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[刚果民主共和国布卡武治疗营养中心收治的0至5岁重度急性营养不良儿童的感染情况及死亡率:一项回顾性队列研究]

[Infectious profile and mortality of children aged 0-5 years admitted with severe acute malnutrition: a retrospective cohort study conducted in the Therapeutic Nutritional Center in Bukavu, Republic of Congo].

作者信息

Kambale Richard Mbusa, Kasengi Joe Bwija, Kivukuto John Mutendela, Cubaka Liévin Murhula, Mungo Bruno Masumbuko, Balaluka Ghislain Bisimwa

机构信息

Université Catholique de Bukavu (UCB), Bukavu, République Démocratique du Congo; Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, République Démocratique du Congo.

ONG-MDA, Coordination Europe, Savigny-sur-Orge, France.

出版信息

Pan Afr Med J. 2016 Mar 28;23:139. doi: 10.11604/pamj.2016.23.139.8370. eCollection 2016.

Abstract

INTRODUCTION

Malnutrition is a backdrop on which several infections are grafted. The aim of this study is to determine the most lethal infections, the median length of stay and the median daily weight gain of malnourished children.

METHOD

A retrospective cohort study of malnutrition in children aged 0-59 months hospitalized in the Therapeutic Nutritional Center in Bukavu from 1 January 2011 to 31 December 2013. The evaluation of the risk of deaths related to infectious complication was made measuring the relative risk. Mann-Whitney test was used for comparing the medians. Adjusted odd ratios using logistic regression and 95% confidence interval for the risk of mortality were given for each infectious cause.

RESULTS

A total of 574 children were included in the study. Five hundred twenty-one (90.8%) children were cured, 10 (1.7%) had discontinued treatment and 43 (7.5%) had died. The median length of stay was 19 (13-26) days and the median daily weight gain was 7 (3-13) g/kg/j. There was a statistically significant association between mortality and sepsis/septic shock (p = 0.0004), meningitis (p = 0.00001) and HIV infection (p = 0.02).

CONCLUSION

A better management of acute malnutrition in our region should be based on the establishment of specialized and well equipped units for the treatment of malnutrition associated with severe infections.

摘要

引言

营养不良是多种感染滋生的背景。本研究的目的是确定最致命的感染、营养不良儿童的中位住院时间和中位每日体重增加量。

方法

对2011年1月1日至2013年12月31日在布卡武治疗营养中心住院的0至59个月儿童的营养不良情况进行回顾性队列研究。通过测量相对风险来评估与感染并发症相关的死亡风险。采用曼-惠特尼检验比较中位数。针对每种感染原因,给出使用逻辑回归调整后的比值比和95%死亡率风险置信区间。

结果

共有574名儿童纳入研究。521名(90.8%)儿童治愈,10名(1.7%)中断治疗,43名(7.5%)死亡。中位住院时间为19(13 - 26)天,中位每日体重增加量为7(3 - 13)克/千克/天。死亡率与败血症/感染性休克(p = 0.0004)、脑膜炎(p = 0.00001)和艾滋病毒感染(p = 0.02)之间存在统计学显著关联。

结论

本地区急性营养不良的更好管理应基于建立专门且设备完善的单位,用于治疗与严重感染相关的营养不良。

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