严重急性营养不良的康复率仍低于最低标准：埃塞俄比亚西南部医疗环境中 6 至 59 个月大儿童康复时间的预测因素。

Severe acute malnutrition's recovery rate still below the minimum standard: predictors of time to recovery among 6- to 59-month-old children in the healthcare setting of Southwest Ethiopia.

机构信息

Department of Public Health, College of Health Sciences, Mattu University, Mattu, Ethiopia.

Department of Nursing, College of Health Sciences, Mattu University, Mattu, Ethiopia.

出版信息

J Health Popul Nutr. 2022 Nov 4;41(1):48. doi: 10.1186/s41043-022-00331-9.

BACKGROUND

Despite currently available, scientifically proven treatments and national guideline, the SAM recovery rate is still considerably behind expectations, and it continues to have a devastating impact on under-five children. Identifying predictors of time to recovery might help to reach the minimal criterion established by the WHO and the national Sphere which decreases child mortality. Therefore, the current study assessed time to recovery and its predictors among children aged 6-59 months admitted with SAM in the Healthcare Setting of Southwest Ethiopia, 2021.

METHODS

An institutional-based multicenter retrospective follow-up study was conducted on 486 children aged 6 to 59 months admitted with SAM cases. Data were entered into Epi-Data version 4.6 and exported to Stata version 14 for further analysis. Cox-Snell residual plot was used to assess the final model's overall goodness of fit. Finally, a significant predictor of time to recovery was identified using Weibull survival regression model, at 0.05 significance level.

RESULT

Overall, 68.72 (95% CI 64.8, 73) of the children recovered and 4.32% died. The overall incidence density was 3.35/100-person day. Independent predictors of time to recovery were, starting complementary feeding at six months (AHR = 1.44; 95%, CI 1.073, 1.935), pneumonia at baseline (AHR = 1.33, 95%, CI 1.049, 1.696), amoxicillin (AHR = 1.31, 95%, CI 1.021, 1.685), and folic acid supplementation (AHR = 1.82, 95% CI 1,237, 2.665).

CONCLUSION

The recovery from SAM at study area after a maximum of 60 days of treatment was below the accepted minimum standard. Complementary feeding, pneumonia, treated by amoxicillin, and folic acid supplementation were predictors of time to recovery. Therefore, providing folic acid and amoxicillin for those in need as well as the earliest possible treatment of concomitant conditions like pneumonia is highly recommended.

背景

尽管目前有科学证实的治疗方法和国家指南，但严重急性营养不良（SAM）的康复率仍然远远低于预期，并且仍对五岁以下儿童造成毁灭性影响。确定康复时间的预测因素可能有助于达到世界卫生组织和国家 Sphere 设定的最低标准，从而降低儿童死亡率。因此，本研究评估了 2021 年在埃塞俄比亚西南部医疗保健机构中因 SAM 入院的 6-59 个月儿童的康复时间及其预测因素。

方法

这是一项基于机构的多中心回顾性随访研究，共纳入了 486 名 6-59 个月因 SAM 入院的儿童。数据输入 Epi-Data 版本 4.6 并导出到 Stata 版本 14 进行进一步分析。Cox-Snell 残差图用于评估最终模型的整体拟合优度。最后，使用威布尔生存回归模型确定了康复时间的显著预测因素，显著性水平为 0.05。

结果

总的来说，68.72%（95%CI 64.8，73）的儿童康复，4.32%的儿童死亡。总体发病密度为 3.35/100 人日。康复时间的独立预测因素包括，6 个月时开始补充喂养（AHR=1.44；95%CI 1.073，1.935）、基线时患有肺炎（AHR=1.33；95%CI 1.049，1.696）、阿莫西林治疗（AHR=1.31；95%CI 1.021，1.685）和叶酸补充（AHR=1.82；95%CI 1.237，2.665）。