Mekonnen Gebrehiwot Berie, Wondie Wubet Tazeb, Legesse Bruck Tesfaye, Abera Netsanet Melkamu, Abuhay Abere Gebru, Yirga Gebrie Kassaw, Demissie Biruk, Engidaw Melaku Tadege
Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, P.O Box: 272, Debre Tabor, Ethiopia.
Department of Pediatrics and Child Health Nursing, College of Health Sciences and Referral Hospital, Ambo University, Ambo, Ethiopia.
Sci Rep. 2025 Apr 28;15(1):14767. doi: 10.1038/s41598-025-98582-z.
Severe acute malnutrition (SAM) is the leading cause of hospital admissions and continues to be the leading cause of death in pediatric wards for children under five (25-30% of deaths), particularly in developing nations. Even if Ethiopia implements SAM treatment guidelines and protocols, the study area needs to have up-to-date data on the recovery rate. This study aimed to assess the recovery rate of severe acute malnutrition and its determinants among under-five children admitted to a therapeutic feeding unit. An institution-based retrospective follow-up study was conducted admitted severely malnourished children from January 1, 2021 to December 30, 2022 in Debre Tabor Comprehensive Specialized Hospital. Data from all 209 study participants were collected using SAM registration logbooks and medical record charts with structured questionnaires. Data were entered into Epi Info version 7 and exported into SPSS version 25 for further analysis. The Kaplan-Meier curve and life table were used to describe the variable. To identify predictors, a Cox proportional hazard analysis was computed. The hazard ratio with a 95% CI was calculated, and a P-value of ≤ 0.05 was considered to declare statistical significance. A review of 209 records of children diagnosed with severe acute malnutrition (SAM) was included in this study. Among these 75.1% recovered from SAM and the median survival time of recovery for children admitted in DTCSH was 15.42 days. Appetite status at admission and HIV status were significantly influenced recovery rates, with children showing poor appetite [Adjusted hazard ratio [AHR] 2.32, 95% CI 1.1-4.95] and HIV-positive status [AHR 2.55, 95% CI 1.001-6.5] at higher risk of delayed recovery rate. In this study, the overall nutritional recovery time was within an acceptable level of the Sphere standards. The main determinants of time to recovery in severely malnourished children were appetite status and HIV status during admission. Therefore, prompt checking of the appetite status of children and screening and intervention accordingly for their HIV status during admission are highly recommended for good nutritional recovery.
重度急性营养不良（SAM）是住院的主要原因，并且仍然是五岁以下儿童在儿科病房死亡的主要原因（占死亡人数的25%-30%），尤其是在发展中国家。即使埃塞俄比亚实施了SAM治疗指南和方案，研究区域仍需要有关于康复率的最新数据。本研究旨在评估入住治疗性喂养单位的五岁以下儿童中重度急性营养不良的康复率及其决定因素。在德布雷塔博尔综合专科医院对2021年1月1日至2022年12月30日期间收治的重度营养不良儿童进行了一项基于机构的回顾性随访研究。使用SAM登记日志和带有结构化问卷的病历图表收集了所有209名研究参与者的数据。数据录入Epi Info 7版本并导出到SPSS 25版本进行进一步分析。采用Kaplan-Meier曲线和生命表来描述变量。为了确定预测因素，进行了Cox比例风险分析。计算了95%置信区间的风险比，P值≤0.05被认为具有统计学意义。本研究纳入了209例被诊断为重度急性营养不良（SAM）儿童的记录。其中75.1%从SAM中康复，在德布雷塔博尔综合专科医院住院儿童的中位康复生存时间为15.42天。入院时的食欲状况和艾滋病毒感染状况对康复率有显著影响，食欲不佳的儿童[调整后风险比[AHR]为2.32，95%置信区间为1.1-4.95]和艾滋病毒呈阳性的儿童[AHR为2.55，95%置信区间为1.001-6.5]康复延迟率风险更高。在本研究中，总体营养康复时间在《Sphere标准》可接受的水平内。重度营养不良儿童康复时间的主要决定因素是入院时的食欲状况和艾滋病毒感染状况。因此，强烈建议在入院时及时检查儿童的食欲状况，并根据其艾滋病毒感染状况进行筛查和干预，以实现良好的营养康复。
