Treatment Outcomes and Associated Risk Factors of Severely Malnourished under Five Children Admitted to Therapeutic Feeding Centers of Mekelle City, Northern Ethiopia
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, admis- sion 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.
Cite this paper
Gebremichael, M. , Bezabih, A. M. and Tsadik, M. (2014). Treatment Outcomes and Associated Risk Factors of Severely Malnourished under Five Children Admitted to Therapeutic Feeding Centers of Mekelle City, Northern Ethiopia. Open Access Library Journal, 1, e446. doi: http://dx.doi.org/10.4236/oalib.1100446.
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