School of Nursing, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia.
Debre Berhan University College of Medicine, Debre-Berhan, Ethiopia.
Epidemiol Health. 2020;42:e2020003. doi: 10.4178/epih.e2020003. Epub 2020 Feb 2.
Recovery time from severe acute malnutrition (SAM) is often a neglected topic despite its clinical impact. Although a few studies have examined nutritional recovery time, the length of hospitalization in those studies varied greatly. Therefore, the aim of this study was to determine the recovery time from SAM and to identify predictors of length of hospitalization among under-5 children.
A retrospective cohort study was conducted among 423 under-5 children with SAM who had been admitted to Yekatit 12 Hospital. Kaplan-Meier analysis was used to estimate time to nutritional recovery, and Cox proportional hazard regression analysis was performed to determine independent predictors.
The nutritional recovery rate was 81.3%, and the median recovery time was 15.00 days (95% confidence interval [CI], 13.61 to 16.39). Age, daily weight gain per kilogram of body weight, vaccination status, and the existence of at least 1 comorbidity (e.g., pneumonia, stunting, shock, and deworming) were found to be significant independent predictors of nutritional recovery time. The adjusted hazard ratio (aHR) for nutritional recovery decreased by 1.9% for every 1-month increase in child age (aHR, 0.98; 95% CI, 0.97 to 0.99).
The overall nutritional recovery time in this study was within the Sphere standards. However, approximately 13.0% of children stayed in the hospital for more than 28.00 days, which is an unacceptably large proportion. Daily weight gain of ≥8 g/kg, full vaccination, and deworming with albendazole or mebendazole reduced nutritional recovery time. Conversely, older age, pneumonia, stunting, and shock increased nutritional recovery time.
严重急性营养不良（SAM）的康复时间往往是一个被忽视的话题，尽管它具有临床影响。尽管有几项研究检查了营养恢复时间，但这些研究中的住院时间差异很大。因此，本研究旨在确定 SAM 的恢复时间，并确定 5 岁以下儿童住院时间的预测因素。
对在 Yekatit 12 医院住院的 423 名患有 SAM 的 5 岁以下儿童进行了回顾性队列研究。使用 Kaplan-Meier 分析估计营养恢复时间，并进行 Cox 比例风险回归分析以确定独立预测因素。
营养恢复率为 81.3%，中位恢复时间为 15.00 天（95%置信区间 [CI]，13.61 至 16.39）。年龄、每日每公斤体重体重增加、疫苗接种状况以及至少存在 1 种合并症（例如肺炎、发育迟缓、休克和驱虫）被发现是营养恢复时间的显著独立预测因素。儿童年龄每增加 1 个月，营养恢复的调整后危险比（aHR）降低 1.9%（aHR，0.98；95%CI，0.97 至 0.99）。
本研究中的总体营养恢复时间符合 Sphere 标准。然而，约 13.0%的儿童在医院停留超过 28.00 天，这是一个不可接受的大比例。每日体重增加≥8 g/kg、完全接种疫苗以及用阿苯达唑或甲苯达唑驱虫可缩短营养恢复时间。相反，年龄较大、肺炎、发育迟缓以及休克会延长营养恢复时间。
