model was fitted to isolate independent determinants of time to cure. All tests were two sided and P values <0.05 were used to declare statistical significance. ResultsThe mean(±SD) time for relapse of severe acute malnutrition among under five children was 22(±9.9) weeks from discharge to relapse time.On multivariable Cox Proportional Hazards model, after adjusting for background variables the hazard of relapse for severe acute malnutrition was significantly higher for children who had edema during admission with (AHR =2.02 ,95%, CI: 1.17-3.50), were in the age group of 6-11 months (AHR = 5.2, 95%, CI:1.95-13.87), had discharge MUAC for the first admission not cured (AHR = 12,95%, CI: 7.90-19.52)ConclusionThe finding showed that children discharged from Severe acute malnutrition are likely to have relapse in three weeks’ time given the prevailing situation of the home environment. Having edema during admission, younger age and not being cured by MUAC at discharge were independent determinants of relapse. The results imply that the need for reviewing follow-up system after discharge and working on the caring practices through behavior change communication to improve the home environment. There also a need for revising the discharge criteria for edematous children rather than basing only on weight change.

scholarly journals Time to relapse of severe acute malnutrition and risk factors among under-five children treated in the health posts of Hadiya Zone, Southern Ethiopia

2021 ◽  
Vol 10 ◽  
Author(s):  
Abera Lambebo ◽  
Dessalegn Tamiru ◽  
Tefera Belachew
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Severe Acute Malnutrition ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Acute Malnutrition ◽  
Southern Ethiopia ◽  
Under Five ◽  
Under Five Children ◽  
Hadiya Zone

Abstract Relapse/repeated episodes are defined as the admission of a child with a diagnosis of severe acute malnutrition (SAM) after being discharged with a status of recovery. However, there is a lack of study that documented the time to relapse of SAM and its risk factors. The present study aimed to identify the time of relapse and its risk factor among under-five children discharged after undergoing treatment for SAM in health facilities of Hadiya Zone, South Ethiopia. An institution-based retrospective cohort study was carried out in the Hadiya Zone of Southern Ethiopia among under-five children. Data were collected from 760 cards of severe acute malnourished children over the past 5 years spanning from 2014/15 to 2019/20. Both first admission and relapse data were abstracted from the records of the SAM children from 1 August to 30 August 2020 and cards of children that were admitted to program by transferee with complete records were included. After checking all the assumptions, multivariable Cox Proportional Hazards model was fitted to isolate independent determinants of time to cure. All tests were two-sided and statistical significance at P-values < 0⋅05. The mean(±sd) time for relapse of SAM among under-five children was 22(±9⋅9) weeks from discharge to relapse time. On multivariable Cox Proportional Hazards model, the hazard of relapse for SAM was significantly higher for children who had oedema (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 MUAC not cured (AHR12, 95% CI 7⋅90, 19⋅52). The finding showed that children discharged from SAM are likely to have relapse in 3 weeks time.

scholarly journals Frequency of relapse for severe acute malnutrition and associated factors among under five children admitted to health facilities in Hadiya Zone, South Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0249232
Author(s):  
Abera Lambebo ◽  
Deselegn Temiru ◽  
Tefera Belachew
Keyword(s):  
Associated Factors ◽  
Negative Binomial ◽  
Severe Acute Malnutrition ◽  
Negative Binomial Regression ◽  
Acute Malnutrition ◽  
Under Five ◽  
South Ethiopia ◽  
Binomial Regression ◽  
Hadiya Zone ◽  
First Admission

Background Severe acute malnutrition is a common cause of morbidity and mortality among under five children in Ethiopia. A child may experience more than one episode of SAM depending on the improvement of the underlying factors. However, there is no study that determined the frequency of relapse of SAM cases after discharge in Ethiopia. Objective To identify the frequency of relapse and associated factors among children discharged after undergoing treatment for SAM in Hadiya Zone, South, Ethiopia. Methods An institution based retrospective cohort study was done among children admitted to health posts for treatment of SAM from 2014/2015-2019/2020 under-five children’s after discharge in health post for severe acute malnutrition in the last five years in Hadiya zone, SNNPR, Ethiopia. Both first admission data and relapse data were abstracted from the records of the SAM children from Aguste 1–30 /2020 Using a data collection format. Data were coded and edited manually, then doubly entered into Epi-Data statistical software version 3.1 and then exported to SPSS for windows version 26. After checking all the assumptions finally Negative binomial regression for poison has been used. All tests were two sided and P values <0.05 were used to declare statistical significance. Results In the last five year there were the proportion of relapsed cases were 9.6%, 95% CI: (7.7%, 11.7%) On multivariable negative binomial regression model, after adjusting for background variables relapse of severe acute undernutrition was significantly associated with having edema during admission with (IRR = 2.21, 95% CI:1.303–3.732), being in the age group of 6–11 months (IRR = 4.74,95% CI:1.79–12.53), discharge MUAC for the first admission (P = 0.001, IRR = 0.37, 95% CI:0.270–0.50) increase the risk of incidence rate ratio(IRR) relapse case of severe acute under nutrition. Conclusion Frequency of SAM relapse was positively associated with age, having edema during admission, while it was negatively associated with discharge MUAC. The results imply the need for reviewing the discharge criteria taking into account the recovery of MUAC as a marker for lean tissue accretion, especially in edematous children and those in the younger age.

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.

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