Abrhajira Primary Hospital, West Gondar Zone, Ethiopia.
Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Ital J Pediatr. 2019 Nov 4;45(1):136. doi: 10.1186/s13052-019-0732-9.
Despite the available interventions to tackle nutritional problems, there is scarce information on time to recovery and its determinants among children with SAM in Ethiopia.
This study was aimed at finding the time to recovery and determinants among 6-59 months children with severe acute malnutrition treated at an outpatient therapeutic programme in North Gondar zone, northwest Ethiopia.
Facility based prospective follow up study was conducted from March 24 to May 24, 2017. A total of 408 children with the age of 6-59 months were included in the study. Structured interviewer administered questionnaire was used. Anthropometric measurements were conducted every week. The median time of recovery, Kaplan Meier (KM) curve, and log rank test were computed. Both bi-variable and multivariable Cox regression model was fitted. To establish an association between time to recovery and its determinants 95% confidence interval (CI) and p-value < 0.05 were used. Proportional hazard assumption was checked graphically and using Schoenfeld residual test.
Out of 389 children, 254 (65.3%) recovered. The median time to recovery was 38.5 ± IQR of 14 days. Children with diarrhoea AHR = 0.81 with 95% CI (0.73, 0.99), children taken amoxicillin AHR = 2.304 with 95% CI (1.68-3.161), and had vomiting at admission AHR = 0.430 with 95% CI (0.205, 0.904) were significant predictors of time to recovery.
The overall time to recovery has not met the minimum sphere international standard which was lower than 75%. It is advisable to give emphasis to patients with diarrhoea and vomiting.
尽管有多种干预措施可用于解决营养问题，但在埃塞俄比亚，关于儿童严重急性营养不良（SAM）患者的康复时间及其决定因素的信息仍然很少。
本研究旨在发现在埃塞俄比亚北贡德尔地区门诊治疗方案中接受治疗的 6-59 个月大的严重急性营养不良儿童的康复时间及其决定因素。
2017 年 3 月 24 日至 5 月 24 日进行了基于机构的前瞻性随访研究。共纳入 408 名 6-59 个月大的儿童。采用结构式访谈问卷调查。每周进行一次人体测量。计算中位数康复时间、Kaplan-Meier（KM）曲线和对数秩检验。拟合双变量和多变量 Cox 回归模型。使用 95%置信区间（CI）和 p 值<0.05 来确定时间恢复与其决定因素之间的关联。通过图形和 Schoenfeld 残差检验来检查比例风险假设。
在 389 名儿童中，254 名（65.3%）康复。中位数康复时间为 38.5±IQR 为 14 天。腹泻儿童的危险比（AHR）为 0.81，95%CI（0.73，0.99），服用阿莫西林的儿童 AHR 为 2.304，95%CI（1.68-3.161），入院时有呕吐的儿童 AHR 为 0.430，95%CI（0.205，0.904）是时间恢复的显著预测因素。
总体康复时间未达到最低国际标准，即 75%以下。建议重视腹泻和呕吐的患者。
