Predictors of Death from Complicated Severe Acute Malnutrition in East Ethiopia: Survival Analysis

Abdu Oumer,1 Leul Mesfin,1 Esubalew Tesfahun,2 Ahmed Ale3 1Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia; 2Department of Public Health, College of Medicine and Health Science, Debre Birhan, University, Debre Birhan, Ethiopia; 3School o...

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Autores principales:	Oumer A, Mesfin L, Tesfahun E, Ale A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	survival pattern predictors time to death severe acute malnutrition hospitals Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/67591c95e0ca4abfbaf6d31f6ccb79c3
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spelling	oai:doaj.org-article:67591c95e0ca4abfbaf6d31f6ccb79c32021-11-23T18:43:01ZPredictors of Death from Complicated Severe Acute Malnutrition in East Ethiopia: Survival Analysis1178-7074https://doaj.org/article/67591c95e0ca4abfbaf6d31f6ccb79c32021-11-01T00:00:00Zhttps://www.dovepress.com/predictors-of-death-from-complicated-severe-acute-malnutrition-in-east-peer-reviewed-fulltext-article-IJGMhttps://doaj.org/toc/1178-7074Abdu Oumer,1 Leul Mesfin,1 Esubalew Tesfahun,2 Ahmed Ale3 1Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia; 2Department of Public Health, College of Medicine and Health Science, Debre Birhan, University, Debre Birhan, Ethiopia; 3School of Medicine, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, EthiopiaCorrespondence: Abdu OumerDepartment of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, EthiopiaEmail omab2320@gmail.comBackground: Severe acute malnutrition (SAM) is still the leading cause of global child morbidity and mortality, with a greater burden in sub-Saharan Africa. A facility-based treatment of SAM demands critical care for improved outcomes and survival of children. However, there is a need to understand predictors for time to death among SAM children for effective interventions.Objective: To assess the predictors of death from complicated severe acute malnutrition among admitted children treated in East Ethiopia.Methods: A 31-month retrospective cohort study was conducted among a total of 665 under-five children admitted with complicated SAM in Dilchora hospital, eastern Ethiopia. The data was extracted from the patient register and medical charts using the kobo tool. The life table, survival, and hazard curves were plotted. Kaplan–Meier with Log rank tests was used to estimate and compare the mean survival time. The bivariable and multivariable Cox proportional hazards models were used to identify predictors of time to death. Crude and adjusted hazard ratios with 95% confidence intervals and p-values were reported.Results: A total of 665 full medical charts were reviewed with a total of 60 (9%; 95% CI: 6.8– 11.2%) deaths were observed, where most of the deaths occurred during the first two weeks of admission, while 74 (11%) and 449 (68%) were cured and recovered (stabilized and transferred to outpatient), respectively. Admitted children having good appetite (AHR=0.15; 95% CI: 0.64– 0.33), pneumonia (AHR=2.46, 95% CI: 1.436, 4.22), diarrhea (AHR=2.16, 95% CI: 1.16, 4.06), tuberculosis (AHR=2.86, 95% CI: 1.08, 7.63) and having a nasogastric tube inserted (AHR=2.33, 95% CI: 1.15, 4.72) were significant predictors of time to death among SAM children.Conclusion: There is unacceptably high under-five mortality due to SAM, which is predicted by co-morbidities (pneumonia, diarrhea, and tuberculosis), with medical complications and nasogastric tubes.Keywords: survival pattern, predictors, time to death, severe acute malnutrition, hospitalsOumer AMesfin LTesfahun EAle ADove Medical Pressarticlesurvival patternpredictors time to deathsevere acute malnutritionhospitalsMedicine (General)R5-920ENInternational Journal of General Medicine, Vol Volume 14, Pp 8763-8773 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	survival pattern predictors time to death severe acute malnutrition hospitals Medicine (General) R5-920
spellingShingle	survival pattern predictors time to death severe acute malnutrition hospitals Medicine (General) R5-920 Oumer A Mesfin L Tesfahun E Ale A Predictors of Death from Complicated Severe Acute Malnutrition in East Ethiopia: Survival Analysis
description	Abdu Oumer,1 Leul Mesfin,1 Esubalew Tesfahun,2 Ahmed Ale3 1Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia; 2Department of Public Health, College of Medicine and Health Science, Debre Birhan, University, Debre Birhan, Ethiopia; 3School of Medicine, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, EthiopiaCorrespondence: Abdu OumerDepartment of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, EthiopiaEmail omab2320@gmail.comBackground: Severe acute malnutrition (SAM) is still the leading cause of global child morbidity and mortality, with a greater burden in sub-Saharan Africa. A facility-based treatment of SAM demands critical care for improved outcomes and survival of children. However, there is a need to understand predictors for time to death among SAM children for effective interventions.Objective: To assess the predictors of death from complicated severe acute malnutrition among admitted children treated in East Ethiopia.Methods: A 31-month retrospective cohort study was conducted among a total of 665 under-five children admitted with complicated SAM in Dilchora hospital, eastern Ethiopia. The data was extracted from the patient register and medical charts using the kobo tool. The life table, survival, and hazard curves were plotted. Kaplan–Meier with Log rank tests was used to estimate and compare the mean survival time. The bivariable and multivariable Cox proportional hazards models were used to identify predictors of time to death. Crude and adjusted hazard ratios with 95% confidence intervals and p-values were reported.Results: A total of 665 full medical charts were reviewed with a total of 60 (9%; 95% CI: 6.8– 11.2%) deaths were observed, where most of the deaths occurred during the first two weeks of admission, while 74 (11%) and 449 (68%) were cured and recovered (stabilized and transferred to outpatient), respectively. Admitted children having good appetite (AHR=0.15; 95% CI: 0.64– 0.33), pneumonia (AHR=2.46, 95% CI: 1.436, 4.22), diarrhea (AHR=2.16, 95% CI: 1.16, 4.06), tuberculosis (AHR=2.86, 95% CI: 1.08, 7.63) and having a nasogastric tube inserted (AHR=2.33, 95% CI: 1.15, 4.72) were significant predictors of time to death among SAM children.Conclusion: There is unacceptably high under-five mortality due to SAM, which is predicted by co-morbidities (pneumonia, diarrhea, and tuberculosis), with medical complications and nasogastric tubes.Keywords: survival pattern, predictors, time to death, severe acute malnutrition, hospitals
format	article
author	Oumer A Mesfin L Tesfahun E Ale A
author_facet	Oumer A Mesfin L Tesfahun E Ale A
author_sort	Oumer A
title	Predictors of Death from Complicated Severe Acute Malnutrition in East Ethiopia: Survival Analysis
title_short	Predictors of Death from Complicated Severe Acute Malnutrition in East Ethiopia: Survival Analysis
title_full	Predictors of Death from Complicated Severe Acute Malnutrition in East Ethiopia: Survival Analysis
title_fullStr	Predictors of Death from Complicated Severe Acute Malnutrition in East Ethiopia: Survival Analysis
title_full_unstemmed	Predictors of Death from Complicated Severe Acute Malnutrition in East Ethiopia: Survival Analysis
title_sort	predictors of death from complicated severe acute malnutrition in east ethiopia: survival analysis
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/67591c95e0ca4abfbaf6d31f6ccb79c3
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Predictors of Death from Complicated Severe Acute Malnutrition in East Ethiopia: Survival Analysis

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