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- Title
Time to Death and its Predictor Among Children Under Five Years of Age with Severe Acute Malnutrition Admitted to Inpatient Stabilization Centers in North Shoa Zone, Amhara Region, Ethiopia.
- Authors
Ashine, Yonatan Eshete; Ayele, Belete Achamyelew; Aynalem, Yared Asmare; Yitbarek, Getachew Yideg
- Abstract
Background: Severe acute malnutrition (SAM) is the leading cause of child mortality in developing nations. In Ethiopia, despite the presence of clinical management protocols, under-five mortality is still high. Moreover, many of the predictors for mortality during inpatient care were not well addressed. Therefore, the aim of the current study was to determine the time to death and its predictors among children under five with severe acute malnutrition. Patients and Methods: A 48-month retrospective cohort study was carried out among 346 children under five from 6 to 59 months of SAM. Data were collected from patient charts by using simple random sampling and entered in EpiData 3.1 and analyzed with STATA 14. A Kaplan–Meier curve and long rank test were used to estimate the survival time and compare survival curves between variables. A Cox proportional hazard model was fitted to identify predictors. Variable with P-value < 0.05 with 95% confidence interval was considered as significant for this study. Results: A total of 346 children were followed with an incidence rate of 5.5 deaths per 1000 person-day observation (95%CI: 3.5– 8.5). During the follow-up, 212 (61%) were males, 20 (5.8%) had died. This study also showed that males were nearly twice as likely to die than females. Sepsis (AHR: 1.62; 95%CI: 1.10– 2.37), hospital admission (AHR: 2.29; 95%CI: 1.43– 3.65), presence of edema, (AHR: 1.81; 95%CI: 1.2– 2.19), TB (AHR: 1.62; 95%CI: 1.10– 2.37) and breast feeding (AHR: 0.41; 95%CI: 0.29– 2.37) were predictors of mortality. Conclusion: The overall mean survival time and death was in line with the minimum SPHERE standard. The main predictors of death were having edema, sepsis, hospital admission and breast feeding status at admission. Therefore, it should be better to treat patients with TB, sepsis, edema according to SAM national protocol and promote breast feeding practice.
- Subjects
ETHIOPIA; MALNUTRITION; CHILD mortality; PROPORTIONAL hazards models; INPATIENT care; BREASTFEEDING; DEVELOPING countries
- Publication
Nutrition & Dietary Supplements, 2020, Vol 12, p167
- ISSN
1179-1489
- Publication type
Article
- DOI
10.2147/NDS.S249045