Survival status and predictors of mortality among children with severe acute malnutrition admitted to general hospitals of Tigray, North Ethiopia: a retrospective cohort study

Abstract

ObjectiveDespite the presence standard protocol for management of severe acute malnutrition case-fatality rates in African hospitals remain unacceptably high. The case in Ethiopia is not different from others. Therefore, this study was aimed to assess survival status and predictors of mortality among children with severe acute malnutrition admitted to stabilization centers of general hospitals in Tigray region, northern Ethiopia. A 24 months retrospective longitudinal study was conducted among 569 randomly selected medical records of children admitted to stabilizing centers. Both bi-variable and multivariable Cox regression analysis was conducted to identify predictors of mortality. Association was summarized using AHR, and statistical significances were declared at 95% CI and P-value < 0.05.ResultsDuring follow up, 456 [82%] of children had got cured, 37 [6.65%] were absconded and 21 [3.8%] were died. The overall mean survival time was 41.93 [95% CI 40.17–43.68] days. Impaired conscious level [AHR = 6.69, 95% CI 2.43–19.93], development of comorbidity after admission [AHR 12.71, 95% CI 2.79–57.94] and being urban in residence [AHR = 2.73, 95% CI 1.12–6.64] were predictors of mortality. Therefore, interventions to reduce further mortality should focus in children having impaired consciousness level and who developed comorbidity after admission.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3937-x) contains supplementary material, which is available to authorized users.

Survival status and mortality predictors among severely malnourished under 5 years of age children admitted to Minia University maternity and children hospital

“…Younger children may be more vulnerable because of depressed immunity, increased risk of infection and insufficient feeding practices [10]. This finding was also supported by findings from other African studies [9,25,26]. Children with comorbidities/complication at admission were 3.25 times more likely to die than children without co-morbidities/complication in our study.…”

“…Children with comorbidities/complication at admission were 3.25 times more likely to die than children without co-morbidities/complication in our study. Similar results were reported in Ethiopia by Jarso et al (2015) and more recently by Guesh et al (2018) [10,26]. Complicated SAM is typically associated with an inpatient mortality risk of 12% to more than 30% in African hospitals [11,[27][28][29] A meta-analysis of inpatient treatment outcomes of SAM among under-5 children in Ethiopia concluded that comorbidities at admission were predictors of mortality [30].…”

Recovery rate and its predictors among children with severe acute malnutrition in Addis Ababa, Ethiopia: A retrospective cohort study

“…The recovery rate in this study was also higher than the findings various studies performed in different locations of Ethiopia [12,14,16,17,20,21,24,26,27,30,[33][34][35][36][37][38][39][40], of which ten [12,14,16,17,20,26,27,33,36,40], five [24,30,34,35,39], two [37,38], and one [21] were from Northern, Southern, Western and Easter Ethiopia, respectively. However, it was also lower than previous studies done in Ethiopia [13,23,25,41], of which two of them were from Northern Ethiopia [23,41] and others were from Western [13] and Southern [25] Ethiopia. These discrepancies could be attributed to differences in the organizational set-up, study and sample population, socio-demographic differences of the study subjects and variation in study settings.…”

The recovery rate from severe acute malnutrition among under-five years of children remains low in sub-Saharan Africa. A systematic review and meta-analysis of observational studies

“…The most retrieved studies (32 studies) were from Ethiopia [4,5,17,18,, followed by Malawi (n = 6 studies) [56][57][58][59][60][61], and Nigeria (n = 3 studies) [62][63][64]. Cameroon [65,66], Kenya [67,68], Sudan [69,70], and Ghana [71,72] were represented by two studies, whereas South Africa [73], Uganda [74], Niger [75], Zambia [76], and Democratic Republic of Congo (DRC) [77] were represented by one study.…”

“…Of these, 2.2 million were found in Sub-Saharan African countries [3]. SAM is continuing to be the major public health problem and an essential contributor to morbidity and mortality in under-five children [4,5]. In interventions taken by community health workers, a recovery rate of around 90% was estimated in a systematic review and meta-analysis done in middle-and low-income counties [6].…”