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- Title
Evaluation of outpatient therapeutic programme ( OTP) for treatment of severe acute malnutrition in Yemen: a focus on treatment default and its risk factors.
- Authors
Al Amad, Mohammed; Al‐Eryani, Lina; Al Serouri, Abdulwahed; Khader, Yousef S.
- Abstract
Objectives This study aimed to measure the treatment default rate among children with severe acute malnutrition (SAM) who were admitted to the outpatient therapeutic programme (OTP) in Yemen and determine its risk factors. Methods A prospective study was conducted among children with SAM who were newly admitted to the 11 OTPs in primary health centres of Sana'a city. A pretested semistructured questionnaire was used for data collection at admission and at after 2 months of admission to the OTP. Univariate and multivariate analysis using binary logistic regression were used to analyse the risk factors of treatment default. Results This study included 339 SAM children. Of those, 186 (55%) children discharged as defaulters, 141 (42%) were cured, and 12 (3%) were transferred to other treatment sites. Many factors related to poor accessibility, poor satisfaction with staff and system, and treatment and acceptability of OTP services factors were significantly associated with treatment default. Having difficulty to attend OTP every week (OR 8.4), unavailability of medication during follow-up visits (OR 5.0), not liking to eat Plumpy'Nut (OR 5.8), and not gaining weight since the start of treatment (OR 9.3) were the strongest predictors of treatment default. Conclusions This study showed a high default rate among SAM children in Sana'a city. Factors related to poor accessibility, poor satisfaction with staff and system, and factors related to treatment and acceptability of OTP services were significantly associated with high default rate. Expansion of OTP services and training OTPs staff on SAM treatment protocols are highly recommended.
- Subjects
YEMEN (Republic); HOSPITAL medical staff; MALNUTRITION; HEALTH services accessibility; HOSPITAL admission &; discharge; OUTPATIENT services in hospitals; LONGITUDINAL method; MEDICAL appointments; MULTIVARIATE analysis; PATIENT satisfaction; PATIENTS; PRIMARY health care; QUESTIONNAIRES; RISK assessment; STATISTICS; WEIGHT gain; LOGISTIC regression analysis; TREATMENT delay (Medicine); ODDS ratio; CHILDREN; EDUCATION
- Publication
Journal of Evaluation in Clinical Practice, 2017, Vol 23, Issue 6, p1361
- ISSN
1356-1294
- Publication type
Article
- DOI
10.1111/jep.12798