Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
PLoS One. 2022 Aug 12;17(8):e0272930. doi: 10.1371/journal.pone.0272930. eCollection 2022.
Severe Acute Malnutrition (SAM) has become a major public health challenge in developing countries including Ethiopia, especially among the underprivileged population. Ethiopia is among the developing countries with the highest burden of acute malnutrition among under-five children. Though, plenty of studies were done on the magnitude of acute malnutrition among under-five children in Ethiopia, there is a limited evidence on time to recovery from SAM and its predictors among children aged 6-59 months in Ethiopia, particularly in the study area.
The study was aimed to assess the time to recovery from SAM and its predictors among children aged 6-59 months at Asosa general hospital (AGH), Benishangul Gumuz, Ethiopia.
A Five years retrospective follow-up study design was employed among 454 children admitted with SAM in AGH from January 2015 to December 2019. The data were extracted from the patient medical records using checklist. The data were coded and entered into Epi-Data 3.1; then exported to STATA/SE-14 for analysis. Proportional Cox regression was performed to identify predictors of recovery time. A proportional hazard assumption was checked. Variables with AHR at 95% CI and P-value less than 0.05 in the multivariable Cox proportional regression was considered as significant predictors of recovery time.
Among the 454 included records of children with SAM, 65.4% (95%CI: 50.1, 69.2) of them were recovered at the end of the follow-up with a median recovery time of 15 IQR(11-18)days. The incidence rate of recovery was 5.28 per 100 child days' observations. Being HIV Negative (AHR = 2.19: 95% CI 1.28, 3.73), Marasmic (AHR = 1.69: 95% CI 1.18, 2.42), and marasmic-kwashiorkor child (AHR = 1.60: 95% CI (1.09, 2.37) independently predicted recovery time.
Though the time to recovery from severe acute malnutrition was in the acceptable range, the proportion of recovery was found to be low in the study area compared to sphere standard. The prognosis of children with severe acute malnutrition was determined by the HIV status of the child and the type of malnutrition experienced. Further strengthening of malnutrition therapeutic centers and routine checkup of the nutritional status of HIV positive children should be emphasized to reduce child mortality and morbidity from under-nutrition.
严重急性营养不良（SAM）已成为包括埃塞俄比亚在内的发展中国家的一个主要公共卫生挑战，尤其是在贫困人群中。埃塞俄比亚是五岁以下儿童急性营养不良负担最重的发展中国家之一。尽管针对埃塞俄比亚五岁以下儿童急性营养不良的严重程度进行了大量研究，但在埃塞俄比亚，6-59 个月儿童从 SAM 中恢复的时间及其预测因素的证据有限，特别是在研究区域。
本研究旨在评估亚苏斯综合医院（AGH）6-59 个月儿童从 SAM 中恢复的时间及其预测因素，亚苏斯综合医院位于本尚古勒-古姆祖地区，埃塞俄比亚。
采用回顾性随访研究设计，对 2015 年 1 月至 2019 年 12 月期间在 AGH 因 SAM 住院的 454 名儿童进行研究。数据从患者病历中使用检查表提取。数据编码并输入 Epi-Data 3.1，然后导出到 STATA/SE-14 进行分析。比例 Cox 回归用于确定恢复时间的预测因素。检查比例风险假设。多变量 Cox 比例回归中，AHR 在 95%CI 和 P 值小于 0.05 的变量被认为是恢复时间的显著预测因素。
在纳入的 454 例 SAM 儿童记录中，65.4%（95%CI：50.1，69.2）在随访结束时恢复，中位恢复时间为 15 IQR（11-18）天。恢复的发生率为每 100 个儿童观察日 5.28 次。HIV 阴性（AHR = 2.19：95%CI 1.28，3.73）、消瘦（AHR = 1.69：95%CI 1.18，2.42）和消瘦-夸希奥克营养不良（AHR = 1.60：95%CI（1.09，2.37））独立预测恢复时间。
尽管从严重急性营养不良中恢复的时间处于可接受的范围内，但与全球标准相比，研究区域的恢复比例较低。儿童严重急性营养不良的预后由儿童的 HIV 状况和所经历的营养不良类型决定。应进一步加强营养不良治疗中心，并定期检查 HIV 阳性儿童的营养状况，以降低因营养不良导致的儿童死亡率和发病率。
