본문 바로가기
KERD
논문KCI 등재

Recovery time from severe acute malnutrition and associated factors among under-5 children in Yekatit 12 Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

초록

OBJECTIVES: Recovery time from severe acute malnutrition (SAM) is often a neglected topic despite its clinical impact. Although a few studies have examined nutritional recovery time, the length of hospitalization in those studies varied greatly. Therefore, the aim of this study was to determine the recovery time from SAM and to identify predictors of length of hospitalization among under-5 children. METHODS: A retrospective cohort study was conducted among 423 under-5 children with SAM who had been admitted to Yekatit 12 Hospital. Kaplan-Meier analysis was used to estimate time to nutritional recovery, and Cox proportional hazard regression analysis was performed to determine independent predictors. RESULTS: The nutritional recovery rate was 81.3%, and the median recovery time was 15.00 days (95% confidence interval [CI], 13.61 to 16.39). Age, daily weight gain per kilogram of body weight, vaccination status, and the existence of at least 1 comorbidity (e.g., pneumonia, stunting, shock, and deworming) were found to be significant independent predictors of nutritional recovery time. The adjusted hazard ratio (aHR) for nutritional recovery decreased by 1.9% for every 1-month increase in child age (aHR, 0.98; 95% CI, 0.97 to 0.99). CONCLUSIONS: The overall nutritional recovery time in this study was within the Sphere standards. However, approximately 13.0% of children stayed in the hospital for more than 28.00 days, which is an unacceptably large proportion. Daily weight gain of ≥8 g/kg, full vaccination, and deworming with albendazole or mebendazole reduced nutritional recovery time. Conversely, older age, pneumonia, stunting, and shock increased nutritional recovery time.

Abstract

OBJECTIVES: Recovery time from severe acute malnutrition (SAM) is often a neglected topic despite its clinical impact. Although a few studies have examined nutritional recovery time, the length of hospitalization in those studies varied greatly. Therefore, the aim of this study was to determine the recovery time from SAM and to identify predictors of length of hospitalization among under-5 children. METHODS: A retrospective cohort study was conducted among 423 under-5 children with SAM who had been admitted to Yekatit 12 Hospital. Kaplan-Meier analysis was used to estimate time to nutritional recovery, and Cox proportional hazard regression analysis was performed to determine independent predictors. RESULTS: The nutritional recovery rate was 81.3%, and the median recovery time was 15.00 days (95% confidence interval [CI], 13.61 to 16.39). Age, daily weight gain per kilogram of body weight, vaccination status, and the existence of at least 1 comorbidity (e.g., pneumonia, stunting, shock, and deworming) were found to be significant independent predictors of nutritional recovery time. The adjusted hazard ratio (aHR) for nutritional recovery decreased by 1.9% for every 1-month increase in child age (aHR, 0.98; 95% CI, 0.97 to 0.99). CONCLUSIONS: The overall nutritional recovery time in this study was within the Sphere standards. However, approximately 13.0% of children stayed in the hospital for more than 28.00 days, which is an unacceptably large proportion. Daily weight gain of ≥8 g/kg, full vaccination, and deworming with albendazole or mebendazole reduced nutritional recovery time. Conversely, older age, pneumonia, stunting, and shock increased nutritional recovery time.

참고문헌 (44)

  1. Robert K, "Nelson textbook of pediatrics", pp.457~528 (2016), Elsevier
  2. "Guideline: updates on the management of severe acute malnutrition in infants and children" (2013)[URL]
  3. Tickell KD, "Inpatient management of children with severe acute malnutrition : a review of WHO guidelines", Bull World Health Organ, 94, pp.642~651 (2016)
  4. Black RE, "Maternal and child undernutrition and overweight in low-income and middle-income countries", Lancet, 382, pp.427~451 (2013)
  5. Chisti MJ, "Mortality rates from severe acute malnutrition requiring hospitalisation is higher in the children of working mothers in Bangladesh", Acta Paediatr, 107, pp.2214~2215 (2018)
  6. "Ethiopia Demographic and Health Survey 2016" (2017)[URL]
  7. "Multidimensional child deprivation in Ethiopia: first national estimates Ethiopia" (2018)[URL]
  8. "Management of severe acute malnutrition in children: working towards results at scale" (2015)[URL]
  9. Attia S, "Mortality in children with complicated severe acute malnutrition is related to intestinal and systemic inflammation : an observational cohort study", Am J Clin Nutr, 104, pp.1441~1449 (2016)
  10. Ali S, "Healthcare associated infection and its risk factors among patients admitted to a tertiary hospital in Ethiopia : longitudinal study", Antimicrob Resist Infect Control, 7, pp.2~ (2018)
  11. Tekeste A, "Cost effectiveness of community-based and in-patient therapeutic feeding programs to treat severe acute malnutrition in Ethiopia", Cost Eff Resour Alloc, 10, pp.4~ (2012)
  12. Isanaka S, "Cost analysis of the treatment of severe acute malnutrition in West Africa", Matern Child Nutr, 13, pp.e12398~ (2017)
  13. Lenters L, "Reproductive, maternal, newborn, and child health: disease control priorities", pp.205~223 (2016), World Bank
  14. Spencer PS, "Interrelationships of undernutrition and neurotoxicity : food for thought and research attention", Neurotoxicology, 33, pp.605~616 (2012)
  15. Haggerty AD, "The effects of long-term hospitalization or institutionalization upon the language development of children", J Genet Psychol, 94, pp.205~209 (1959)
  16. Commodari E, "Children staying in hospital : a research on psychological stress of caregivers", Ital J Pediatr, 36, pp.40~ (2010)
  17. Oumer A, "Survival status and predictors of mortality among children aged 0-59 months admitted with severe acute malnutrition in Dilchora Referral Hospital, Eastern Ethiopia", East Afr J Health Biomed Sci, 1, pp.13~22 (2016)
  18. Asres DT, "Recovery time and associated factors of severe acute malnutrition among children in Bahir Dar city, Northwest Ethiopia : an institution based retrospective cohort study", BMC Nutr, 4, pp.17~ (2018)
  19. Derseh B, "Co-morbidity, treatment outcomes and factors affecting the recovery rate of under-five children with severe acute malnutrition admitted in selected hospitals from Ethiopia : retrospective follow up study", Nutr J, 17, pp.116~ (2018)
  20. Tirore MG, "Survival status and factors associated with treatment outcome of severely malnourished children admitted to Ayder referral hospital : a cross-sectional study", BMC Nutr, 3, pp.66~ (2017)
  21. Banbeta A, "Modeling time-to-cure from severe acute malnutrition : application of various parametric frailty models", Arch Public Health, 73, pp.6~ (2015)
  22. Mekuria G, "Treatment outcome and associated factors of severe acute malnutrition among 6–59 months old children in Debre Markos and Finote Selam hospitals, Northwest Ethiopia : a retrospective cohort study", BMC Nutr, 3, pp.42~ (2017)
  23. Trehan I, "Antibiotics as part of the management of severe acute malnutrition", Malawi Med J, 28, pp.123~130 (2016)
  24. Singh P, "Experience and outcome of children with severe acute malnutrition using locally prepared therapeutic diet", Indian J Pediatr, 83, pp.3~8 (2016)
  25. Massa D, "Treatment outcome of severe acute malnutrition and determinants of survival in Northern Ethiopia : a prospective cohort study", Int J Nutr Metab, 8, pp.12~23 (2016)
  26. Kabalo MY, "Children with oedema recover better than those with severe wasting in outpatient therapeutic program at Boloso Sore district, Southwest Ethiopia", BMC Res Notes, 11, pp.118~ (2018)
  27. Mengesha MM, "Treatment outcome and factors affecting time to recovery in children with severe acute malnutrition treated at outpatient therapeutic care program", Glob Health Action, 9, pp.30704~ (2016)
  28. Gebremichael DY, "Predictors of nutritional recovery time and survival status among children with severe acute malnutrition who have been managed in therapeutic feeding centers, Southern Ethiopia : retrospective cohort study", BMC Public Health, 15, pp.1267~ (2015)
  29. Girum T, "Survival status and predictors of mortality among severely acute malnourished children <5 years of age admitted to stabilization centers in Gedeo Zone : a retrospective cohort study", Ther Clin Risk Manag, 13, pp.101~110 (2017)
  30. Adal, TG, "Incidence and predictors of mortality among severe acute malnourished under five children admitted to Dilla University Referal hospital : a retrospective longitudinal study", J Biol Agric Healthc, 16, pp.114~127 (2016)
  31. "Addis Ababa population 2018" (2017)[URL]
  32. "Protocol for the management of severe acute malnutrition" (2007)[URL]
  33. Moges T, "Management and outcome of severely malnourished children admitted to Zewditu Memorial Hospital, Ethiopia", East Afr J Public Health, 6, pp.162~167 (2009)
  34. Desyibelew HD, "Recovery rate and associated factors of children age 6 to 59 months admitted with severe acute malnutrition at inpatient unit of Bahir Dar Felege Hiwot Referral hospital therapeutic feeding unite, northwest Ethiopia", PLoS One, 12, pp.e0171020~ (2017)
  35. Sphere Project, "The sphere handbook: humanitarian charter and minimum standards in humanitarian response", pp.164~174 (2018), Sphere Association
  36. Moramarco S, "Filling the gaps for enhancing the effectiveness of community-based programs combining treatment and prevention of child malnutrition : results from the Rainbow Project 2015–17 in Zambia", Int J Environ Res Public Health, 15, pp.1807~ (2018)
  37. Irena AH, "Diarrhea is a major killer of children with severe acute malnutrition admitted to inpatient set-up in Lusaka, Zambia", Nutr J, 10, pp.110~ (2011)
  38. Yohannes T, "Mortality and morbidity trends and predictors of mortality in under-five children with severe acute malnutrition in Hadiya zone, South Ethiopia : a four-year retrospective review of hospital-based records(2012-2015)", BMC Nutr, 3, pp.18~ (2017)
  39. Kabeta A, "Factors associated with treatment outcomes of under-five children with severe acute malnutrition admitted to therapeutic feeding unit of Yirgalem hospital", Clin Mother Child Health, 14, pp.261~ (2017)
  40. Burrell A, "Monitoring and discharging children being treated for severe acute malnutrition using mid-upper arm circumference : secondary data analysis from rural Gambia", Int Health, 9, pp.226~233 (2017)
  41. Shanka NA, "Recovery rate and determinants in treatment of children with severe acute malnutrition using outpatient therapeutic feeding program in Kamba District, South West Ethiopia", J Nutr Disord Ther, 5, pp.155~ (2015)
  42. Bourke CD, "Immune dysfunction as a cause and consequence of malnutrition", Trends Immunol, 37, pp.386~398 (2016)
  43. Rytter MJ, "The immune system in children with malnutrition--a systematic review", PLoS One, 9, pp.e105017~ (2014)
  44. Admasu A, "Survival status and its associated factors among under-five children admitted with complicated severe acute malnutrition in hospitals of Wolaita zone. South Ethiopia : Retrospective Cohort Study", J Nutrit Health Food Sci, 5, pp.1~12 (2017)

관련 논문AI추천

Outcome of Children with Severe Acute Malnutrition and Diarrhea: a Cohort StudyPraveen Kumar, Richa Dua, Ruchika Kumar, Sakshi Bhatnagar, Srikanta Basu대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2019 · 제22권 제3호Anthropometric and Body-Composition Changes in Severely Acute Malnourished Children (12–59 Months) Post-Nutritional Rehabilitation: A Follow-Up StudyPraveen Kumar, Rajesh Kumar Sinha, Shivani Rohatgi, Sukhneet Suri대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2025 · 제28권 제6호Efficacy of mid-upper arm circumference in identification, follow-up and discharge of malnourished children during nutrition rehabilitationAnselimo Makokha, Hans De Steur, Hibbah Araba Saeed, Joseph Birundu Mogendi, Xavier Gellynck한국영양학회 · Nutrition Research and Practice2015 · 제9권 제3호Screening Tools for Malnutrition in Hospitalized Children with Respiratory Tract Infections: A Single Center Experience in a Low/Middle Income CountryEnas A.A. Abdallah, Hala H Mansour, Mortada H. F. El-Shabrawi, Nehal El Koofy, Salma M Yosry, Shaimaa Sayed대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2025 · 제28권 제6호Community Management of Acute Malnutrition in the Developing WorldCyprian Ouma, Mesfin Loha, Nam Seon Beck, Se-Eun Park, Sungtae Kim, Thomas F Wierzba대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2012 · 제15권 제4호Performance of mid-upper arm circumference to diagnose acute malnutrition in a cross-sectional community-based sample of children aged 6-24 months in NigerAnneli Eriksson, Joel Monárrez-Espino, Sarah K Marshall한국영양학회 · Nutrition Research and Practice2019 · 제13권 제3호

이 간행물의 다른 논문 (73건)