Treatment outcomes of severe acute malnutrition and predictors of recovery in under-five children treated within outpatient therapeutic programs in Ethiopia: a systematic review and meta-analysis

Bitew, Zebenay Workneh; Alemu, Ayinalem; Worku, Teshager

doi:10.1186/s12887-020-02188-5

Cited by 11 publications

(9 citation statements)

References 51 publications

(96 reference statements)

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“…1 2 The Intergovernmental Panel on Climate Change (IPCC) also predicts that climate change will lead to more desertification and crop failures in vulnerable areas, such as Ethiopia [3][4][5] where malnutrition remains one of the major public health problems. [6][7][8][9] In communities that rely on subsistence agriculture, food insecurity often peaks seasonally in preharvest periods. 10 11 Affected households adapt by reducing the frequency and size of daily meals; selling livestock or dairy products; borrowing food or money from merchants or local social networks; selling wood, charcoal or grass; engaging in paid labour and renting out farm land.…”

Section: Introductionmentioning

confidence: 99%

“…Over the centuries, Ethiopia has experienced droughts and famine events, averaging once per decade 1 2. The Intergovernmental Panel on Climate Change (IPCC) also predicts that climate change will lead to more desertification and crop failures in vulnerable areas, such as Ethiopia3–5 where malnutrition remains one of the major public health problems 6–9…”

Section: Introductionmentioning

confidence: 99%

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Seasonality and predictors of childhood stunting and wasting in drought-prone areas in Ethiopia: a cohort study

Kabalo

Lindtjørn

2022

BMJ Open

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Background and objectivesOver centuries, Ethiopia has experienced severe famines and periods of serious drought, and malnutrition remains a major public health problem. The aims of this study were to estimate seasonal variations in child stunting and wasting, and identify factors associated with both forms of child malnutrition in drought-prone areas.MethodsThis cohort study was conducted among a random sample of 909 children in rural southern Ethiopia. The same children were followed for 1 year (2017–2018) with quarterly repeated measurements of their outcomes: height-for-age and weight-for-height indices (Z-scores). Linear regression models were used to analyse the association between both outcomes and baseline factors (eg, household participation in a social safety net programme and water access) and some time-varying factors (eg, household food insecurity).ResultsChild wasting rates varied with seasonal household food insecurity (ᵪ2trend= 15.9, p=0.001), but stunting rates did not. Household participation in a social safety net programme was associated with decreased stunting (p=0.001) and wasting (p=0.002). In addition to its association with decreased wasting (p=0.001), protected drinking water access enhanced the association between household participation in a social safety net programme and decreased stunting (p=0.009). Absence of a household latrine (p=0.011), lower maternal education level (p=0.001), larger family size (p=0.004) and lack of non-farming income (p=0.002) were associated with increased child stunting.ConclusionsSeasonal household food insecurity was associated with child undernutrition in rural Ethiopia. Strengthening community-based food security programmes, such as the Ethiopian social safety net programme, could help to reduce child undernutrition in drought-prone areas. Improving clean water access and sanitation could also decrease child undernutrition.Key terms:Z-scores; Social safety net program; Water access

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Seasonality and predictors of childhood stunting and wasting in drought-prone areas in Ethiopia: a cohort study

Kabalo

Lindtjørn

2022

BMJ Open

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“…First, children are identified by health extension workers using MUAC and edema criteria according to the national protocol [ 7 ]. An appetite test for children 6–59 months is performed every week and supplementation of medications like amoxicillin on admission of all SAM patients for 5 days, measles vaccine on the fourth week if the child has not yet received the measles vaccine for children 9–59 months and de-worming at 2nd week of treatment for children 24–59 months in OTP [ 7 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Predictors of time to recovery from uncomplicated severe acute malnutrition among 6–59 months children treated in out patient treatment in health posts of Nagele Arsi district: a retrospective cohort study

Tsegaye¹,

Lencha

Kumsa

2022

BMC Pediatr

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Background Access to outpatient therapeutic feeding programs (OTP) for all children who have uncomplicated severe acute malnutrition (SAM) remains a global public health priority. Identifying predictors that determine time-to-recovery from severe acute malnutrition optimize therapeutic success. However, reliable evidence on the determinants of time to recovery at health posts was not available in Nagele Arsi district of South Ethiopia. Objective This study was aimed to identify determinants of time-to-recovery from uncomplicated SAM among children aged (6–59) months treated at an OTP in health posts of Nagele Arsi district, Southern Ethiopia. Methods Institutional based retrospective cohort study was conducted among 357 children treated in Negele Arsi district from July1, 2018 to June 30, 2020. The children were selected using simple random sampling from 20 health posts. SAM treatment outcomes were compared against international SPHERE standards. The average time-to-recovery was estimated using Kaplan-Meier survival curve and the independent predictors of time to recovery were determined using multivariable Cox-proportional hazard model. The strength of the association was done using adjusted hazard ratio (AHR) with 95% confidence intervals. Statistical significance was declared at p value < 0.05. The results were presented by text, tables and figures. Result A total of 284 (79.6%) children recovered during follow up. The mean weight gain for recovered children was 4.7 + 2.4 g/kg/day. The median time-to-recovery was 44 days 95% CI (42.7–45.3). Children who received Amoxicillin, AHR =2.574, 95% CI (1.879–3.525); de-wormed, AHR = 1.519, 95% CI (1.137–2.031); received Vitamin A, AHR = 2.518, 95% CI, (1.921–3.301) and new admissions, AHR = 1.823, 95%CI, (1.224–2.715) were more likely to recover. However, those who admitted with non-edema, AHR = 0.256, 95% CI, (0.189–0.346); had cough at admission, AHR = 0.513, 95 CI, (0.366–0.719) and had diarrhea at admission AHR = 0.5, 95% CI, 0.5 (0.350–0.712) were less likely to recover. Conclusion and recommendation The recovery rate was within the acceptable ranges of International Sphere Standards. Those children who had cough and diarrhea should be given due attention from health extension workers and program planners. Appropriate provision of routine medication and timely intervention of co-morbidity are needed to increase chance of early recovery.

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“…Over the centuries, Ethiopia has experienced droughts and famine events, averaging once per decade 1,2 . The Intergovernmental Panel on Climate Change (IPCC) also predicts that climate change will lead to more desertification and crop failures in vulnerable areas, such as Ethiopia [3][4][5] where malnutrition remains one of the major public health problems [6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Seasonality and predictors of childhood stunting and wasting in drought-prone areas in Ethiopia: A cohort study

Kabalo

Lindtjørn

2022

Preprint

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Background and objectives: Over centuries, Ethiopia has experienced severe famines and periods of serious drought, and malnutrition remains a major public health problem. The aims of this study were to estimate seasonal variations in child stunting and wasting, and identify factors associated with both forms of child malnutrition in drought-prone areas. Methods: This cohort study was conducted among a random sample of 909 children in rural southern Ethiopia. The same children were followed for one year (2017 - 2018) with quarterly repeated measurements of their outcomes: height-for-age and weight-for-height indices (Z-scores). Linear regression models were used to analyse the association between both outcomes and baseline factors (e.g., household participation in a social safety net program and water access) and some time-varying factors (e.g., household food insecurity). Results: Child wasting rates (i.e., low weight-for-heigh Z-scores) varied with seasonal household food insecurity (ᵪ2 trend = 15.9, p = 0.001), but stunting rates (i.e., low height-for-age Z-scores) did not. Household participation in a social safety net program was associated with decreased stunting (p = 0.001) and wasting (p = 0.002). In addition to its association with decreased wasting (p = 0.001), protected drinking water access enhanced the association between household participation in a social safety net program and decreased stunting (p = 0.009). Absence of a household latrine (p = 0.011), lower maternal education level (p = 0.001), larger family size (p = 0.004), and lack of non-farming income (p = 0.002) were associated with increased child stunting. Conclusions: Seasonal household food insecurity was associated with child undernutrition in rural Ethiopia. Strengthening community-based food security programs, such as the Ethiopian social safety net program, could help to reduce child undernutrition in drought-prone areas. Improving clean water access and sanitation could also decrease child undernutrition. Key terms: Z-scores; Social safety net program; Water access

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Treatment outcomes of severe acute malnutrition and predictors of recovery in under-five children treated within outpatient therapeutic programs in Ethiopia: a systematic review and meta-analysis

Cited by 11 publications

References 51 publications

Seasonality and predictors of childhood stunting and wasting in drought-prone areas in Ethiopia: a cohort study

Seasonality and predictors of childhood stunting and wasting in drought-prone areas in Ethiopia: a cohort study

Predictors of time to recovery from uncomplicated severe acute malnutrition among 6–59 months children treated in out patient treatment in health posts of Nagele Arsi district: a retrospective cohort study

Seasonality and predictors of childhood stunting and wasting in drought-prone areas in Ethiopia: A cohort study

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