scholarly journals Treatment outcome and factors affecting time to recovery in children with severe acute malnutrition treated at outpatient therapeutic care program

2016 ◽  
Vol 9 (1) ◽  
pp. 30704 ◽  
Author(s):  
Melkamu Merid Mengesha ◽  
Negussie Deyessa ◽  
Balewgizie Sileshi Tegegne ◽  
Yadeta Dessie
Keyword(s):  
Treatment Outcome ◽  
Severe Acute Malnutrition ◽  
Care Program ◽  
Acute Malnutrition ◽  
Factors Affecting ◽  
Therapeutic Care

scholarly journals Examining Response to Treatment of Severe Acute Malnutrition in Children 6–59 Months Old in Afghanistan, Chad, Mali, and Niger (P12-002-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Erin Boyd
Keyword(s):  
Weight Gain ◽  
Health Center ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Daily Weight Gain ◽  
Z Score ◽  
Factors Affecting ◽  
Number Of Children ◽  
Status Number ◽  
Significant Factors

Abstract Objectives Identify the most significant factors affecting the trajectory of recovery from severe acute malnutrition (SAM), as measured by average daily weight gain in each child 6–59 months of age who were diagnosed and treated for SAM and treated, adjusting for covariates including: breastfeeding status, number of children in household, illness, and distance to health center. Hypothesis 1a: Children 6–59 months enrolled in SAM treatment have slower times to recovery and slower weight gain if they are admitted for treatment at a lower anthropometric cut-off admission (weight for height z-score < −4) than children admitted for treatment at a higher anthropometric cut-off (weight for height z-score ≥ −4). Hypothesis 1b: Older children (24–59 months) recover more quickly than younger children (6–23 months) controlling for ration size. Methods A retrospective panel data analysis on children 6–59 months enrolled in standard outpatient treatment for severe acute malnutrition (SAM) between 2014 and 2016 was conducted. The study period was between September-December 2018. Children were exhaustively sampled. Children with edema, children with implausible z-scores for W/H (<−5 and >5) and H/A (<−6 and >6), children who were referred for inpatient therapeutic feeding to a stabilization center, and children from the same household, except in the case of twins, were eliminated from the analysis. There was one database per country. A total of 1384 children between 6–59 months were included in the analysis. Results The most significant factors affecting the proportional weight gain include age at enrollment (P = 0.001, 95%CI = −0.00—0.00) and Weight for height z-score (WHZ) (P = 0.00, 95%CI = 0.04—0.05) in each child 6–59 months of age who were diagnosed with SAM and treated, adjusting for covariates including: breastfeeding status, number of children in household, illness, and distance to health center. Sex of child did not significantly affect proportional weight gain (P = 0.404, 95%CI = −0.012–0.005). Conclusions The existing protocol to treat severe acute malnutrition should be modified to treat younger children and children who are admitted with a lower weight for height z-score due to different vulnerabilities. Funding Sources The research was conducted as part of a dissertation at The Friedman School of Nutrition Science and Policy at Tufts University. Data were obtained from World Vision.

scholarly journals Treatment Outcome of Severe Acute Malnutrition and associated factors among under-five children in outpatient therapeutics unit in Gubalafto Wereda, North Wollo Zone, Amara Regional State, North Ethiopia, 2019 G.C

2019 ◽  
Author(s):  
Biruk Beletew Abate ◽  
Befkad Dress ◽  
Ayelign Mengesha Kassie ◽  
Mesifn Wudu Kassaw
Keyword(s):  
Treatment Outcome ◽  
Recovery Rate ◽  
Associated Factors ◽  
Service Providers ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Under Five ◽  
Under Five Children ◽  
Therapeutic Program ◽  
Management Protocol

Abstract Background: In Ethiopia uncomplicated severe acute malnutrition is managed through the outpatient therapeutic program at health posts level. This brings the services for the management of Severe Acute Malnutrition closer to the community by making services available at decentralized treatment points within the primary health care settings. So far, evidence on the treatment outcome of the program is limited. Thus, the main aim of this study was to determine the magnitude of treatment outcomes of severe acute malnutrition and associated factors among under-five children at outpatient therapeutic feeding units. Methods: This was a retrospective cohort study conducted on 600 children who had been managed for SAM under OTP in Gubalafto Wereda from April to May/2019. The children were selected using systematic random sampling from 9 health posts. The structured, pre-tested and adapted questionnaire was used to collect the data. The data was entered by using EPI-data Version 4.2 and exported to SPSS version 24.0 for analysis. Bivariate and Multivariate regression was also carried out to determine the association between dependent and independent variables. Results: A total of 600 records of children with a diagnosis of severe acute malnutrition were reviewed. Of these cases of malnutrition, the recovery rate was revealed as 65 %. The death rate, default rate, and medical transfer were 2.0, 16.0, and 17.0 respectively. Children who took immunization were had 6.85 times higher odds of recovery than children who were not immunized (AOR=6.85 at 95% CI (3.68-12.76)). The likelihood of recovery was 3.78 times higher among children with new admission than those with re-admission (AOR=3.78at 95% CI ((1.77-8.07))). Likewise, children provided with amoxicillin were 3.38 times more likely to recover compared to their counterparts who were not provided (AOR=3.38 at 95% CI ((1.61-7.08))). Conclusions: The recovery rate and medical transfer were lower than sphere standard. Presence of cough, presence of diarrhea admission category, provision of amoxicillin, and immunization status were factors identified as significantly associated with treatment outcome of Sever Acute Malnutrition. Building capacity of OTP service providers and regular monitoring of service provision based on the management protocol were recommended.

scholarly journals Comparative Analysis of the Survival Status and Treatment Outcome of Under-five Children Admitted with Severe Acute Malnutrition Among Hospital-based and Health Center Based Stabilization Centers, South Ethiopia

2018 ◽  
Vol 11 (1) ◽  
pp. 209-220 ◽  
Author(s):  
Tadele Girum ◽  
Ebrahim Muktar ◽  
Abdulsemed Worku
Keyword(s):  
Treatment Outcome ◽  
Health Center ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Cumulative Probability ◽  
Ratio Test ◽  
Stabilization Centers ◽  
Under Five ◽  
Under Five Children ◽  
Survival Status

Background:Severe acute malnutrition has been managed at Hospital stabilization centers until the management at health center based stabilization centers was started recently. However, the treatment outcome was not assessed in relation to the existing hospital-based management. Therefore, this study comparatively assessed the treatment outcome and survival status of severe acute malnutrition among Health center-based and hospital-based stabilization centers. The finding will be used by healthcare providers, planners and policymakers at large.Methods:Randomly selected 400 records of under-five children admitted to five stabilization centers (2 hospitals and 3 health center) in Gedeo Zone was included. Data was entered by Epi Info version 7 and analyzed by STATA version 11. Survival difference was checked by life table and Kaplan-Mier with Log-Rank test. Cox proportional hazards model was built by forward stepwise procedure; compared to likely hood ratio test and Harrell’s concordance and fitness checked by the cox-snell residual plot.Result:The study showed that the cumulative probability of Survival is significantly different at Hospital stabilization center and health center stabilization centers (p.value <0.001) with shorter survival at hospitals. During the follow-up period, 28(13.86%) children from hospital and 5(2.5%) children from health center died, while 155(76.73%) children from the hospital and 145(73.23%) children from health center got cured. Eighteen (4.5%)children were defaulted. Death is significantly higher at the hospital, while default rate and cure rate are not significantly different. Altered pulse rate [AHR=2.44, 95% CI =1.47-4, p<0.001], NG tube insertion [AHR=1.8, 95% CI =1.04-3.1, p=0.038], Anemia [AHR=1.53, 95% CI =1.02-2.3, p<0.041] and Hypoglycemia [AHR=2.78, 95% CI =1.8-4.3, p<0.001] were found to be independent predictors of death.Conclusion:The survival of children in hospital is shorter and mortality is higher. An overall treatment outcome was in acceptable ranges. Intervention to further reduce deaths at hospitals has to focus on children with comorbidities and altered general conditions and early detection.

scholarly journals The effects of psychosocial stimulation on the development, growth, and treatment outcome of children with severe acute malnutrition age 6–59 months in southern Ethiopia: a parallel group cluster randomized control trial (EPSoSAMC study)

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Tesfalem T. Tessema ◽  
Andamlak G. Alamdo ◽  
Tewodrose G. Yirtaw ◽  
Fana A. Deble ◽  
Eyoel B. Mekonen ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Inpatient Care ◽  
Severe Acute Malnutrition ◽  
Scientific Evidence ◽  
Acute Malnutrition ◽  
Southern Ethiopia ◽  
Parallel Group ◽  
Psychosocial Stimulation ◽  
Cluster Randomized

Abstract Background Severe Acute Malnutrition (SAM) remains a major cause of child mortality. To improve the management and survival of children the World Health Organization (WHO) endorsed the protocol for the management of SAM. The protocol suggested the integration of psychosocial stimulation as part of the medico-nutritional care process to prevent the long-term adverse developmental impact of the SAM. However, there is little scientific evidence behind the recommended stimulation intervention. Method A parallel-group cluster-randomized controlled trial will be conducted among 144 children with SAM age 6–59 months in Southern Ethiopia. The study will have two groups where: children with SAM admitted in the intervention health facilities will receive psychosocial stimulation in addition to the routine inpatient care and for 6 months after discharge. Children with SAM admitted in the SC of the control health facilities will receive the routine inpatient care without psychosocial stimulation and home-based follow up for 6 months after discharge. All mothers/ caregivers will also receive uniform health education on child health-related issues. The primary outcome of the study will be child development while the secondary outcomes will include child growth and treatment outcome. All outcomes will be assessed four times: at enrollment, upon discharge from the SC, at 3 and 6 months of follow up. The data will be analyzed using STATA Version 15 Statistical Software. The anthropometric Z-scores and percentile of the median will be calculated child using WHO Anthro Version 3.2.2 Statistical Software. To assess the overall effect of the intervention by controlling other potential contributing factors, a generalized linear mixed model will be used. Discussion The present study will have an important contribution in generating supplementary evidence regarding the effect of psychosocial stimulation interventions on the development and growth outcomes of children with SAM. The study will further address the impact of the intervention on treatment outcome indicators that are still under-researched areas requiring new scientific evidence. Trial registration Pan African Clinical Trials Registry -PACTR201901730324304. Registered 25 November 2018, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=5739

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