Desyibelew Hanna Demelash, Fekadu Abel, Woldie Haile
Department Of Public Health, Faculty of Health Science, Woldia University, Woldia, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2017 Feb 6;12(2):e0171020. doi: 10.1371/journal.pone.0171020. eCollection 2017.
Despite numerous advances made in improving child health and the clinical management protocols for treating severe acute malnutrition at treatment centers, evidences concerning the treatment outcomes are scarce. Therefore, this study was conducted to assess the recovery rate and associated factors of severely acute malnourished children of age 6 to 59 months admitted to inpatient therapeutic feeding unit at Felege Hiwot Referral Hospital.
We conducted a hospital-based cross-sectional study including 401 severely malnourished children who were admitted from September 2012 to January 2016. Bivariable and a Multivariable logistic regression model were fitted to identify factors associated with recovery rate. Adjusted Odds ratio with its 95% CI was reported and P-value less than 0.05 was considered as significant.
Fifty eight percent (58.4%) (95%CI: 53.1-64.1) of admitted children were recovered with a mean recovery time of 18 (±6.3) days. Being female, children who were fully and partially vaccinated, who had better MUAC measurement, who stayed longer in the hospital, and children who took routine vitamin-A supplementation had better recovery rate. However, children who had co-morbidity at admission, had human immune virus (HIV) and Tuberculosis (TB) infection, and who had edema were less likely to recover.
Recovery rate was low as compared to international SPHERE cutoff points (> 75% recovery rate). Interventions that could address the outlined factors would be helpful to improve treatment recovery rate of admitted children.
尽管在改善儿童健康以及治疗中心治疗重度急性营养不良的临床管理方案方面取得了诸多进展，但关于治疗结果的证据却很少。因此，本研究旨在评估费莱格·希沃特转诊医院住院治疗喂养单元收治的6至59个月重度急性营养不良儿童的康复率及相关因素。
我们开展了一项基于医院的横断面研究，纳入了2012年9月至2016年1月收治的401名重度营养不良儿童。采用双变量和多变量逻辑回归模型来确定与康复率相关的因素。报告调整后的比值比及其95%置信区间，P值小于0.05被视为具有统计学意义。
58.4%（95%置信区间：53.1 - 64.1）的入院儿童康复，平均康复时间为18（±6.3）天。女性、完全和部分接种疫苗的儿童、上臂中段臂围测量值较好的儿童、住院时间较长的儿童以及接受常规维生素A补充的儿童康复率更高。然而，入院时患有合并症、感染人类免疫病毒（HIV）和结核病（TB）以及有水肿的儿童康复的可能性较小。
与国际SPHERE标准（康复率>75%）相比，康复率较低。解决上述因素的干预措施将有助于提高入院儿童的治疗康复率。
