Zegeye Martha Kassahun, Belew Aysheshim Kassahun, Aserese Addisalem Damtie, Daba Derese Bekele
Department of Public Health College of Medicine and Health Science, Ambo University Ambo Ethiopia.
Department of Human Nutrition Institute of Public Health, University of Gondar Gondar Ethiopia.
Health Sci Rep. 2022 Nov 29;6(1):e959. doi: 10.1002/hsr2.959. eCollection 2023 Jan.
Malnutrition is a serious public health issue and a frequent impact of human immunodeficiency virus (HIV) infection, which raises the risk of morbidity and mortality in affected people. Despite the World Health Organization's (WHO) support for the use of ready-to-use therapeutic foods (RUTF) to treat malnutrition, research on the length of time it takes for children with HIV infection to recover from malnutrition and the factors that predict it is lacking, particularly Ethiopia.
An institution-based retrospective follow-up study was carried out in the Amhara regional state referral hospitals in Northern Ethiopia. From 2013 to 2018, a total of 478 children who received RUTF treatments were chosen using a simple random sampling technique. To calculate the likelihood of recovery and the median recovery period, incidence and Kaplan-Meier survival analyses were performed. The Cox regression model was used to identify predictors of time to recovery from malnutrition. The multivariable model only included variables with a value below 0.2. While factors were deemed to be substantially linked with the outcome variable if their value was less than 0.05.
The median recovery duration was 5 months (95% confidence interval [CI] = 4-5 months), and the nutritional recovery rate was 64.64% (95% CI = 60.2-68.9). Moderate acute malnutrition (adjusted hazard ratio [AHR] = 4.60, 95% [CI] = 2.85-7.43), WHO clinical stage I (AHR = 4.01, 95% CI = 1.37-11.77), absence of opportunistic infection (AHR = 1.76, 95% CI = 1.19-2.61), haemoglobin (Hgb) count above the threshold (AHR = 1.36, 95% CI = 1.01-1.85) and family size of 1-3 (AHR = 2.38, 95% CI = 2.38-5.00) were significantly linked to rapid recovery from malnutrition.
In comparison to the period specified by the national guideline (3 months for moderate and 6 months for severe acute malnutrition), the median time to recovery was lengthy. Acute malnutrition, clinical stage, opportunistic infection, Hgb count, and family size were statistically associated with early recovery from malnutrition.
营养不良是一个严重的公共卫生问题，也是人类免疫缺陷病毒（HIV）感染的常见影响，这增加了受影响人群发病和死亡的风险。尽管世界卫生组织（WHO）支持使用即食治疗性食品（RUTF）来治疗营养不良，但关于HIV感染儿童从营养不良中恢复所需的时间以及预测其恢复的因素的研究却很缺乏，尤其是在埃塞俄比亚。
在埃塞俄比亚北部阿姆哈拉地区转诊医院开展了一项基于机构的回顾性随访研究。2013年至2018年期间，采用简单随机抽样技术共选取了478名接受RUTF治疗的儿童。为计算恢复的可能性和中位恢复期，进行了发病率和Kaplan-Meier生存分析。采用Cox回归模型确定营养不良恢复时间的预测因素。多变量模型仅纳入P值低于0.2的变量。当因素的P值小于0.05时，则认为其与结果变量有显著关联。
中位恢复持续时间为5个月（95%置信区间[CI]=4-5个月），营养恢复率为64.64%（95%CI=60.2-68.9）。中度急性营养不良（调整后风险比[AHR]=4.60，95%[CI]=2.85-7.43）、WHO临床I期（AHR=4.01，95%CI=1.37-11.77）、无机会性感染（AHR=1.76，95%CI=1.19-2.61）、血红蛋白（Hgb）计数高于阈值（AHR=1.36，95%CI=1.01-1.85）以及家庭规模为1-3人（AHR=2.38，95%CI=2.38-5.00）与营养不良的快速恢复显著相关。
与国家指南规定的时间（中度急性营养不良为3个月，重度急性营养不良为6个月）相比，中位恢复时间较长。急性营养不良、临床分期、机会性感染、Hgb计数和家庭规模与营养不良的早期恢复在统计学上相关。
