Determinants of mortality among under-five children admitted with severe acute malnutrition in Addis Ababa, Ethiopia.

Bitew, ZW; Ayele, EG; Worku, T; Alebel, A; Alemu, A; Worku, F; Yesuf, A

Determinants of mortality among under-five children admitted with severe acute malnutrition in Addis Ababa, Ethiopia.

Bitew, ZW Ayele, EG Worku, T Alebel, A Alemu, A Worku, F Yesuf, A

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Publisher:: BioMed Central
Publication Type:: Journal Article
Citation:: Nutrition Journal, 2021, 20, (1), pp. 94-94
Issue Date:: 2021-12-20

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Field	Value	Language
dc.contributor.author	Bitew, ZW
dc.contributor.author	Ayele, EG
dc.contributor.author	Worku, T
dc.contributor.author	Alebel, A
dc.contributor.author	Alemu, A
dc.contributor.author	Worku, F
dc.contributor.author	Yesuf, A
dc.date.accessioned	2022-01-17T01:09:59Z
dc.date.available	2021-11-09
dc.date.available	2022-01-17T01:09:59Z
dc.date.issued	2021-12-20
dc.identifier.citation	Nutrition Journal, 2021, 20, (1), pp. 94-94
dc.identifier.issn	1475-2891
dc.identifier.issn	1475-2891
dc.identifier.uri	http://hdl.handle.net/10453/153193
dc.description.abstract	BACKGROUND: Management of severe acute malnutrition (SAM) has been a program priority in Ethiopia, but it remains the leading cause of mortality in under-five children. Hence, this study aimed to identify the incidence density rate of mortality and determinants among under-five children with severe acute malnutrition in St. Paul's Hospital Millennium Medical College, 2012 to 2019. METHODS: A retrospective cohort study was conducted and data were collected using a structured checklist from 673 charts, of which 610 charts were included in the final analysis. The Kaplan-Meier survival curve with Log-rank test was used to estimate the survival time. Bi-variable and multi-variable Cox proportional hazard regression models were fitted to identify determinants of death. Schoenfeld residuals test was used to check a proportional hazard assumption. Goodness of fit of the final model was checked using Nelson Aalen cumulative hazard function against Cox-Snell residual. RESULTS: In this study, 61 (10%) children died making the incidence density rate of death 5.6 (95% CI: 4.4, 7.2) per 1000 child-days. Shock (Adjusted Hazard Ratio) [AHR] =3.2; 95% CI: 1.6, 6.3)), IV fluid infusion (AHR = 5.2; 95% CI: 2.4, 10.4), supplementing F100 (AHR = 0.12; 95%CI: 0.06, 0.23) and zinc (AHR = 0.45; 95% CI: 0.22, 0.93) were determinants of death. CONCLUSION: The overall proportion of deaths was within the range put forth by the Sphere standard and the national SAM management protocol. Shock and IV fluid infusion increased the hazard of death, whereas F100 & zinc were found to decrease the likelihood death. Children with SAM presented with shock should be handled carefully and IV fluids should be given with precautions.
dc.format	Electronic
dc.language	eng
dc.publisher	BioMed Central
dc.relation.ispartof	Nutrition Journal
dc.relation.isbasedon	10.1186/s12937-021-00750-0
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1111 Nutrition and Dietetics
dc.subject.classification	Nutrition & Dietetics
dc.title	Determinants of mortality among under-five children admitted with severe acute malnutrition in Addis Ababa, Ethiopia.
dc.type	Journal Article
utslib.citation.volume	20
utslib.location.activity	England
utslib.for	1111 Nutrition and Dietetics
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2022-01-17T01:09:54Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	20
utslib.citation.issue	1

Abstract:

BACKGROUND: Management of severe acute malnutrition (SAM) has been a program priority in Ethiopia, but it remains the leading cause of mortality in under-five children. Hence, this study aimed to identify the incidence density rate of mortality and determinants among under-five children with severe acute malnutrition in St. Paul's Hospital Millennium Medical College, 2012 to 2019. METHODS: A retrospective cohort study was conducted and data were collected using a structured checklist from 673 charts, of which 610 charts were included in the final analysis. The Kaplan-Meier survival curve with Log-rank test was used to estimate the survival time. Bi-variable and multi-variable Cox proportional hazard regression models were fitted to identify determinants of death. Schoenfeld residuals test was used to check a proportional hazard assumption. Goodness of fit of the final model was checked using Nelson Aalen cumulative hazard function against Cox-Snell residual. RESULTS: In this study, 61 (10%) children died making the incidence density rate of death 5.6 (95% CI: 4.4, 7.2) per 1000 child-days. Shock (Adjusted Hazard Ratio) [AHR] =3.2; 95% CI: 1.6, 6.3)), IV fluid infusion (AHR = 5.2; 95% CI: 2.4, 10.4), supplementing F100 (AHR = 0.12; 95%CI: 0.06, 0.23) and zinc (AHR = 0.45; 95% CI: 0.22, 0.93) were determinants of death. CONCLUSION: The overall proportion of deaths was within the range put forth by the Sphere standard and the national SAM management protocol. Shock and IV fluid infusion increased the hazard of death, whereas F100 & zinc were found to decrease the likelihood death. Children with SAM presented with shock should be handled carefully and IV fluids should be given with precautions.

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http://hdl.handle.net/10453/153193