scholarly journals Management of severe acute malnutrition for children; principal consideration in outpatient therapeutic program in context of Ethiopia -Review

2016 ◽  
Vol 5 (1) ◽  
pp. 53 ◽  
Author(s):  
Mulugeta Kabalo
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Therapeutic Program ◽  
Outpatient Therapeutic Program

scholarly journals Factors associated with child survival in children admitted to outpatient therapeutic program at public health institutions in Afar Regional State, Ethiopia: a prospective cohort study

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Misgan Legesse Liben ◽  
Abel Gebre Wuneh ◽  
Reda Shamie ◽  
Kiros G/her
Keyword(s):  
Public Health ◽  
Vitamin A ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Vitamin A Supplementation ◽  
Therapeutic Program ◽  
Regional State ◽  
Public Health Institutions ◽  
Health Institutions ◽  
Outpatient Therapeutic Program

Abstract Introduction About 20 million children suffer from severe acute malnutrition each year. The World Health Organization recommends the outpatient therapeutic program as a standard treatment protocol for the management of uncomplicated severe acute malnutrition and for children who are transferred from inpatient cares after recovery. This study aimed to assess the treatment outcome of severe acute malnutrition and determinants of survival in children admitted to outpatient therapeutic program at public health institutions, Afar Regional State. Methods Institution-based prospective cohort study was conducted on 286 children aged 6–59 months admitted to the outpatient therapeutic program, from April to September 2017, at selected public health institutions in Afar Regional State. For the comparison of time to recovery among the different groups of children on the outpatient therapeutic program, Kaplan-Meir curve was used and significance test for these differences was assessed by the log-rank test. Then, a proportional hazard in the Cox model was used to identify independent predictors of survival. p value < 0.05 was considered significant. Results Of 286 children, 238 (83.2%; 95% CI (79, 88)), 18 (6.3%), 14 (4.9%), 8 (2.8%), and 8 (2.8%) cases were cured, defaulters, non-responder, died, and transfer to inpatient care, respectively. The overall mean rate of weight gain was 10.5(± 3.45) g/kg/day, and mean length of stay was 44.15(± 8.77) days. The recovery rate of children whose mothers travel less than 2 h to the health institution was about three times (AHR, 2.91; 95% CI (2.18, 3.88)) higher than children whose mothers travel 2 h and above. Compared with children who received vitamin A supplementation, children who lack supplementation were less likely (AHR, 0.39; 95% CI (0.25, 0.59)) to be cured. Moreover, the rate of recovery from outpatient therapeutic program among children who received antibiotics was about 1.4 times (AHR, 1.38; 95% CI (1.01, 1.89)) higher compared with children who did not receive of antibiotics. Conclusion This study showed that nearly eight children in every ten had recovered from severe acute malnutrition. Therefore, considering the distance of health facility from children’s residence, improving vitamin A supplementation and antibiotics are vital in improving the rate of recovery. Further research is also required to identify and address barriers to the provision of antibiotics and vitamin A supplementation.

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.

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