Gashu Chalachew, Kassa Yoseph, Geremew Habtamu, Mulugeta Mengestie
Department of Statistics College of Natural and Computational Science, Oda Bultum University Chiro Ethiopia.
Department of Nursing College of Health Science, Oda Bultum University Chiro Ethiopia.
Health Sci Rep. 2024 May 28;7(6):e2135. doi: 10.1002/hsr2.2135. eCollection 2024 Jun.
Severe acute malnutrition remains a significant health challenge, particularly in low- and middle-income countries. The aim of this study was to determine the survival time of under-five children with severe acute malnutrition.
A retrospective cohort study was conducted at a hospital, focusing on under-five children with severe acute malnutrition. The study included 322 inpatients admitted to the Chiro hospital in Chiro, Ethiopia, between September 2019 and August 2020, whose data was obtained from medical records. Survival functions were analysed using Kaplan‒Meier plots and log-rank tests. The survival time of severe acute malnutrition was further analysed using the Cox proportional hazards model and Bayesian parametric survival models, employing integrated nested Laplace approximation methods.
Among the 322 patients, 118 (36.6%) died as a result of severe acute malnutrition. The estimated median survival time for inpatients was found to be 2 weeks. Model selection criteria favored the Bayesian Weibull accelerated failure time model, which demonstrated that age, body temperature, pulse rate, nasogastric (NG) tube usage, hypoglycemia, anemia, diarrhea, dehydration, malaria, and pneumonia significantly influenced the survival time of severe acute malnutrition.
This study revealed that children below 24 months, those with altered body temperature and pulse rate, NG tube usage, hypoglycemia, and comorbidities such as anemia, diarrhea, dehydration, malaria, and pneumonia had a shorter survival time when affected by severe acute malnutrition under the age of five. To reduce the death rate of children under 5 years of age, it is necessary to design community management for acute malnutrition to ensure early detection and improve access to and coverage for children who are malnourished.
严重急性营养不良仍然是一项重大的健康挑战，尤其是在低收入和中等收入国家。本研究的目的是确定患有严重急性营养不良的五岁以下儿童的生存时间。
在一家医院进行了一项回顾性队列研究，重点关注患有严重急性营养不良的五岁以下儿童。该研究纳入了2019年9月至2020年8月期间在埃塞俄比亚奇罗的奇罗医院住院的322名患者，其数据来自医疗记录。使用Kaplan-Meier曲线和对数秩检验分析生存函数。采用积分嵌套拉普拉斯近似方法，使用Cox比例风险模型和贝叶斯参数生存模型进一步分析严重急性营养不良的生存时间。
在322名患者中，118名（36.6%）死于严重急性营养不良。住院患者的估计中位生存时间为2周。模型选择标准支持贝叶斯威布尔加速失效时间模型，该模型表明年龄、体温、脉搏率、鼻胃管使用、低血糖、贫血、腹泻、脱水、疟疾和肺炎对严重急性营养不良的生存时间有显著影响。
本研究表明，24个月以下的儿童、体温和脉搏率改变的儿童、使用鼻胃管的儿童、低血糖儿童以及患有贫血、腹泻、脱水、疟疾和肺炎等合并症的儿童，在五岁前受到严重急性营养不良影响时生存时间较短。为降低五岁以下儿童的死亡率，有必要设计急性营养不良的社区管理措施，以确保早期发现并改善营养不良儿童的就医机会和覆盖率。
