Relapse of severe acute malnutrition in children’s discharged from outpatient therapeutic program and its associated factors in Gambella region, south west, Ethiopia: A cross-sectional study
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Date
2021-06
Authors
Journal Title
Journal ISSN
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Publisher
Addis Abeba University
Abstract
Background: Severe acute malnutrition affects millions of children in low-and middle-income
countries. Currently, children with severe acute malnutrition without complication are treated in
the outpatient therapeutic program and the program has been reported to be effective as it
achieves internationally agreed standards for recovery rate. However, relapse post-discharge
from the program is poorly defined, scarcely evaluated across programs and research.
Objective: The study aimed to assess the magnitude of severe acute malnutrition among
children (6-59 months) of age who have been discharged from the outpatient therapeutic
program as cured and its associated factors in the Gambella region, South West Ethiopia.
Methods: A facility-based cross-sectional study was conducted among 208 children aged 6-59
months who have been discharged from the outpatient therapeutic program as cured between
January, 2019-January, 2020 and their caregivers. The data was collected from April; 2020 to
June; 2020 and children were assessed after a median (inter-quartile range) of 6 (4-9) months of
recovery. Caregivers were interviewed using a structured questionnaire and were asked to bring
children to health facilities to take the anthropometric measurement and to examine them for
oedema. Anthropometric measurements including, weight and height were measured and then,
anthropometric indices was calculated using Anthro software version 3.2.2. The collected data
were entered in Epi-data version 4.4.1 and analyzed by SPSS version 23.
Result: Out of the sampled children, the magnitude of severe acute malnutrition relapse using
weight-for-height (WHZ) <-3 z-score was 10.1% (95% CI: 5.8-14%). Upon multivariable
logistic regression analysis, children with mothers who had not obtained any IYCF education
(AOR: 5.7, 95% CI, (1.3-26.9), children’s who were not fully vaccinated for their age (AOR: 8,
95% CI, 1.8-34.8), and children with MUAC at discharge of <12.5 cm (AOR: 4.4, 95% CI: 1.118.8)
had
higher
odds
of
severe
acute
malnutrition
post-discharge
than their
counterparts.
Conclusion:
The study found that; the magnitude of severe acute malnutrition in children
discharged as cured was high. And children, with mothers who had not obtained any IYCF
education, who were not fully vaccinated for their age and whose MUAC at discharge below
12.5 cm had higher odds of severe acute malnutrition post-discharge. Therefore, the current
study finding suggests that; to limit relapse programs should avoid premature discharge before a
MUAC of <12.5 cm and periodic monitoring of discharged children should be organized.
Description
Keywords
Malnutrition ,Children’s