Department of Midwifery, College of Health Sciences Mettu University, Mettu, Ethiopia.
Department of Nursing, College of Health Sceinces, Addis Ababa University, Addis Ababa, Ethiopia.
BMJ Open. 2024 Aug 6;14(8):e083855. doi: 10.1136/bmjopen-2023-083855.
This study aims to assess the survival status and predictors of mortality among under-5 children with severe acute malnutrition in Addis Ababa, Ethiopia.
A retrospective cohort study was employed on randomly selected 422 medical records of children under the age of 5 admitted to stabilisation centres in Addis Ababa, Ethiopia. Survival analysis and Cox regression analysis were conducted to determine time spent before the outcome and predictors of desired outcome.
The stabilisation centres in four governmental hospitals in Addis Ababa, Ethiopia: Tikur Anbessa Specialised Hospital, Zewditu Memorial Hospital, Yekatit 12 Hospital and Tirunesh Beijing Hospital PARTICIPANTS: Of 435 severely malnourished children under the age of 5 admitted to four governmental hospitals in Addis Ababa, Ethiopia, from January 2020 to December 2022, we were able to trace 422 complete records. The remaining 13 medical records were found to be incomplete due to missing medical history information for those children.
The primary outcome is the survival status of under-5 children with severe acute malnutrition after admission to the stabilisation centres. The secondary outcome is predictors of survival among these children.
Of 422 children, 44 (10.4%) died, with an incidence rate of 10.3 per 1000 person-days. The median hospital stay was 8 days. Full vaccination (adjusted HR (AHR) 0.2, 95% CI 0.088 to 0.583, p<0.05), feeding practices (F-75) (AHR 0.2, 95% CI 0.062 to 0.651, p<0.01), intravenous fluid administration (AHR 3.7, 95% CI 1.525 to 8.743, p<0.01), presence of HIV (AHR 2.2, 95% CI 1.001 to 4.650, p<0.05), pneumonia (AHR 2.2, 95% CI 1.001 to 4.650, p<0.01) and occurrence of shock (AHR3.5, 95% CI 1.451 to 8.321, p<0.01) were identified as significant predictors of mortality.
The study identified a survival rate slightly higher than the acceptable range set by the social and public health economics study group. Factors like vaccination status, HIV, pneumonia, shock, intravenous fluid and the absence of feeding F-75 predicted mortality.
本研究旨在评估埃塞俄比亚亚的斯亚贝巴五岁以下严重急性营养不良儿童的生存状况和死亡预测因素。
对随机选择的 422 名在埃塞俄比亚亚的斯亚贝巴的稳定中心接受治疗的 5 岁以下儿童的医疗记录进行回顾性队列研究。进行生存分析和 Cox 回归分析，以确定结果发生前的时间和预期结果的预测因素。
埃塞俄比亚亚的斯亚贝巴的四家政府医院的稳定中心：提克勒·安贝萨专科医院、泽维图纪念医院、耶卡蒂特 12 医院和提尔努什·北京医院
2020 年 1 月至 2022 年 12 月期间，我们从埃塞俄比亚亚的斯亚贝巴的四家政府医院中追踪到了 435 名严重营养不良的五岁以下儿童，但只有 422 名儿童的完整记录能够被找到。其余 13 份医疗记录因缺少这些儿童的病史信息而被认为是不完整的。
主要结果是在稳定中心入院后五岁以下严重急性营养不良儿童的生存状况。次要结果是这些儿童生存的预测因素。
在 422 名儿童中，有 44 名（10.4%）死亡，发病率为每 1000 人天 10.3 人。住院中位数为 8 天。完全接种疫苗（调整后的 HR（AHR）0.2，95%CI 0.088 至 0.583，p<0.05）、喂养习惯（F-75）（AHR 0.2，95%CI 0.062 至 0.651，p<0.01）、静脉输液（AHR 3.7，95%CI 1.525 至 8.743，p<0.01）、HIV 感染（AHR 2.2，95%CI 1.001 至 4.650，p<0.05）、肺炎（AHR 2.2，95%CI 1.001 至 4.650，p<0.01）和休克（AHR3.5，95%CI 1.451 至 8.321，p<0.01）被确定为死亡的显著预测因素。
本研究确定的生存率略高于社会和公共卫生经济学研究小组设定的可接受范围。疫苗接种状况、HIV、肺炎、休克、静脉输液和缺乏喂养 F-75 等因素预测了死亡率。
