Treatment outcome and associated factors for severely malnourished children (1–5 years) admitted to Lacor Hospital and Gulu Regional Referral Hospital in Uganda
Globally, severe acute malnutrition (SAM) accounts for >1/3–0⋅5 of deaths in children <5 years, and approximately 54 % deaths in developing countries. The minimum international standard set for the management of SAM is a cure rate of at least 75 % and death rate <10 %. The present study was...
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Cambridge University Press
2021-01-01
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| Series: | Journal of Nutritional Science |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2048679021000112/type/journal_article |
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| author | E. Muwanguzi J. Eros Oboi A. Nabbamba R. Wanyama |
| author_facet | E. Muwanguzi J. Eros Oboi A. Nabbamba R. Wanyama |
| author_sort | E. Muwanguzi |
| collection | DOAJ |
| description | Globally, severe acute malnutrition (SAM) accounts for >1/3–0⋅5 of deaths in children <5 years, and approximately 54 % deaths in developing countries. The minimum international standard set for the management of SAM is a cure rate of at least 75 % and death rate <10 %. The present study was conducted to determine treatment outcome and associated factors among children 1–5 years hospitalised with SAM in Lacor and Gulu Regional Referral Hospital (GRRH) in 2017. A retrospective observational method supplemented with a qualitative inquiry was done. A total of 317 patients’ records were reviewed in either hospital; checklist data were analysed using SPSS version 16 with P-values <0⋅05 considered for statistical significance. The case fatality rate (CFR) was 12⋅6 % (GRRH) and 9⋅5 % (Lacor). The average length of stay (LOS) was 14⋅69 d (GRRH) and 14⋅10 d (Lacor). There was statistical significance between Human Immunodeficiency Virus (HIV) status, blood transfusion, type of SAM, treatment provision at admission, antibiotics, mid-upper arm circumference (MUAC), hospital category and treatment outcome. In total, ten key informants were interviewed and they reported the presence of co-infections and severity of SAM complications as having an important bearing on treatment outcome. A significant proportion of patients were discharged not cured 19⋅9 % (Lacor) v. 16⋅4 % (GRRH). The CFR in GRRH was higher than the WHO recommendation. The LOS in both hospitals was within recommended. These results provide a generalisable problem in most African hospitals and could explain the persistently high rates of SAM in Africa. |
| first_indexed | 2024-04-10T04:43:28Z |
| format | Article |
| id | doaj.art-f084eb85a7f2471cb5f7aa7e60aab3c9 |
| institution | Directory Open Access Journal |
| issn | 2048-6790 |
| language | English |
| last_indexed | 2024-04-10T04:43:28Z |
| publishDate | 2021-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Journal of Nutritional Science |
| spelling | doaj.art-f084eb85a7f2471cb5f7aa7e60aab3c92023-03-09T12:38:45ZengCambridge University PressJournal of Nutritional Science2048-67902021-01-011010.1017/jns.2021.11Treatment outcome and associated factors for severely malnourished children (1–5 years) admitted to Lacor Hospital and Gulu Regional Referral Hospital in UgandaE. Muwanguzi0https://orcid.org/0000-0001-5943-299XJ. Eros Oboi1A. Nabbamba2R. Wanyama3The Infectious Disease Institute, Kampala, UgandaDepartment of Medicine, Gulu University, P.O. Box 166, Gulu, UgandaDepartment of Medicine, Gulu University, P.O. Box 166, Gulu, UgandaDepartment of Biochemistry, Gulu University, P.O. Box 166, Gulu, UgandaGlobally, severe acute malnutrition (SAM) accounts for >1/3–0⋅5 of deaths in children <5 years, and approximately 54 % deaths in developing countries. The minimum international standard set for the management of SAM is a cure rate of at least 75 % and death rate <10 %. The present study was conducted to determine treatment outcome and associated factors among children 1–5 years hospitalised with SAM in Lacor and Gulu Regional Referral Hospital (GRRH) in 2017. A retrospective observational method supplemented with a qualitative inquiry was done. A total of 317 patients’ records were reviewed in either hospital; checklist data were analysed using SPSS version 16 with P-values <0⋅05 considered for statistical significance. The case fatality rate (CFR) was 12⋅6 % (GRRH) and 9⋅5 % (Lacor). The average length of stay (LOS) was 14⋅69 d (GRRH) and 14⋅10 d (Lacor). There was statistical significance between Human Immunodeficiency Virus (HIV) status, blood transfusion, type of SAM, treatment provision at admission, antibiotics, mid-upper arm circumference (MUAC), hospital category and treatment outcome. In total, ten key informants were interviewed and they reported the presence of co-infections and severity of SAM complications as having an important bearing on treatment outcome. A significant proportion of patients were discharged not cured 19⋅9 % (Lacor) v. 16⋅4 % (GRRH). The CFR in GRRH was higher than the WHO recommendation. The LOS in both hospitals was within recommended. These results provide a generalisable problem in most African hospitals and could explain the persistently high rates of SAM in Africa.https://www.cambridge.org/core/product/identifier/S2048679021000112/type/journal_articleDeadDefaultedDischarged curedNot curedSevere acute malnutritionTreatment outcome |
| spellingShingle | E. Muwanguzi J. Eros Oboi A. Nabbamba R. Wanyama Treatment outcome and associated factors for severely malnourished children (1–5 years) admitted to Lacor Hospital and Gulu Regional Referral Hospital in Uganda Journal of Nutritional Science Dead Defaulted Discharged cured Not cured Severe acute malnutrition Treatment outcome |
| title | Treatment outcome and associated factors for severely malnourished children (1–5 years) admitted to Lacor Hospital and Gulu Regional Referral Hospital in Uganda |
| title_full | Treatment outcome and associated factors for severely malnourished children (1–5 years) admitted to Lacor Hospital and Gulu Regional Referral Hospital in Uganda |
| title_fullStr | Treatment outcome and associated factors for severely malnourished children (1–5 years) admitted to Lacor Hospital and Gulu Regional Referral Hospital in Uganda |
| title_full_unstemmed | Treatment outcome and associated factors for severely malnourished children (1–5 years) admitted to Lacor Hospital and Gulu Regional Referral Hospital in Uganda |
| title_short | Treatment outcome and associated factors for severely malnourished children (1–5 years) admitted to Lacor Hospital and Gulu Regional Referral Hospital in Uganda |
| title_sort | treatment outcome and associated factors for severely malnourished children 1 5 years admitted to lacor hospital and gulu regional referral hospital in uganda |
| topic | Dead Defaulted Discharged cured Not cured Severe acute malnutrition Treatment outcome |
| url | https://www.cambridge.org/core/product/identifier/S2048679021000112/type/journal_article |
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