Suhul Hospital, Northwest Tigray.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Ecol Food Nutr. 2021 Nov-Dec;60(6):751-764. doi: 10.1080/03670244.2021.1907746. Epub 2021 Apr 9.
Severe acute malnutrition is a life-threatening condition that contributes to over half of under five deaths in developing countries. Urgent and specialized treatment to improve the time to recovery and recovery rate is very important. However, data regarding time to nutritional recovery is limited in Ethiopia. Hence, this study aimed to determine the average time to recovery and its determinants among children aged 6 to 59 months admitted with SAM to the stabilization centers of Wag Himra zone, northeast Ethiopia. A retrospective cohort study was conducted on 501 patients charts of children with severe acute malnutrition (SAM) admitted to stabilization centers (SCs) from September 2014 to August 2017. The charts were selected using the systematic random sampling technique. Data were extracted from the charts of each child using a pretested standard checklist and entered using Epi data version 3.1 and analyzed by STATA 14. A Cox proportional-hazard regression analysis was carried out to identify determinants of time to recovery. Any statistical test was considered significant at -values < 0.05. In this study, the overall recovery rate from SAM was 80.4% (95% Confidence Interval [CI]: 76, 84) with the median nutritional recovery time of 11 (Inter Quartile Range [IQR]: 8-18) days. Patients aged 6-23 months (Adjusted Hazard Ratio [AHR] = 0.74, 95%CI: 0.60, 0.92), and had pneumonia (AHR = 0.44; 95% CI: 0.32, 0.59), anemia (AHR = 0.65; 95% CI: 0.52, 0.81) and vomiting (AHR = 0.63, 95% CI: 0.49, 0.82) at admission were less likely to recover quickly compared to those who did not have these conditions or were in other age categories, whereas edematous malnourished children (AHR = 2.85; 95% CI: 2.28, 3.56) were positively and significantly associated with early recovery. The median nutritional recovery time fell within the recommended international standards. However, the length of stay was significantly longer among children with severe wasting, aged 6-23 months, and had vomiting, pneumonia, and anemia at admission than their counterparts. Therefore, interventions should focus on young children with severe wasting, pneumonia, vomiting, and anemia to prevent prolonged stay in the SCs without recovery. Retrospectively registered.
严重急性营养不良是一种危及生命的病症，导致发展中国家 5 岁以下儿童死亡人数过半。为了提高康复速度和康复率，急需采取专门的治疗措施。然而，埃塞俄比亚严重急性营养不良儿童的营养恢复时间数据有限。因此，本研究旨在确定 Wag Himra 区稳定中心收治的 6 至 59 个月大的严重急性营养不良（SAM）儿童的平均恢复时间及其决定因素。本研究采用回顾性队列研究方法，对 2014 年 9 月至 2017 年 8 月期间在 Wag Himra 区稳定中心（SCs）收治的 501 名严重急性营养不良（SAM）儿童的病历进行了研究。采用系统随机抽样技术选取病历。使用预先测试的标准检查表从每个儿童的病历中提取数据，并使用 EpiData 版本 3.1 录入数据，使用 STATA 14 进行分析。采用 Cox 比例风险回归分析确定恢复时间的决定因素。任何统计学检验的 p 值均小于 0.05。本研究中，SAM 总康复率为 80.4%（95%置信区间[CI]：76，84），中位营养恢复时间为 11 天（四分位距[IQR]：8-18）。6-23 月龄（调整后危险比[AHR]：0.74，95%CI：0.60，0.92）、患有肺炎（AHR：0.44；95%CI：0.32，0.59）、贫血（AHR：0.65；95%CI：0.52，0.81）和呕吐（AHR：0.63，95%CI：0.49，0.82）的儿童较其他年龄组和无上述疾病的儿童恢复速度较慢，而水肿性营养不良的儿童（AHR：2.85；95%CI：2.28，3.56）则与早期恢复呈正相关且具有统计学意义。营养恢复时间的中位数在国际推荐标准范围内。然而，与同龄人相比，严重消瘦、6-23 月龄、入院时呕吐、肺炎和贫血的儿童住院时间明显延长。因此，干预措施应重点关注严重消瘦、患有肺炎、呕吐和贫血的幼儿，以防止他们在稳定中心住院时间延长而无法康复。本研究为回顾性注册研究。
