Factors Influencing Outcomes of Children Hospitalized with Acute Severe Malnutrition

Abstract

Background: Nutrition is still a global health issue, and improving nutrition is among the targets of the Sustainable Developmental Goals (SDGs). One of Indonesia's SDGs indicators is to reduce prevalence of malnutrition in children. Indonesia, as a developing country, implements a comprehensive malnutrition treatment program for children, including various aspects related to management of children with acute malnutrition. The purpose of this study was to identify factors associated with the outcome of children hospitalized with acute severe malnutrition. Methods: This cross sectional study enrolled 195 children with severe acute malnutrition, admitted to hospital from November 2016 to August 2017. Statistical Analysis was conducted using multivariable logistic regression to identify factors associated with the outcome. Adjusted Ratio with Confident Interval 95% and the value of P <0 .05 was considered significant. Result: A total of 195 children were diagnosed havings acute severe malnutrition. A history of complete immunization status (p value <0.001) was proved to be directly proportional to the recovery rate of patients with acute severe malnutrition. Provision of other types of antibiotic (p value 0.001) showed to increase recovery rates of patients with acute severe malnutrition. Several comorbid diseases reduced recovery rates such as pneumonia (Crude OR 0.619) tuberculosis (Crude OR 0.606) and HIV (p value 0.08). Conclusions: This study shows that although the provided treatments are appropriate with the standard treatment for severe malnutrition, they still encounter high levels of morbidity. Further large-scale studies should be conducted to develop better interventions and management of acute severe malnutrition, in order to achieve better outcome.

Anemia and metabolic acidosis as risk factor of mortality in children with severe acute malnutrition

“…This study found that malnutrition was more prevalent in male patients (60.1%). This study is in line with the previous study (Rusmil et al, 2018) which states that malnourished were more common in boys by 59%. Another study conducted by Arya et al also found that the prevalence of malnutrition was higher in males (59%) (Arya et al, 2017).…”

“…Another study conducted by Arya et al also found that the prevalence of malnutrition was higher in males (59%) (Arya et al, 2017). It also stated that there was no significant relationship between gender and mortality (Arya et al, 2017;Rusmil et al, 2018). This is consistent with the results of this study which the pvalue was 0.46.…”

“…Thus were align with the results of our study, namely that more children under five experienced malnutrition (57.2%) compared to the non-toddler group. This study showed that there was no significant relationship between age and mortality which was supported by other studies (Mena et al, 2018;Rusmil et al, 2018).…”

“…Also, Mena found that the most dominant comorbid were non-infectious (53.2%) (Mena et al, 2018). However, another study showed different results which the most dominant comorbid was pneumonia 35.4% followed by anemia 31.3% (Rusmil et al, 2018). Also, another study found that acute respiratory infections and tuberculosis were the most common comorbidities in children with malnutrition at 26.5 and 21.5% (Arya et al, 2017).…”

“…Malnutrition affects individuals in all age groups, but children under five years were the most vulnerable population with greater morbidity and mortality. This age group needs more attention because of greater need for growth and development than other age groups (Chisti et al, 2015) Also, Kusnandi found 58% of children under 5 years suffered malnutrition (Rusmil et al, 2018). A study by Mena found that 67.3% of children under 5 were malnourished (Mena et al, 2018).…”