Predictors of undesirable treatment outcomes of severe acute malnutrition among inpatient children in Addis Ababa, Ethio
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RESEARCH ARTICLE
Open Access
Predictors of undesirable treatment outcomes of severe acute malnutrition among inpatient children in Addis Ababa, Ethiopia: a retrospective cohort study Absalat Serawit Negussie1*
and Amare Worku Tadesse2
Abstract Background: In 2018, malnutrition contributed to 45% of all global cause of child death. These early child deaths were due to conditions that could either be prevented or treated with basic interventions. Hence, this study intended to provide a quantitative estimate of factors associated with undesirable treatment outcomes of severe acute malnutrition (SAM). Methods: We studied a retrospective cohort of 304 children aged 6–59 months with complicated SAM admitted to Yekatit 12 Hospital Medical College from 2013 to 2016. We extracted data from hospital records on nutritional status, socio-demographic factors and medical conditions during admission. The analysis was carried out using SPSS version 20. The Kaplan-Meier estimator was employed to analyze the recovery rate of the children treated for SAM and multivariable Cox regression was used to determine factors that predict inpatient undesirable treatment outcomes. Result: From a total of 304 children 6–59 months with SAM, 133 (51.4%) were boys. Marasmus was the most common type (132 (51%)) of severe acute malnutrition. The recovery, death and defaulter rate were 70.4, 12.2 and 8.2% respectively. The main predictors of undesirable treatment outcomes were found to be the presence of HIV antibody (AHR = 3.208; 95% CI: [1.045–9.846]) and sepsis (AHR = 7.677, 95% CI: [2.320–25.404]). Conclusion: The study revealed that the overall treatment outcomes were below the SPHERE standard recommendation. The main predictors of undesirable treatment outcomes among inpatient children treated for SAM were HIV and sepsis. Intervention to reduce undesirable treatment outcomes should focus on comorbidities, especially HIV and sepsis. Keywords: Severe acute malnutrition, Inpatient, Undesirable treatment outcome, Children
Background The United Nations’ first Millennium Development Goal (MDGs) to “eradicate extreme poverty and hunger” was measured by assessing a set of indicators, which included the prevalence of underweight children under the * Correspondence: [email protected] 1 Addis Continental Institute of Public Health, P.O.box 26571/1000, Addis Ababa, Ethiopia Full list of author information is available at the end of the article
age of 5 years [1]. The extreme situation of malnutrition, not uncommon among children under the age of 5 years, is referred to as Severe Acute Malnutrition (SAM). The World Health Organization (WHO) defines SAM based on three anthropometric indicators: low weight for height/length ratio (WFH) below − 3 SD, presence of nutritional edema, and/ or a mid-upper arm circumference (MUAC) of less than 115 mm [2, 3]. The WHO guidelines for treatment of complicated
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharin
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