Survival Status and Determinants of Mortality Among Severely Malnourished Children Aged 0-59 Months Admitted to Jinka Hospital, South Omo Zone, Ethiopia: A Retrospective Cohort Study (original) (raw)
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2020
Background Malnutrition is still a global public health problem contributing for under-five morbidity and mortality. Specifically, childhood mortality attributable to malnutrition is high at Felege-Hiwot Comprehensive Specialized Hospital. 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 hospital. Therefore, estimated time to death and its predictors can provide an input for program planners and decision-makers in the study area.Methods An institutional-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 Meir was used to estimate cumulative survival probability and ...
Archives of Public Health
Background: Globally, approximately 19 million children under 5 years are suffering from Severe Acute Malnutrition (SAM). It is a major cause of morbidity and mortality in low-income countries including Ethiopia. However, little is known regarding predictors of mortality among these children in Ethiopia. The current study aimed to assess the potential predictors of mortality among under-five children with SAM admitted to a stabilization center. Method: A retrospective cohort study was conducted in 527 under-five children who were admitted for SAM at the University of Gondar comprehensive specialized hospital from 2014 to 2016. Data were collected from a randomly selected chart after getting ethical clearance. Data were cleaned, coded and entered to Epi-info (version 7) and analyzed using STATA (version14). The outcome was computed by using tables and graphs. A multivariable cox proportional hazards model was fitted to identify predictors of mortality. Result: Overall, the median follow-up period was 10 days with interquartile range (Q1, Q3: 8, 17). At the end of the follow-up, the mortality rate was 66(12.52%).
Nutrition Journal
Background Management of severe acute malnutrition (SAM) has been a program priority in Ethiopia, but it remains the leading cause of mortality in under-five children. Hence, this study aimed to identify the incidence density rate of mortality and determinants among under-five children with severe acute malnutrition in St. Paul’s Hospital Millennium Medical College, 2012 to 2019. Methods A retrospective cohort study was conducted and data were collected using a structured checklist from 673 charts, of which 610 charts were included in the final analysis. The Kaplan-Meier survival curve with Log-rank test was used to estimate the survival time. Bi-variable and multi-variable Cox proportional hazard regression models were fitted to identify determinants of death. Schoenfeld residuals test was used to check a proportional hazard assumption. Goodness of fit of the final model was checked using Nelson Aalen cumulative hazard function against Cox-Snell residual. Results In this study, 61 ...
BMC Nutrition
Background: Severe acute malnutrition remains one of the most common causes of morbidity and mortality in Sub-Saharan Africa. The objective of this study was to investigate morbidity and mortality trends and factors associated with mortality of under-five children admitted and managed for severe acute malnutrition in NEMMH. Methods: Four years retrospective cohort study was conducted on 500 under-five children admitted with the diagnosis of severe acute malnutrition. The study population was all under-five children admitted to the inpatient nutrition unit between 2012 and 2015. Data was entered using Epi-Data version 3.1 and exported to SPSS version 16 for analysis. A Kaplan-Meier curve was also used to estimate survival probability of different types of severe acute malnutrition. Cox proportional hazards regression was used to predict the risk of death among predictor while adjusting for other variables. A P-value less than 0.05 was considered as statistically significant. Result: A total of 500 children were enrolled into the study. Kwashiorkor was the most frequently recorded morbidity accounting for 43.0%. Pneumonia was seen the commonest form of comorbid disease. It was the most common co-morbidity across all morbidity groups. (27.6% in kwashiorkor, 37.5% in marasmus and 37.7% in marasmic-kwashiorkor). The average length of stay in the hospital was 11 days. Children with new admission were 86% less likely to die than repeated admission given that the children were admitted to paediatric ward (HR: 0.14, 95% CI: (0.06, 0.35). Kaplan Meier survival curves also showed children with marasmus and those with repeated admission had reduced survival rates. The overall mortality rate was 7%. The mortality trends vary irregularly in each year but morbidity trend increased with admission from 2014 to 2015. Conclusion: Mortality trends of SAM vary irregularly across the years but morbidity trends increased with admission from 2014 to 2015. An admission type was significantly associated with mortality. Morbidity and co-morbid diseases did not show significant effect on mortality of the children. Health extension workers and stakeholders should give due concern on promotion of proper nutrition in a community.
Ethiopian Journal of Pediatrics and Child Health
Background: Malnutrition continues to be a long-term year-round phenomenon, threatening under 5 children unacceptably the most. It is responsible for 25,000 children’s hospitalization per month and nearly 50% of all under-5 mortalities in Ethiopia. The national burden of SAM highlights the importance of addressing predictors of recovery rates. Methodology: An institution-based retrospective cohort study was implemented from a period of august 2020- august 2021. Data were collected using a structured questionnaire and entered and analyzed using SPSS 25. The output of both bivariate and multivariate logistic regression analysis was presented using an odd ratio and 95% CI. A p-value of less than 0.05 was taken as statistically significant. Results: Among the total study cases of 241 children, 192(79.7%) records were recovered, 15 (6.2%) died, and 20(8.3%) were defaulted. The majority of the children, 155(64.3%) had nonedematous malnutrition. The independent predictors of mortalit...
International Journal of Child Health and Nutrition, 2021
Malnutrition (over and undernutrition) is a major public health problem across the globe, especially undernutrition is responsible for one-third of the death of children in underprivileged populations. Each year more than 25 to 35 million under-five children have suffered from Severe Acute Malnutrition (SAM). The sub-Saharan African countries account for the lion's share of this case fatality rate. The case in Ethiopia is not different from other countries. This study's main aim is to assess predictors for the cure rate of Severe Acute Malnutrition in 6-59 month Children in stabilizing center at Pawe General Hospital, Northwest Ethiopia. A retrospective cohort study. Methods: Hospital-based retrospective cohort study was employed among 454 admitted under-five SAM children from Januarys1st 2015-to December 30, 2019. Data were cleaned, coded, and entered into Epi-Data 3.1; then exported to STATA/SE-14/R for analysis. Survival analysis was used to check each variable's proportional hazard assumption and no variable Schoenfield test <0.05. Variable with AHR at 95 % CI at P-value less than 0.05 considered as significant. Final model adequacy was checked by Nelson Alana and Cox Snell residual plot test. Result: Totally 454 (90.4%) individual data were included for final analysis; Sixty-five percent of 65.4% (95%CI: 50.1-69.2) admitted children declared as cured, 16.52 % of them defaulted and 11.5% of children reported as dead. The median age and median cure time of SAM children were found at 2.2 years and 13 days (±7), respectively. Children diagnosed marasmus (AHR=1.56: 95% CI 1.08-2.2, p<0.018), with No nasal-gastric intubation (NGT) during admission (AHR= 1.31: 95%CI (1.04-1.67, P<0.029) and taking F-100 milk (AHR=5.42 95% CI (2.92-9.85, p<0.001) were associated with treatment cure rate. The conclusions: The overall treatment cure rate of this study was remaining low at 65.4% compared to the sphere standard sets reference (i.e., >75-77.9 %). Concerning associated factors addressing F-100 milk, making SAM underfive children with no NGT and increased treatment cure rate was independently associated with treatment cure rate.
BMC Nutrition
Background: In Ethiopia, the health sector has increased its efforts to enhance good nutritional practices through health education, treatment of extremely malnourished children and provision of micronutrients for mothers and children. But, the poor nutritional status of women and children continues to be still a major public health problem. Methods: A retrospective cohort study was conducted to assess the treatment outcome and associated factors of severe acute malnutrition among a total of 253 children age 6-59 months old. Severe acute malnutrition registration logbook and patient charts were used as a source of data. Data were entered in to Epi-data version 3.1 and exported to SPSS version 20 for analysis. To identify associated factors, Cox proportional hazard analysis was computed and p-value <0.05 at 95% confidence interval was considered as statistically significant.
BackgroundUndernutrition among children is a significant contributor to the global disease burden and a leading cause of child mortality. Ethiopia, home to more than 16 million children under 5 years old, is one of the countries that have high levels of wasting. The aim of this study was to assess survival status and predictors of mortality among children with severe acute malnutrition admitted to Dubti Zonal Referral hospital from January 1/2017 to September 30/2019.MethodsFacility-based retrospective cohort was conducted among 331 severely acutely malnourished children. Data were collected from SAM management registration, individual patient cards and multi-charts admitted from January 1/2017 to September 30/2019. Cox-regression was used to characterize survival within the cohort and to estimate the effect of specific variables while controlling for potential confounders. The hazard ratio was used as a measure of the outcome. P-value less than 0.05 was considered statistically sig...