Mekuria Getnet, Derese Tariku, Hailu Getachew
1Department of Applied Human Nutrition, Bahir Dar Institute of Technology, Bahir Dar University, Bahir Dar, Ethiopia.
Finote Selam District Hospital, Finote Selam, Ethiopia.
BMC Nutr. 2017 May 15;3:42. doi: 10.1186/s40795-017-0161-3. eCollection 2017.
In Ethiopia, the health sector has increased its efforts to enhance good nutritional practices through health education, treatment of extremely malnourished children and provision of micronutrients for mothers and children. But, the poor nutritional status of women and children continues to be still a major public health problem.
A retrospective cohort study was conducted to assess the treatment outcome and associated factors of severe acute malnutrition among a total of 253 children age 6-59 months old. Severe acute malnutrition registration logbook and patient charts were used as a source of data. Data were entered in to Epi-data version 3.1 and exported to SPSS version 20 for analysis. To identify associated factors, Cox proportional hazard analysis was computed and -value <0.05 at 95% confidence interval was considered as statistically significant.
The recovery rate was 77.9% and the overall median recovery time was 11 days. Those children age from 24 to 35 months had 34% lower probability of recovery from SAM compared to 6-11 months old children (AHR = 0.66, 95% CI: 0.35-0.89). Children whose ages from 36 to 59 months had 47% lower probability of recovery from SAM compared to 6-11 months old children (AHR = 0.53, 95% CI: 0.31-0.91). HIV negative children had 2.48 times higher probability of getting recovered from SAM compared to HIV positive children (AHR = 2.48, 95% CI: 1.23-5.01). Children who didn't take folic acid supplement had 65% lower probability of recovery from SAM compared to children who took folic acid supplement (AHR = 0.35, 95% CI: 0.14-0.89).
This study found that recovery rate of 6-59 months old children treated for severe acute malnutrition in therapeutics units was in acceptable range based on the WHO recommendation. Folic acid supplementation and screening for HIV status should be promoted at all levels of health facilities during early age.
在埃塞俄比亚，卫生部门已加大力度，通过健康教育、治疗极度营养不良儿童以及为母亲和儿童提供微量营养素来加强良好的营养实践。但是，妇女和儿童的不良营养状况仍然是一个主要的公共卫生问题。
进行了一项回顾性队列研究，以评估总共253名6至59个月大儿童中重度急性营养不良的治疗结果及相关因素。重度急性营养不良登记日志和患者病历用作数据来源。数据录入Epi - data 3.1版本，并导出到SPSS 20版本进行分析。为确定相关因素，计算了Cox比例风险分析，95%置信区间下P值<0.05被视为具有统计学意义。
恢复率为77.9%，总体中位恢复时间为11天。与6至11个月大的儿童相比，24至35个月大的儿童从重度急性营养不良中恢复的概率低34%（风险比=0.66，95%置信区间：0.35 - 0.89）。与6至11个月大的儿童相比，36至59个月大的儿童从重度急性营养不良中恢复的概率低47%（风险比=0.53，95%置信区间：0.31 - 0.91）。与艾滋病毒阳性儿童相比，艾滋病毒阴性儿童从重度急性营养不良中恢复的概率高2.48倍（风险比=2.48，95%置信区间：1.23 - 5.01）。与服用叶酸补充剂的儿童相比，未服用叶酸补充剂的儿童从重度急性营养不良中恢复的概率低65%（风险比=0.35，95%置信区间：0.14 - 0.89）。
本研究发现，根据世界卫生组织的建议，治疗单位中接受重度急性营养不良治疗的6至59个月大儿童的恢复率在可接受范围内。应在早期各级卫生设施中推广叶酸补充和艾滋病毒状况筛查。
