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. 2019 Feb 20;14(2):e0211628.
doi: 10.1371/journal.pone.0211628. eCollection 2019.

Treatment cure rate and its predictors among children with severe acute malnutrition in northwest Ethiopia: A retrospective record review

Fasil Wagnew  1 , Getiye Dejenu  1 , Setegn Eshetie  2 , Animut Alebel  1 , Wubet Worku  2 , Amanuel Alemu Abajobir  3
Affiliations

Treatment cure rate and its predictors among children with severe acute malnutrition in northwest Ethiopia: A retrospective record review

Fasil Wagnew et al. PLoS One. .

Abstract

Background: More than 29 million that is an estimated 5%, under-five children suffer from severe acute malnutrition (SAM) globally, with a nine times higher risk of mortality than that of well-nourished children. However, little is known regarding outcomes and predictors of SAM in Ethiopia. Therefore, this study aims to determine treatment cure rate and its predictors among children aged 6-59 months with SAM admitted to a stabilization center.

Methodology: A retrospective record review was employed in SAM children at the University of Gondar Comprehensive Specialized Hospital (UOGCSH) from 2014 to 2016. SAM defined as weight for height below -3 z scores of the median World Health Organization (WHO) growth standards or presence of bilateral edema or mid upper arm circumference < 115mm for a child ≥6months age. All SAM patients with medical complication(s) or failure to pass appetite test are admitted to the malnutrition treatment center for inpatient follow-up. Data were extracted from a randomly selected records after getting ethical clearance. Data were cleaned, coded and entered to Epi-info version-7, and analyzed using STATA/se version-14. Descriptive statistics and analytic analyses schemes including bivariable and multivariable Cox proportional hazards model were conducted.

Result: Among a total of 416 records recruited for this study, 288 (69.2%) SAM children were cured at the end of the follow up, with a median cure time of 11 days. Kwash-dermatosis (AHR (Adjusted Hazard Ratio): 1.48(95% CI: 1.01, 2.16)), anemia (AHR: 1.36(95% CI: 1.07, 1.74)), tuberculosis (AHR: 1.6(95% CI: 1.04, 2.43)) and altered body temperature at admission (AHR: 1.58(95% CI: 1.04, 2.4) were independent predictors of time to cure.

Conclusion: The cure rate in SAM children was low relative to sphere standard guideline. Prognosis of SAM largely depends on the presence of other comorbidities at admission. Available intervention modalities need to address coexisting morbidities to achieve better outcomes in SAM children.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Treatment cure rate of 6–59 months old children with SAM.
Fig 2
Fig 2. Major medical comorbidities among 6–59 months old children with SAM.
Fig 3
Fig 3. Log rank survival estimates for time to cure among SAM children with kwash-dermatosis.
Fig 4
Fig 4. Log rank survival estimates for time to cure among SAM children with TB disease.
Fig 5
Fig 5. Log rank survival estimates for time to cure among SAM children with anemia.
See this image and copyright information in PMC

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