埃塞俄比亚西部儿科患者中重度急性营养不良的治疗结果及其决定因素
Treatment Outcome of Severe Acute Malnutrition and Its Determinants among Pediatric Patients in West Ethiopia.
作者信息
Mena Muluken Berhanu, Dedefo Mohammed Gebre, Billoro Bruke Berhanu
机构信息
Bitena Primary Hospital, Wolaita, Ethiopia.
Department of Pharmacy, Wollega University, Nekemte, Ethiopia.
出版信息
Int J Pediatr. 2018 Jul 30;2018:8686501. doi: 10.1155/2018/8686501. eCollection 2018.
BACKGROUND
Malnutrition is a silent killer that is underreported, underaddressed, and as a result underprioritized. It is reported that severe acute malnutrition is the commonest reason for pediatrics hospital admission in many poor countries; 25 to 30% of children with severe malnutrition die during hospital admissions.
OBJECTIVE
To determine treatment outcome of severe acute malnutrition and identify its determinants among pediatric patients in pediatrics ward of Nekemte Referral Hospital.
METHODS
A retrospective hospital-based cross-sectional study was done from November 2015 to April 2017. Data had been collected by using checklist for recording information from patient card and register book. Association between independent variables and depend variable was assessed using bivariate and stepwise multivariable logistic regression, respectively. Level of statistical significance was declared at p value < 0.05.
RESULTS
Out of 205 admitted children with severe acute malnutrition, 137 (66.8%) cases were cured from SAM, 9 (4.4%) cases were died because of SAM, and (16.6%) cases were defaulter from SAM management, and 25 (12.2%) cases were transferred out. Multivariable logistic regression showed that children admitted with both edema and wasting AOR = 8.30, 95% CI (1.72, 40.09) P=0.008, children without hypothermia AOR = 2.91, 95%CI (1.10, 7.69) P=0.031, children who stay 8-14 days AOR = 3.86, 95%CI (1.01, 14.75) P=0.048, children without pneumonia AOR = 7.82, 95%CI (2.74, 222.29) P=0.001, children without anemia AOR = 3.22, 95%CI (1.04, 9.97) P=0.042, and children without HIV AOR = 9.21, 95% CI (2.20, 38.54) P=0.002 were more likely to be cured from severe acute malnutrition.
CONCLUSION
Treatment outcome of severe acute malnutrition in this study is good. It shows that around three-fourths of the children were cured. Factors such as admission criteria, hypothermia, length of stay, pneumonia, anemia, and presence of HIV were associated with treatment response.
背景
营养不良是一个隐匿的杀手，其报告不足、未得到充分解决，因此未被列为优先事项。据报道，严重急性营养不良是许多贫困国家儿科住院的最常见原因；25%至30%的严重营养不良儿童在住院期间死亡。
目的
确定内克姆特转诊医院儿科病房中儿科患者严重急性营养不良的治疗结果，并确定其决定因素。
方法
2015年11月至2017年4月进行了一项基于医院的回顾性横断面研究。通过使用检查表从患者卡片和登记簿中记录信息来收集数据。分别使用双变量和逐步多变量逻辑回归评估自变量与因变量之间的关联。当p值<0.05时宣布具有统计学意义。
结果
在205例入院的严重急性营养不良儿童中，137例（66.8%）的严重急性营养不良病例治愈，9例（4.4%）因严重急性营养不良死亡，（16.6%）的病例在严重急性营养不良管理中失访，25例（12.2%）的病例转出。多变量逻辑回归显示，同时患有水肿和消瘦的儿童AOR = 8.30，95%CI（1.72，40.09）P = 0.008，无体温过低的儿童AOR = 2.91，95%CI（1.10，7.69）P = 0.031，住院8 - 14天的儿童AOR = 3.86，95%CI（1.01，14.75）P = 0.048，无肺炎的儿童AOR = 7.82，95%CI（2.74，222.29）P = 0.001，无贫血的儿童AOR = 3.22，95%CI（1.04，9.97）P = 0.042，无艾滋病毒的儿童AOR = 9.21，95%CI（2.20，38.54）P = 0.002更有可能从严重急性营养不良中治愈。
结论
本研究中严重急性营养不良的治疗效果良好。结果表明约四分之三的儿童被治愈。诸如入院标准、体温过低、住院时间、肺炎、贫血和艾滋病毒感染等因素与治疗反应相关。
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