Treatment Outcome and Associated Factors of Acute Malnutrition Among Children in the Therapeutic Feeding Center of Public Hospitals in Addis Ababa, Ethiopia: An Institutional-Based Cross-Sectional Study

Abstract

Background

Severe acute malnutrition is the most prevalent reason for admission to a pediatric unit, and it is a leading cause of mortality in many countries, including Ethiopia, at 25% to 30%, where it affects both developed and developing countries. The objective of this study was to assess treatment outcomes and associated factors among children aged 6–59 months with severe acute malnutrition.

Methods

A cross-sectional study was conducted using secondary data from medical records of patients enrolled in the therapeutic feeding center from January 2016 to March 2019. There were 385 samples collected at 3 public referral hospitals in Addis Ababa, which were selected by simple random sampling. A structured questionnaire was used to collect data from the available individual folders and registers. The data analysis was performed using binary and multivariable logistic regression models. The odds ratio with 95% CI was used to identify predictor variables. Variables that have a p-value <0.05 were considered significant.

Results

Children who had tuberculosis were 79% less likely to recover than those who had no tuberculosis. In this study, deaths accounted for 9.1%, recovered were 72.2%, and defaulters accounted for 11.6% with a mean length of stay of 18.6 (CI: 16.9, 20.2) days and an average weight gain of 7.2 g/kg/day (CI: 5.7, 8.2).

Conclusion

Treating comorbidities on time can help children to recover early and reduce readmission. Integration of severe acute malnutrition screening into all service delivery points can help early identification and treatment. In the meantime, treating them with ready-to-use therapeutic feeding has a significant change in recovery.

Keywords:

• severe acute malnutrition
• length of hospital stay
• treatment outcome
• Ethiopia

Ethics Approval

Ethical clearance was based on Helsinki declaration obtained from the SPHMMC’s institutional review board with reference Number of P.M.23/586 and Addis Ababa city Government health bureau with a reference number of A/A/H/B 317/227. As the study was conducted through a review of records, no consent was obtained from the mothers or caregivers of the study subjects. No personal identifiers were used to collect the data to maintain confidentiality. All medical records and individual charts were made as per the regular practice of the pediatric ward department.

Acknowledgments

We appreciate the devotion and commitment of the medical directors, chief executive officers, card room officials, data collectors, and supervisors of Yekatit12 hospital medical college, Minillik II referral hospital, and Zewditu Memorial hospital in providing data. We appreciate the technical assistance provided by Saint Paul’s Hospital Millennium Medical College.

Author Contributions

All authors made substantial contribution to the work reported conception and study design, execution, acquisition of data, or analysis and interpretation of data; took part in drafting the article, critically reviewing for important intellectual content; gave final approval of the version to be published, have agreed on the journal to which the article was submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors declare no competing interests in this work.