Treatment Outcomes and Associated Risk Factors of Severely Malnourished under Five Children Admitted to Therapeutic Feeding Centers of Mekelle City, Northern Ethiopia

Abstract

Background: Despite presence of clinical management protocols for treating severe acute malnutrition, its case fatality rate remains high in health facilities from developing countries. Objectives: To assess treatment outcomes and associated risk factors for death of children aged 6 -59 months with complicated severe acute malnutrition. Methods: A cohort of 469 children aged 6 -59 months with complicated severe acute malnutrition admitted to nutritional rehabilitation units of Mekelle City were followed retrospectively. Data on nutritional status, socio-demographic factors, admission medical conditions and management characteristics were collected. Median test, Chi-square test and Cox's proportional hazard regression were used for statistical analysis. Results: Overall case fatality rate was 12.8%. The median length of stay and median weight gain was 17 days and 12.1 g/kg/day, respectively. Two third of the deaths occurred during the first week of admission. Diarrhea (HR: 2.45, 95% CI: 1.23 -4.89), IV antibiotic (HR: 5.87, 95% CI: 1.73 -19.87), blood transfusion (HR: 3.05, 95% CI: 1.51 -6.17) and IV infusion (HR: 2.52, 95% CI: 1.25 -5.07) were found to be associated with time to death. Conclusion: Unacceptably high case fatality rate was observed at the therapeutic feeding units of Mekelle City. Diarrhea, IV antibiotic, blood transfusion and IV infusion were the risk factors for death of severely malnourished under five children. Appropriate clinical management of severe acute malnutrition in the first week of inpatient stay with frequent monitoring for signs associated with clinical deterioration of children hospitalized with complicated SAM is most critical to the survival of the children.

Determinants of treatment outcomes of severe acute malnutrition among under-5 children in Yekatit 12 Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

“…This may result in devastating outcomes of SAM like prolonged hospitalization and death. The present study is in line with studies done in West Ethiopia, and Finoteselam and Debre-Markos hospitals (20,37) and contrary to studies done in northwest Ethiopia (14,38).…”

“…A few studies in different regions of Ethiopia reported higher percentages of death and default (10)(11)(12)(13)(14). According to the report death and default rates are alarming in the country which needs further study to describe the treatment outcome of SAM in other hospitals and to determine contributing factors.…”

Recovery Time from Severe Acute Malnutrition and Development of Complementary Food Supplement For Affected Ethiopian Children

“…It is consistent with other institution-based studies in Ethiopia, such as Mekelle City which reported 17 days [9]. However, it was higher than the study done in Zambia that reported 13 days [10].This might be related to differences in treatment and caring practices, health care settings and other socioeconomic factors among the study areas.…”

Outcomes of Severely Malnourished Children Aged 6 - 59 Months on Outpatient Management Program in Kitui County Hospital, Kenya

“…Yet it was higher compared to a similar study conducted in Nairobi which was 3.79/kg/day [15] and was comparable to a study conducted in Tigray Northern Ethiopia (5.24 g/kg/day) [16]. However, it was lower than in studies carried out by Chane et al [24] (10.1 g/kg/day), by Hossain et al [25] (10 g/kg/day) and by Gebremichael et al [26] in Ayder referral in Ethiopia (10.7 g/kg/day). These discrepancies could have been due to differences in causes of malnutrition across various settings.…”