Dataset Information

Treatment outcomes among children admitted stabilization centers in Eastern Ethiopia: retrospective study.

ABSTRACT:

Background

There is improved access to Sever Acute Malnutrition management in Ethiopia; however, studies have revealed an alarming rate of defaulters' poor recovery and deaths, emphasizing the importance of researching to identify major causes. As a result, the goal of this research is to identify treatment outcome determinants and associated factors in severely malnourished children aged 6-59 months admitted to public hospitals in Eastern Ethiopia's stabilization centers.

Methods

This study used an institutional-based retrospective cohort study design with 712 children aged 6 to 59 months. Data was gathered using a Sever Acute Malnutrition registration logbook and patient charts. Participants were chosen at random from their respective healthcare facilities based on population proportion. Epi-data was entered and analyzed using STATA version 14. To identify associated factors, the Cox proportional hazard Ratio was calculated, and a p-value of 0.05 at the 95% confidence interval was considered statistically significant.

Results

This study revealed that only 70.65% (95% CI = 67.19, 73.88) of the children were cured while 17.84% defaulted from the management and 5.90% died. Children who did not have tuberculosis (AHR = 1.58, 95%CI:1.04, 2.40), anemia (AHR = 1.31, 95% CI:1.03, 1.68), Kwash dermatosis (AHR = 1.41, 95%CI:1.04, 1.91), or on NG-tube (AHR = 1.71, 95%CI:1.41, 2.08) were more likely to be cured from SAM.

Conclusion

This study discovered that the cure rate is extremely low and the defaulter rate is extremely high. As a result, intervention modalities that address the identified factor are strongly recommended to accelerate the rate of recovery in Eastern Ethiopia.

SUBMITTER: Ahmed JA

PROVIDER: S-EPMC10392950 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Treatment outcomes among children admitted stabilization centers in Eastern Ethiopia: retrospective study.

Ahmed Jemal Abrahim JA Yusuf Newas N Wilfong Tara T Tukeni Kedir Negesso KN Berhanu Hiwot H Roba Kedir Teji KT

Frontiers in public health 20230718

<h4>Background</h4>There is improved access to Sever Acute Malnutrition management in Ethiopia; however, studies have revealed an alarming rate of defaulters' poor recovery and deaths, emphasizing the importance of researching to identify major causes. As a result, the goal of this research is to identify treatment outcome determinants and associated factors in severely malnourished children aged 6-59 months admitted to public hospitals in Eastern Ethiopia's stabilization centers.<h4>Methods</h4 ...[more]

PMID: 37533525

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Project description:BACKGROUND:In spite of the availability of guidelines for the management of severe acute malnutrition (SAM) in Ethiopia, high comorbidity and poor treatment outcomes are still observed in therapeutic feeding centers among under -five children with SAM. The aim of this study was to assess comorbidity, treatment outcomes and factors affecting the recovery rate of children aged 1-59?months with SAM admitted into Therapeutic Feeding Centers (TFCs). METHODS:A total of 413 records of children with SAM admitted in three selected hospitals from July 2013 to July 2015?G.C were retrospectively reviewed. Descriptive analysis was used to compare performance indicator values with SPHERE project reference standards (the minimum standard to be attained during nutritional therapy). Cox-proportional hazard regression analysis was performed to estimate the predictors of recovery rate at p-value <?0.05. RESULT:The mean age of children was 16?months (95% CI, 15.0, 17.0). Out of 413 children with SAM, 231 (55.9%) recovered, 24 (5.8%) died and 16.3% were defaulted from TFCs. The mean weight gain (in gram per weight of kilogram per day) for recovered children was 15.61?g/kg/day (95% CI, 14.15, 17.07). The overall median recovery time for these children was 12?days (95% CI, 11.22, 12.78). Moreover, most (77.5%) of children admitted with SAM were marasmic followed by Kwash (16%). Pneumonia (54.8%), diarrhea (41.8%) and rickets (21.4%) were co-morbidities which affected SAM children. A child being admitted at Mehal Meda Hospital (Adjusted Hazard Ratio (AHR)?=?2.01; 95% CI: 1.34, 2.91), edematous form of malnutrition (AHR?=?0.59; 95% CI: 0.39, 0.90) and being a child infected with pneumonia (AHR?=?0.71; 95% CI: 0.51, 0.98) were predictors of nutritional recovery rate. CONCLUSION:Under five pneumonia, diarrhea and rickets were co-morbidities that should be prevented. Recovery rate was poor when compared to SPHERE project reference value (which is >?75%). Predictors, namely presence of pneumonia and edematous form of malnutrition reduced nutritional recovery rate. Whereas, being admitted at Mehal Meda Hospital improved recovery rate. Therefore, hospitals should work in collaboration with health extension workers to prevent co-morbidities and strengthen screening and referral of malnutrition cases at community level. Moreover, Zonal Health Department and District Health Offices should facilitate experience sharing among health facilities.

Project description:ObjectiveThis study aims to assess the survival status and predictors of mortality among under-5 children with severe acute malnutrition in Addis Ababa, Ethiopia.DesignA retrospective cohort study was employed on randomly selected 422 medical records of children under the age of 5 admitted to stabilisation centres in Addis Ababa, Ethiopia. Survival analysis and Cox regression analysis were conducted to determine time spent before the outcome and predictors of desired outcome.SettingsThe stabilisation centres in four governmental hospitals in Addis Ababa, Ethiopia: Tikur Anbessa Specialised Hospital, Zewditu Memorial Hospital, Yekatit 12 Hospital and Tirunesh Beijing Hospital PARTICIPANTS: Of 435 severely malnourished children under the age of 5 admitted to four governmental hospitals in Addis Ababa, Ethiopia, from January 2020 to December 2022, we were able to trace 422 complete records. The remaining 13 medical records were found to be incomplete due to missing medical history information for those children.Primary and secondary outcome measuresThe primary outcome is the survival status of under-5 children with severe acute malnutrition after admission to the stabilisation centres. The secondary outcome is predictors of survival among these children.ResultsOf 422 children, 44 (10.4%) died, with an incidence rate of 10.3 per 1000 person-days. The median hospital stay was 8 days. Full vaccination (adjusted HR (AHR) 0.2, 95% CI 0.088 to 0.583, p<0.05), feeding practices (F-75) (AHR 0.2, 95% CI 0.062 to 0.651, p<0.01), intravenous fluid administration (AHR 3.7, 95% CI 1.525 to 8.743, p<0.01), presence of HIV (AHR 2.2, 95% CI 1.001 to 4.650, p<0.05), pneumonia (AHR 2.2, 95% CI 1.001 to 4.650, p<0.01) and occurrence of shock (AHR3.5, 95% CI 1.451 to 8.321, p<0.01) were identified as significant predictors of mortality.ConclusionThe study identified a survival rate slightly higher than the acceptable range set by the social and public health economics study group. Factors like vaccination status, HIV, pneumonia, shock, intravenous fluid and the absence of feeding F-75 predicted mortality.

Project description:BackgroundPoisoning is a global public health problem that has more unfavorable outcomes in developing countries. This study aimed to assess treatment outcomes and associated factors among poisoned patients treated at Saint Peter Specialized Hospital Toxicology Center.MethodsAn institutional-based retrospective cohort study was employed by reviewing medical chart records of acutely poisoned patients who had been admitted at St. Peter Specialized Hospital Toxicology Center on 01/01/2017 to 30/12/2023 and the medical chart records review was employed from 01/01/2024 to 30/01/2024. This study analyzed records of 553 poisoned patients. A systematic random sampling technique was used to select the study unit. Data were entered and analyzed using Statistical Package for Social Sciences (SPSS) Windows version 26. A binary logistic regression model was used to identify associated factors for treatment outcomes of poisoned patients. A p-value <0.05 was considered statistically significant.ResultA total of 553 documents of poisoned patients were assessed. The overall mortality rate was 18 (3.25%), and four patients developed chronic complications. Factor analyses show that arrival to the center before 4 h (AOR = 0.43, P = 0.008) predicted recovery, whereas arrival at the toxicology center after 8 h (AOR = 2.21, P = 0.004), being hypotensive (AOR = 1.85, P = 0.002), needing intubation (AOR = 2.52, P = 0.014), and the presence of two or more complication (AOR = 3.3, P < 0.001) at admission were predictors of mortality.Conclusion and recommendationThe mortality rate for poisoned patients was 18 (3.25%). In this study, delayed arrival to the toxicology center, being hypotensive, needing intubation, and the presence of two or more complications at admission were factors associated with the mortality and morbidity of the patients. Establishing a strong referral link between the toxicology center and regional health institutions, ensuring the availability of possible advanced clinical setup early recognition, and aggressively resuscitating critically ill patients will help minimize unfavorable outcomes.

Project description:IntroductionAcute poisoning causes morbidity and mortality worldwide. There is scarce of information on acute poisoning in the study area.ObjectiveTo assess treatment outcome and the associated factors among patients admitted with acute poisoning at Hiwot Fana Comprehensive Specialized Hospital, Eastern Ethiopia.MethodsA cross-sectional study was conducted. All acutely poisoned patients who had been admitted at the emergency department of Hiwot Fana Comprehensive Specialized Hospital from 1 January 2016 to 31 December 2020 who fulfilled the inclusion criteria of the study were included. Data were collected by review of medical records. Poor treatment outcome of acute poisoning was defined as the acutely poisoned patient was died, or survived with disability. Multivariate logistic regression analysis was used to determine factors associated with the outcome of acute poisoning.ResultA total of 175 patient's medical records were reviewed. Of these, 150 patient's medical records had complete information and were included in the final analysis. The majority of participants 89 (59.3%) were in the age group of 19-37 years. More than half of the participants 86 (57.3%) were females. Organophosphate was the most poisoning agent encountered in 62 cases. Acetaminophen was the predominant drug poisoning agent encountered in 10 participants. Among 30 patients managed with antidote, 18 patients were treated with atropine for organophosphate poisoning. Of all the poisoning cases admitted during the study period, 16.7% died. Participants who were poisoned by themselves were 2.4 times more likely to have poor treatment outcomes than those who were poisoned accidentally: 2.44 (95% confidence interval: 1.10-5.42). The odd of having poor treatment outcome in participants who were poisoned by drugs was 2.13 more likely: 2.13 (95% confidence interval: 1.21-3.32).ConclusionOrganophosphate was the predominant cause of acute poisoning encountered in 62 cases. The modes of poisoning and drug poisoning were significant risk factors associated with poor treatment outcomes of acute poisoning.

Dataset Information

Treatment outcomes among children admitted stabilization centers in Eastern Ethiopia: retrospective study.

Background

Methods

Results

Conclusion

Publications

Treatment outcomes among children admitted stabilization centers in Eastern Ethiopia: retrospective study.

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