Recovery rate and associated factors of children age 6 to 59 months admitted with severe acute malnutrition at inpatient unit of Bahir Dar Felege Hiwot Referral hospital therapeutic feeding unite, northwest Ethiopia

PLoS ONE
Q1
Feb 2017
Citations:69
Influential Citations:13
Observational Studies (Human)
83
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Enhanced Details

Methods
Hospital-based cross-sectional study using retrospective record review; 401 children aged 6–59 months with severe acute malnutrition admitted to Felege Hiwot Therapeutic Feeding Unit, Bahir Dar, Northwest Ethiopia, from September 2012 to January 2016.
Intervention
Phase I: F75 milk therapeutic food (130 ml per feed, ~100 kcal) six times daily; transition to Phase II using F100 diluted to match Phase I total quantity; Phase II: F100 given as tolerated with added diet until weight-for-height >85% and edema-free for 10 consecutive days; F100 can be prepared by diluting one large package in 2 L water or one small package in 500 mL water. Supplements during TFU include Vitamin A (routine), Folic acid, Iron, Zinc (for diarrhea), Deworming, and Vitamin D (special medication).
Results
Recovery rate was 58.4% (234/401; 95% CI 53.1–64.1); mean recovery time 18 days (SD 6.3). Recovery odds were higher with full vaccination (AOR 4.12; 95% CI 1.64–10.35) or partial vaccination (AOR 7.16; 95% CI 1.97–25.25), female sex (AOR 1.86; 95% CI 1.11–3.11), and each 1 cm increase in MUAC (AOR 1.44; 95% CI 1.09–1.90); longer length of stay increased recovery odds (AOR 1.09 per day; 95% CI 1.05–1.12). Edema (AOR 0.46; 95% CI 0.22–0.95), co-morbidity at admission (AOR 0.16; 95% CI 0.05–0.51), HIV/AIDS (AOR 0.12; 95% CI 0.03–0.41), and TB (AOR 0.13; 95% CI 0.04–0.35) reduced recovery odds; Vitamin A as routine medication increased recovery (AOR 2.84; 95% CI 1.41–5.72). Recovery rate remains below SPHERE standard (>75%). To improve outcomes, implement targeted interventions addressing co-morbidity (HIV/TB), edema, vaccination, MUAC at admission, and Vitamin A supplementation, and optimize length of stay.
Limitations
Retrospective hospital-based study using secondary records; potential missing/incomplete data; inability to account for essential covariates; single-site study; limited generalizability.

Abstract

Background Despite numerous advances made in improving child health and the clinical management protocols for treating severe acute malnutrition at treatment centers, evidences concerning the treatment outcomes are scarce. Therefore, this study was c...