Predictors of Recovery from Complicated Severe Acute Malnutrition among Children 6-59 Months Admitted at Mbale Hospital, Uganda

Introduction: In Uganda, 300,000 children under 5 years are acutely malnourished with 1.3% suffering from Severe Acute Malnutrition (SAM). Mbale Regional Referral hospital (MRRH) nutrition unit admits SAM children with comorbidities into inpatient care striving to ensure recovery, reduce morbidity a...

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Main Authors: Magdalene Akos Odikro, Michael Ediau, Angela Nakanwagi Kisakye, Fiston Muneza, George Kiwanuka, Henry Wamani
Format: Article
Language:English
Published: African Field Epidemiology Network 2021-03-01
Series:Journal of Interventional Epidemiology and Public Health
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Online Access:https://www.afenet-journal.net/content/article/4/5/full/
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author Magdalene Akos Odikro
Michael Ediau
Angela Nakanwagi Kisakye
Fiston Muneza
George Kiwanuka
Henry Wamani
author_facet Magdalene Akos Odikro
Michael Ediau
Angela Nakanwagi Kisakye
Fiston Muneza
George Kiwanuka
Henry Wamani
author_sort Magdalene Akos Odikro
collection DOAJ
description Introduction: In Uganda, 300,000 children under 5 years are acutely malnourished with 1.3% suffering from Severe Acute Malnutrition (SAM). Mbale Regional Referral hospital (MRRH) nutrition unit admits SAM children with comorbidities into inpatient care striving to ensure recovery, reduce morbidity and mortality. We assessed the incidence and predictors of time to recovery among SAM children admitted as inpatients in MRRH nutrition unit. Methods: We reviewed records of children 6-59 months old managed at the inpatient unit for SAM at MRRH from 2013 to 2016. Data on patient demographics, comorbidities, medications administered, and treatment outcomes were collected from the integrated nutrition register and patient charts. Recovery incidence was determined using Kaplan Meier survival analysis. Cox proportional hazards regression competing risks model with death, default and transfer as competing risks was fit to identify predictors of time to recovery. Results: Overall, 322 patient records were reviewed of which 183 (56.8%) were males with median age of 19 months (IQR; 14-26 months). Of these, 246 (76.4%) recovered with recovery incidence of 31.3 per 1000 person days and a median recovery time of 27 days (IQR; 16-38 days). Children with SAM who were dewormed during treatment were 33% more likely to recover faster compared to their counterparts who were not dewormed (AHR= 1.33; C.I = 1.01-1.74). Conclusion: Recovery was in acceptable range of Sphere standards and deworming was a predictor of time to recovery. The Uganda Ministry of health should ensure nutritional rehabilitation units follow the stipulated guidelines for management of SAM. Findings were limited by missing data.
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spelling doaj-art-68d4daec5b5c4685ad22567b645786172025-08-20T03:13:03ZengAfrican Field Epidemiology NetworkJournal of Interventional Epidemiology and Public Health2664-28242021-03-0141https://doi.org/10.37432/jieph.2021.4.1.34Predictors of Recovery from Complicated Severe Acute Malnutrition among Children 6-59 Months Admitted at Mbale Hospital, UgandaMagdalene Akos Odikro0Michael Ediau1Angela Nakanwagi Kisakye2Fiston Muneza3George Kiwanuka4Henry Wamani5School of Public Health, College of Health Sciences Makerere University, P.O Box 7072, Kampala, Uganda; Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), Department of Epidemiology and Disease Control, University of GhanaSchool of Public Health, College of Health Sciences Makerere University, P.O Box 7072, Kampala, Uganda; Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA; Division of Global Public Health, Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, San Diego, CA, USASchool of Public Health, College of Health Sciences Makerere University, P.O Box 7072, Kampala, Uganda; African Field Epidemiology Network (AFENET), Lugogo House Plot 42, Lugogo Bypass, P.O Box 12874, Kampala, UgandaSchool of Public Health, College of Health Sciences Makerere University, P.O Box 7072, Kampala, UgandaSchool of Public Health, College of Health Sciences Makerere University, P.O Box 7072, Kampala, UgandaSchool of Public Health, College of Health Sciences Makerere University, P.O Box 7072, Kampala, UgandaIntroduction: In Uganda, 300,000 children under 5 years are acutely malnourished with 1.3% suffering from Severe Acute Malnutrition (SAM). Mbale Regional Referral hospital (MRRH) nutrition unit admits SAM children with comorbidities into inpatient care striving to ensure recovery, reduce morbidity and mortality. We assessed the incidence and predictors of time to recovery among SAM children admitted as inpatients in MRRH nutrition unit. Methods: We reviewed records of children 6-59 months old managed at the inpatient unit for SAM at MRRH from 2013 to 2016. Data on patient demographics, comorbidities, medications administered, and treatment outcomes were collected from the integrated nutrition register and patient charts. Recovery incidence was determined using Kaplan Meier survival analysis. Cox proportional hazards regression competing risks model with death, default and transfer as competing risks was fit to identify predictors of time to recovery. Results: Overall, 322 patient records were reviewed of which 183 (56.8%) were males with median age of 19 months (IQR; 14-26 months). Of these, 246 (76.4%) recovered with recovery incidence of 31.3 per 1000 person days and a median recovery time of 27 days (IQR; 16-38 days). Children with SAM who were dewormed during treatment were 33% more likely to recover faster compared to their counterparts who were not dewormed (AHR= 1.33; C.I = 1.01-1.74). Conclusion: Recovery was in acceptable range of Sphere standards and deworming was a predictor of time to recovery. The Uganda Ministry of health should ensure nutritional rehabilitation units follow the stipulated guidelines for management of SAM. Findings were limited by missing data.https://www.afenet-journal.net/content/article/4/5/full/severe acute malnutritionwastingdeworminghealth outcomestreatment outcomeugandaincidencequantitative methods
spellingShingle Magdalene Akos Odikro
Michael Ediau
Angela Nakanwagi Kisakye
Fiston Muneza
George Kiwanuka
Henry Wamani
Predictors of Recovery from Complicated Severe Acute Malnutrition among Children 6-59 Months Admitted at Mbale Hospital, Uganda
Journal of Interventional Epidemiology and Public Health
severe acute malnutrition
wasting
deworming
health outcomes
treatment outcome
uganda
incidence
quantitative methods
title Predictors of Recovery from Complicated Severe Acute Malnutrition among Children 6-59 Months Admitted at Mbale Hospital, Uganda
title_full Predictors of Recovery from Complicated Severe Acute Malnutrition among Children 6-59 Months Admitted at Mbale Hospital, Uganda
title_fullStr Predictors of Recovery from Complicated Severe Acute Malnutrition among Children 6-59 Months Admitted at Mbale Hospital, Uganda
title_full_unstemmed Predictors of Recovery from Complicated Severe Acute Malnutrition among Children 6-59 Months Admitted at Mbale Hospital, Uganda
title_short Predictors of Recovery from Complicated Severe Acute Malnutrition among Children 6-59 Months Admitted at Mbale Hospital, Uganda
title_sort predictors of recovery from complicated severe acute malnutrition among children 6 59 months admitted at mbale hospital uganda
topic severe acute malnutrition
wasting
deworming
health outcomes
treatment outcome
uganda
incidence
quantitative methods
url https://www.afenet-journal.net/content/article/4/5/full/
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