Recovery time from severe acute malnutrition and associated factors among under-5 children in Yekatit 12 hospital, Addis Ababa, Ethiopia.
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Date
2019-06
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Addis Abeba University
Abstract
Background: Nearly 20 million under-five children are affected by severe acute malnutrition
worldwide. In Africa, more than 14.0 million under-5 children are wasted, of which 4.1
million children are severely wasted. Ethiopia is one of the countries with highest under-five
child mortality rate, with malnutrition underlying to 28% of all children deaths.
According to world health organization and the SPHERE project, at least 75% of children
admitted due to SAM should be recovered and they should be recovered in less than or equal
to 28 days.
Objective: The main objective of this study was to assess recovery time from severe acute
malnutrition and associated factors among under-5 children admitted and treated in Yekatit 12
Hospital.
Method: A retrospective cohort study was conducted in Yekatit 12 hospital. The study
population was under-5 children with severe acute malnutrition who have been managed at
Yekatit 12 hospital therapeutic feeding unit. The total sample size was 423 and quantitative
pretested data abstraction format was used. Kaplan Meier analysis was used to estimate time to
nutritional recovery; Log rank was used to test whether the observed difference of recovery
time between different groups of predictor variables is significant or not; and Cox
proportional-hazard regression analysis was carried out to determine independent predictors.
Result: The nutritional recovery rate was 81.3% and the median recovery time was 15 days
(95% CI: 13.608-16.392). By controlling other factors, age, daily weight gain per Kg,
vaccination status, comorbidities like pneumonia, stunting, shock, and deworming were
significant predictors of nutritional recovery time.
Conclusion:
In conclusion, the overall death rate in this study is poor compared to sphere project reference
value. However, recovery rate, default rate and nutritional recovery time were in the
acceptable range of SHHERE project reference value. Daily Wt gain of ≥8g/Kg, full
vaccination, and deworming with albendazole/mebendazole were proven to reduce nutritional
recovery time. Conversely, older age, the presence of pneumonia, the presence of stunting, and
the presence of shock as comorbidities were proven to increase nutritional recovery time.
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Keywords
Recovery time, severe acute malnutrition, under-5 children, Yekatit 12 Hospital.