Nutrition and Dietary Supplements (Sep 2020)
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
Abstract
Yonatan Eshete Ashine,1 Belete Achamyelew Ayele,2 Yared Asmare Aynalem,3 Getachew Yideg Yitbarek4 1Department of Nutrition, North Wollo Zone Health Office, Amhara Regional Health Bureau, Woldia, Ethiopia; 2Wogeda Primary Hospital, Amhara Regional Health Bureau, South Gondar, Ethiopia; 3Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Birhan, Ethiopia; 4Department of Biomedical Sciences (Medical Physiology), College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Yonatan Eshete Ashine; Getachew Yideg Yitbarek Email [email protected]; [email protected]: 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.Keywords: censored, malnutrition, predictors, time to death, Ethiopia
