The Infectious Disease Institute, Kampala, Uganda.
Department of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda.
J Nutr Sci. 2021 May 6;10:e33. doi: 10.1017/jns.2021.11. eCollection 2021.
Globally, severe acute malnutrition (SAM) accounts for >1/3-0⋅5 of deaths in children <5 years, and approximately 54 % deaths in developing countries. The minimum international standard set for the management of SAM is a cure rate of at least 75 % and death rate <10 %. The present study was conducted to determine treatment outcome and associated factors among children 1-5 years hospitalised with SAM in Lacor and Gulu Regional Referral Hospital (GRRH) in 2017. A retrospective observational method supplemented with a qualitative inquiry was done. A total of 317 patients' records were reviewed in either hospital; checklist data were analysed using SPSS version 16 with values <0⋅05 considered for statistical significance. The case fatality rate (CFR) was 12⋅6 % (GRRH) and 9⋅5 % (Lacor). The average length of stay (LOS) was 14⋅69 d (GRRH) and 14⋅10 d (Lacor). There was statistical significance between Human Immunodeficiency Virus (HIV) status, blood transfusion, type of SAM, treatment provision at admission, antibiotics, mid-upper arm circumference (MUAC), hospital category and treatment outcome. In total, ten key informants were interviewed and they reported the presence of co-infections and severity of SAM complications as having an important bearing on treatment outcome. A significant proportion of patients were discharged not cured 19⋅9 % (Lacor) . 16⋅4 % (GRRH). The CFR in GRRH was higher than the WHO recommendation. The LOS in both hospitals was within recommended. These results provide a generalisable problem in most African hospitals and could explain the persistently high rates of SAM in Africa.
在全球范围内，严重急性营养不良（SAM）占 5 岁以下儿童死亡人数的> 1/3-0.5，约占发展中国家死亡人数的 54%。SAM 管理的最低国际标准是治愈率至少为 75%，死亡率<10%。本研究旨在确定 2017 年在 Lacor 和 Gulu 地区转诊医院（GRRH）因 SAM 住院的 1-5 岁儿童的治疗结果和相关因素。采用回顾性观察方法，并辅以定性调查。在两家医院共回顾了 317 名患者的记录；检查表数据使用 SPSS 版本 16 进行分析，<0.05 的值被认为具有统计学意义。病死率（CFR）分别为 12.6%（GRRH）和 9.5%（Lacor）。平均住院时间（LOS）分别为 14.69 天（GRRH）和 14.10 天（Lacor）。HIV 状态、输血、SAM 类型、入院时的治疗提供情况、抗生素、上臂中部周长（MUAC）、医院类别和治疗结果之间存在统计学意义。共采访了 10 名关键知情者，他们报告说合并感染和 SAM 并发症的严重程度对治疗结果有重要影响。相当一部分患者出院时未治愈 19.9%（Lacor），16.4%（GRRH）。GRRH 的 CFR 高于世卫组织的建议。两家医院的 LOS 都在推荐范围内。这些结果在大多数非洲医院普遍存在问题，可能解释了非洲持续高 SAM 率的原因。
