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2023 年,在埃塞俄比亚提格雷州人道主义危机期间,对患有严重急性营养不良的 1-59 个月大儿童进行管理的稳定时间及其预测因素的前瞻性队列研究。

Stabilizing time and its predictors among 1-59 months old children managed for severe acute malnutrition during the humanitarian crisis in Tigray regional state of Ethiopia, 2023: a prospective cohort study.

机构信息

Medical Teams International (MTI), Shire Field Office, Nutrition Supervisor, Shire, Ethiopia.

College of Health Sciences, Aksum University, Aksum, Ethiopia.

出版信息

BMC Pediatr. 2024 Apr 1;24(1):221. doi: 10.1186/s12887-024-04711-4.

Abstract

BACKGROUND

Higher rate of acute malnutrition is observed in emergencies compared to non-emergency settings and severe acute malnutrition upsurges alarmingly and become deadly in humanitarian crises due to lack of food, lack of quality water supply and insufficient healthcare. Research is one learning tool by identifying strength and areas of improvement. However, little is known about outcomes of therapeutic feeding programmes in comparison with the standard indicators set in humanitarian setting.

METHODS

Health facility based prospective cohort study was conducted using routinely collected programme data of children hospitalized to the inpatient therapeutic feeding center in suhul general hospital from January 1st, 2023 to June 30, 2023. Data was collected using a form developed relating to the federal ministry of health standard management protocols for severe acute malnutrition then it was cleaned, coded and entered to EpiData version 4.2.0 and then exported to SPSS version 25 for analysis.

RESULTS

From 184 children, 96.2% were stabilized while the remaining 3.8% were censored with overall median stabilizing time of 8 days. Weight gain was used as one of the discharging criteria for infants less than six months and their mean weight gain found to be 12.89 g per kilogram daily. Appetite test (AHR = 0.338; 95% CI: 0.221-0.518), blood transfusion (AHR = 5.825; 95% CI: 2.568-13.211), IV fluid resuscitation (AHR = 2.017; 95% CI: 1.094-3.717), IV antibiotics (AHR = 2.288; 95% CI: 1.164-4.500) and NG tube feeding (AHR = 1.485; 95% CI: 1.065-2.071) were identified as significant predictors of stabilizing time.

CONCLUSION

All the outcome indicators for stabilization center are consistent with the SPHERE association set of standards during humanitarian intervention. The hospital and other concerned humanitarian organizations should focus on sustaining these achievements as suhul hospital is the main treatment center for children suffering from severe acute malnutrition in the northwest zone of Tigray regional state. Further pre-post experimental studies which compare the stabilizing time before and after crisis are recommended.

摘要

背景

与非紧急情况相比,紧急情况下急性营养不良的发生率更高,由于缺乏食物、缺乏优质供水和医疗保健不足,严重急性营养不良急剧增加,在人道主义危机中变得致命。研究是一种通过确定优势和改进领域来学习的工具。然而,与人道主义环境中设定的标准指标相比,人们对治疗性喂养方案的结果知之甚少。

方法

使用 2023 年 1 月 1 日至 6 月 30 日在苏胡尔综合医院住院治疗中心住院的儿童的常规收集方案数据,进行了基于卫生机构的前瞻性队列研究。使用与联邦卫生部严重急性营养不良标准管理方案相关的表格收集数据,然后对其进行清理、编码并输入 EpiData 版本 4.2.0,然后导出到 SPSS 版本 25 进行分析。

结果

在 184 名儿童中,96.2%的儿童稳定,其余 3.8%的儿童被删失,总体中位数稳定时间为 8 天。体重增加是 6 个月以下婴儿出院的标准之一,他们的平均体重日增长率为 12.89 克/公斤。食欲试验(AHR=0.338;95%CI:0.221-0.518)、输血(AHR=5.825;95%CI:2.568-13.211)、静脉补液复苏(AHR=2.017;95%CI:1.094-3.717)、静脉抗生素(AHR=2.288;95%CI:1.164-4.500)和 NG 管喂养(AHR=1.485;95%CI:1.065-2.071)被确定为稳定时间的显著预测因子。

结论

稳定中心的所有结果指标都与人道主义干预期间 SPHERE 协会的标准一致。医院和其他相关人道主义组织应专注于维持这些成就,因为苏胡尔医院是提格雷州西北部地区严重急性营养不良儿童的主要治疗中心。建议进行前后对照实验研究,比较危机前后的稳定时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8a6/10983702/20af25b76c19/12887_2024_4711_Fig1_HTML.jpg

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