Child Survival Initiatives, Harar, Ethiopia.
School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Front Public Health. 2022 Jul 14;10:914837. doi: 10.3389/fpubh.2022.914837. eCollection 2022.
Acute malnutrition is a major global public health problem, particularly in low and middle-income countries. A targeted supplementary feeding program is an approach recommended to address moderate acute malnutrition in food insecure settings. Preventing and treating moderate acute malnutrition requires identifying factors shown to affect the treatment outcome and duration of stay on treatment. This study aimed to determine the treatment outcome and predictors of recovery time from moderate acute malnutrition among children 6-59 months of age in Darolebu district, Eastern Ethiopia.
A retrospective cohort study design was conducted on 540 children with moderate acute malnutrition. A Kaplan-Meier survival analysis was used to estimate the recovery time. Cox proportional hazard regression model was used to determine the association between the independent and the outcome variables. The proportional hazard assumption of the model was checked graphically and statistically. Any violation of the proportional hazard assumption of the model was also considered and adjusted in the analysis. Finally, a variable with a value <0.05 in the multivariate cox regression model was considered statistically significant.
The overall recovery rate was 73% (95% CI 69.4-76.4%) with the median time to recovery of 16 weeks. Being between the ages of 24 and 59 months (AHR = 1.24, 95% CI: 1.01-1.54), having a mid-upper arm circumference (MUAC) at admission between 11.5 and 11.9 cm (AHR = 1.27, 95% CI: 1.34-2.61), walking for an hour or less to receive services (AHR = 1.2, 95% CI: 1.02-1.89), using ready-to-use supplementary food (AHR= 1.8, 95%CI: 1.38-2.39) were significant predictors of recovery time.
The recovery rate was slightly below the accepted minimum international standard, suggesting that further work is needed to improve the treatment outcomes and mortality and morbidity associated with moderate acute malnutrition.
急性营养不良是一个重大的全球公共卫生问题，尤其是在中低收入国家。在粮食不安全的环境中，有针对性的补充喂养方案是解决中度急性营养不良的一种推荐方法。预防和治疗中度急性营养不良需要确定影响治疗结果和治疗持续时间的因素。本研究旨在确定在埃塞俄比亚东部达罗勒布区 6-59 个月大的儿童中，中度急性营养不良的治疗结果和恢复时间的预测因素。
对 540 名中度急性营养不良儿童进行回顾性队列研究。采用 Kaplan-Meier 生存分析估计恢复时间。Cox 比例风险回归模型用于确定独立变量和结果变量之间的关系。通过图形和统计学检查模型的比例风险假设。如果模型的比例风险假设被违反，也将在分析中进行考虑和调整。最后，在多变量 Cox 回归模型中，具有 <0.05 值的变量被认为具有统计学意义。
总体恢复率为 73%（95%CI 69.4-76.4%），中位恢复时间为 16 周。年龄在 24 至 59 个月之间（AHR = 1.24，95%CI：1.01-1.54）、入院时上臂中部周长（MUAC）在 11.5 至 11.9cm 之间（AHR = 1.27，95%CI：1.34-2.61）、步行一小时或更短时间接受服务（AHR = 1.2，95%CI：1.02-1.89）、使用即食补充食品（AHR=1.8，95%CI：1.38-2.39）是恢复时间的显著预测因素。
恢复率略低于可接受的国际最低标准，这表明需要进一步努力改善中度急性营养不良的治疗结果以及与之相关的死亡率和发病率。
