Incidence and predictors of severe acute malnutrition mortality in children aged 6–59 months admitted at Pawe general hospital, Northwest Ethiopia

Abstract

Background Severe acute malnutrition (SAM) is defined as a weight-for-height < -3z scores of the median WHO growth standards, or visible severe wasting or the presence of nutritional edema. SAM related mortality rates in under-five children are well documented in Ethiopia but data on their predictors are limited. We aimed to document factors associated with SAM related mortality to inform better inpatient management. Methods A facility-based retrospective cohort study was conducted among children admitted due to SAM at Pawe General Hospital, Northwest Ethiopia, from the 1st of January 2015 to the 31st of December 2019. Data from the records of SAM children were extracted using a standardized checklist. Epi-Data version 3.2 was used for data entry, and Stata version 14 was used for analysis. Bi-variable and multivariable Cox regression analyses were conducted to identify predictors of mortality. Variables with P<0.05 were considered significant predictors of mortality. Results Five-hundred sixty-eight SAM cases were identified of mean age was 27.4 (SD± 16.5) months. The crude death rate was 91/568 (16.02%) and the mean time to death was determined as 13 (±8) days. Independent risk factors for death were: (i) vomiting AHR = 5.1 (1.35–21.1, p = 0.026), (ii) diarrhea AHR = 2.79 (1.46–5.4, p = 0.002), (iii) needing nasogastric therapy AHR = 3.22 (1.65–6.26, p = 0.001), (iv) anemia AHR = 1.89 (1.15–3.2, p = 0.012), and (v) being readmitted with SAM AHR = 1.7 (1.12–2.8, p = 0.037). Conclusion SAM mortality was high in under-five children in our setting. The identified risk factors should inform treatment and prevention strategies. Improved community health education should focus on healthy nutrition and seeking early treatment. Inpatient mortality may be reduced by stricter adherence to treatment guidelines and recognizing early the key risk factors for death.

Malaria serosurvey among acute febrile patients come for health care seeking at the high malaria-endemic setting of North West Ethiopia

“…According to WHO, anemia was classified for both adults and children with hemoglobin concentration < 11 g/dL. 20 , 27 …”

“…According to WHO, anemia was classified for both adults and children with hemoglobin concentration < 11 g/dL. 20,27 Bed net utilization. There was self-reported ownership and regular use of bed nets.…”

Effects of probiotic and synbiotic supplementation on ponderal and linear growth in severely malnourished young infants in a randomized clinical trial

“…Globally, 13.6 million children under the age of five are affected by severe acute malnutrition (SAM) 1 , the most severe form of undernutrition. Malnutrition is responsible for around 60% of childhood deaths under the age of 5 years and two-thirds of those occur during 1st year of life 2 . Despite introducing standardized treatment and re-feeding protocols, inpatient mortality reaches up to 30% in many hospitals 3 – 6 .…”

Time to readmission and associated factors after post treatment discharge of severe acute malnourished under-five children in Pawe General Hospital

“…It is responsible directly or indirectly for 60% of the 10.9 million deaths annually among under-five children, and two-thirds of these deaths occur during the first year of life [ 4 – 6 ]. Globally, in 2018, one in 12 of the estimated 52 million children under five had SAM [ 7 , 8 ], and 2.9 million of these children were admitted for inpatient treatment [ 2 , 4 , 9 ].…”