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Mortality and morbidity trends and predictors of mortality in under-five children with severe acute malnutrition in Hadiya zone, South Ethiopia: a four-year retrospective review of hospital-based records (2012-2015).

ABSTRACT: Background:Severe acute malnutrition remains one of the most common causes of morbidity and mortality in Sub-Saharan Africa. The objective of this study was to investigate morbidity and mortality trends and factors associated with mortality of under-five children admitted and managed for severe acute malnutrition in NEMMH. Methods:Four years retrospective cohort study was conducted on 500 under-five children admitted with the diagnosis of severe acute malnutrition. The study population was all under- five children admitted to the inpatient nutrition unit between 2012 and 2015. Data was entered using Epi-Data version 3.1 and exported to SPSS version 16 for analysis. A Kaplan- Meier curve was also used to estimate survival probability of different types of severe acute malnutrition. Cox proportional hazards regression was used to predict the risk of death among predictor while adjusting for other variables. A P-value less than 0.05 was considered as statistically significant. Result:A total of 500 children were enrolled into the study. Kwashiorkor was the most frequently recorded morbidity accounting for 43.0%. Pneumonia was seen the commonest form of comorbid disease. It was the most common co-morbidity across all morbidity groups. (27.6% in kwashiorkor, 37.5% in marasmus and 37.7% in marasmic-kwashiorkor). The average length of stay in the hospital was 11 days.Children with new admission were 86% less likely to die than repeated admission given that the children were admitted to paediatric ward (HR: 0.14, 95% CI: (0.06, 0.35). Kaplan Meier survival curves also showed children with marasmus and those with repeated admission had reduced survival rates. The overall mortality rate was 7%. The mortality trends vary irregularly in each year but morbidity trend increased with admission from 2014 to 2015. Conclusion:Mortality trends of SAM vary irregularly across the years but morbidity trends increased with admission from 2014 to 2015. An admission type was significantly associated with mortality. Morbidity and co-morbid diseases did not show significant effect on mortality of the children. Health extension workers and stakeholders should give due concern on promotion of proper nutrition in a community.

SUBMITTER: Yohannes T

PROVIDER: S-EPMC7050820 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Mortality and morbidity trends and predictors of mortality in under-five children with severe acute malnutrition in Hadiya zone, South Ethiopia: a four-year retrospective review of hospital-based records (2012-2015).

Yohannes Tadele T Laelago Tariku T Ayele Menen M Tamrat Temesgen T

BMC nutrition 20170227

<h4>Background</h4>Severe acute malnutrition remains one of the most common causes of morbidity and mortality in Sub-Saharan Africa. The objective of this study was to investigate morbidity and mortality trends and factors associated with mortality of under-five children admitted and managed for severe acute malnutrition in NEMMH.<h4>Methods</h4>Four years retrospective cohort study was conducted on 500 under-five children admitted with the diagnosis of severe acute malnutrition. The study popul ...[more]

PMID: 32153800

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Project description:BackgroundSevere acute malnutrition is a common cause of morbidity and mortality among under five children in Ethiopia. A child may experience more than one episode of SAM depending on the improvement of the underlying factors. However, there is no study that determined the frequency of relapse of SAM cases after discharge in Ethiopia.ObjectiveTo identify the frequency of relapse and associated factors among children discharged after undergoing treatment for SAM in Hadiya Zone, South, Ethiopia.MethodsAn institution based retrospective cohort study was done among children admitted to health posts for treatment of SAM from 2014/2015-2019/2020 under-five children's after discharge in health post for severe acute malnutrition in the last five years in Hadiya zone, SNNPR, Ethiopia. Both first admission data and relapse data were abstracted from the records of the SAM children from Aguste 1-30 /2020 Using a data collection format. Data were coded and edited manually, then doubly entered into Epi-Data statistical software version 3.1 and then exported to SPSS for windows version 26. After checking all the assumptions finally Negative binomial regression for poison has been used. All tests were two sided and P values <0.05 were used to declare statistical significance.ResultsIn the last five year there were the proportion of relapsed cases were 9.6%, 95% CI: (7.7%, 11.7%) On multivariable negative binomial regression model, after adjusting for background variables relapse of severe acute undernutrition was significantly associated with having edema during admission with (IRR = 2.21, 95% CI:1.303-3.732), being in the age group of 6-11 months (IRR = 4.74,95% CI:1.79-12.53), discharge MUAC for the first admission (P = 0.001, IRR = 0.37, 95% CI:0.270-0.50) increase the risk of incidence rate ratio(IRR) relapse case of severe acute under nutrition.ConclusionFrequency of SAM relapse was positively associated with age, having edema during admission, while it was negatively associated with discharge MUAC. The results imply the need for reviewing the discharge criteria taking into account the recovery of MUAC as a marker for lean tissue accretion, especially in edematous children and those in the younger age.

Project description:BackgroundIn low-income countries out of, 60.7 million unintended pregnancies, 19% of them are subjected to abortion of which 11% of were unsafe. Surprisingly, about 2.5 million occur in women under the age of 20 years. Aim of this study is to measure the level of contraceptive utilization and associated factors among youths in Hosanna town administration.MethodInstitutional based cross-sectional study was conducted in Hossana town administration, Hadiya zone, Southern Ethiopia. A multistage sampling procedure was employed by clustering health facilities into reproductive health clubs and health facilities to select 781 study participants. Data was collected by using structured pre-tested, self-administered questionnaires. All coded and cleaned data were entered into EPI-info version 3.5.1 and it was exported to SPSS version 16.0 for recoding and further analysis.ResultAmong youths who had been sexually active within the last 12 months, 67.6% had used contraceptives prior to the survey. Multivariate analysis was found statistically significant association between contraceptive utilization and education status of mothers who attained university AOR = 4.57 [95% CI (1.29, 16.19)], utilization of sexual and reproductive health services within last 12 months AOR = 2.26 [(95% CI: 1.33, 3.86)], age initiation of first sex between 15-19 year OR = 2.63 [(95% CI 1.48,4.64)], discussion with sexual partner AOR = 1.99 [(95% CI: 1.27, 3.13)], good knowledge on contraceptive advantage AOR = [1.89 (95%CI: 1.07, 3.32)]. Whereas educational status: being secondary level decrease utilization of contraceptives by 51% AOR = 0.49 [95% CI (0.27, 0.94)].Conclusion & recommendationThe findings of our study imply that level of contraceptive utilization is higher than as compared to the previous studies. Discussion with a sexual partner as well as with a spouse, having awareness on contraceptive advantages, early age initiation of sexual intercourse, maternal educational status and getting sexual and reproductive health services recently were identified as predictors of contraceptive utilization.

Project description:BACKGROUND:The utilization of routine health information is an essential factor of the structural capacity of health departments and public health performance depends on the effectiveness of information use for routine and programed decisions. Considerable research has been conducted in health data collection and ways to improve data quality, but little is known about utilization of routine health information among health workers in Ethiopia in general and in the study area in particular. OBJECTIVES:The aim of this study was to assess level of utilization of routine health information and associated factors among health workers in Hadiya zone, Southern Ethiopia, 2019. METHODS AND MATERIALS:Facility-based cross-sectional study design with both quantitative and qualitative data collection methods was employed at the Hadiya zone from March 10-25, 2019. A total of 480 health workers were included in the study and systematic random sampling was employed to select the health care workers in the study. The results were analyzed and presented in tables and graphs. Finally, the binary logistic regression was used to examine independent predictors. RESULT:Good level of utilization of routine health information was reported by 301 (62.7%, 95% CI: 58.5%-66.9%) of the health workers. Training [AOR = 8.12; 95% CI: (4.33-15.23)], supportive supervision [AOR = 2.34; 95% CI:(1.40-3.92)], good perceived culture of health information [AOR = 5.05; 95% CI: (2.99-8.50], having a standard set of indicators (AOR = 2.05 95%; CI: (1.23-3.41) and competence on routine health information tasks [AOR = 5.85; 95% CI: (3.41-10.02)] were independent predictors. CONCLUSION:Good level of utilization of routine health information was noted in less than two-third of the study participants. Further training, supportive supervision, perceived culture of health information, having standard set of indicators and competence on routine health information task were factors that improve routine health information utilization.

Project description:BackgroundThe improvement of various health outcomes, including the reduction of maternal, neonatal, infant, and child mortality as well as the increased use of maternity and newborn health services, was significantly assisted by rural health extension workers. Implementing health extension programs and offering the community high-quality healthcare services requires job satisfaction. In the study area, there has been little research on job satisfaction and related variables. Therefore, the purpose of this study was to evaluate the degree of job satisfaction among rural health extension workers in the Hadiya zone, Southern Ethiopia, as well as associated factors.MethodsA facility-based cross-sectional study was conducted among 262 rural health extension workers from May 30, 2021, to July 02, 2021. A simple random sampling method was used to select six rural districts. Data were gathered utilizing structured interviewer-administered questions and skilled data collectors. EpiData V4.4.1 was used to store the data, and SPSS Version 25 was used for analysis. To determine the relationship between the variables, bivariate and multivariate logistic regressions were used. The association was reported using the adjusted odds ratio (AOR) with a 95% confidence interval (95%CI), and the significance level was set at a p-value of 0.05.ResultsThis study showed that 52.7% of rural health extension workers were satisfied with their jobs. Support from Keble leaders [AOR = 5.3; 95% CI (2.6, 11.1)], on-job training [AOR = 5.7, 95% CI (2.2, 14.9)], supportive supervision [AOR = 4.3; 95% CI (1.7, 10.8)] and reward or recognition [AOR = 7.4, 95% CI (3.0, 18.1)] were factors that associated with job satisfaction of health extension workers.ConclusionAccording to this study, more than half of rural health extension workers were happy with their jobs. Health extension workers' job satisfaction was affected by support from keble leaders, supportive supervision, on-the-job training, and recognition and rewards. In order to increase the happiness of the health extension workers, supporting supervision must be strengthened and the best performers must be recognized.

Project description:Background:Severe acute malnutrition is one of the major public health problems in developing countries having a devastating effect on the lives of many children under 5 years of age. In Ethiopia, there has been isolated studies conducted on malnutrition with no study attempting to identify the determinants of severe acute malnutrition in the rural district of Enebsie Sarmidr.This study intends to identify the determinants of severe acute malnutrition in rural district located in North West Ethiopia. Methods:A Community based un matched case -control study was carried on 311 (64 cases and 247 controls) children aged between birth-59 months with their respective mothers or care takers from March 1-30/ 2016. Odds Ratio along with 95% confidence interval was estimated to identify determinants of severe acute malnutrition using the multivariable logistic regression. Results:The response rate was 97.8%. Severe acute malnutrition was significantly associated with age groups birth-24 months (AOR?=?2.64, 95% CI 1.17-5.95), late initiation of breast feeding greater than an hour after birth (AOR?=?4.26, 95% CI 1.74-10.42), nonexclusive breast feeding (AOR =5.81, 95% CI 1.80-18.79), diarrheal disease in the preceding 2 weeks before SAM (AOR?=?7.98, 95% CI 2.57-24.74), febrile illnesses preceding 2 weeks before SAM (AOR?=?2.87 95% CI 1.13-7.63), decreased or maintained mealing of the mother compared to the regular during pregnancy or lactation (AOR?=?8.15, 95% CI 3.70-17.98) and birth interval less than 2 years (AOR?=?3.34, 95% CI 1.55-7.20) after controlling other variables effect. Conclusion:A child's age, late initiation of breast feeding, nonexclusive breast feeding, diarrheal diseases and febrile illnesses preceding 2 weeks before SAM, decreased or maintained mealing compared to the regular during pregnancy and lactating of the mother and narrow birth interval were identified as determinants of SAM. Therefore, collaborative efforts are needed to improve promotion of better child caring practices specifically, child and maternal feeding practices and prevention and treatment of acute illnesses.

Project description:BACKGROUND:Severe forms of malnutrition have drastic effects on childhood morbidity and mortality in sub-Saharan countries, including Ethiopia. Although few studies have previously estimated treatment outcomes of severe acute malnutrition (SAM) in Ethiopia, the findings were widely varied and inconsistent. This study thus aimed to pool estimates of treatment outcomes and identify predictors of mortality among children with SAM in Ethiopia. METHODS:A systematic review was carried out to select 21 eligible articles from identified 1013 studies (dating from 2000 to 2018) that estimated treatment outcomes and predictors of mortality among SAM children. Databases including PubMed, CINHAL, Web of Sciences; Cochrane, Psych INFO and Google Scholar were comprehensively reviewed using medical subject headings (MESH) and a priori set criteria PRISMA guideline was used to systematically review and meta-analyze eligible studies. Details of sample size, magnitude of effect sizes, including Hazard Ratio (HRs) and standard errors were extracted. Random-effects model was used to calculate pooled estimates in Stata/se version-14. Cochran's Q, I2, and meta-bias statistics were assessed for heterogeneity and Egger's test for publication bias. RESULT:Twenty-one studies were included in the final analysis, which comprised 8057 under-five children with SAM in Ethiopia. The pooled estimates of treatment outcomes, in terms of death, recovery, defaulter and transfer out and non-response rates were 10.3% (95% CI: 8.3, 12.3), 70.5% (95% CI: 65.7, 72.2), 13.8% (95% CI: 10.8, 16.9) and 5.1% (95% CI: 3.3, 6.9), respectively. Diarrhea (HR: 1.5, 95% CI: 1.1, 2.2), dehydration (HR: 3.1, 95% CI: 2.3, 4.2) and anemia (HR: 2.2, 95% CI: 1.5, 3.3) were statistically significant predictors of mortality among these children. No publication bias was detected. CONCLUSION:Treatment outcomes in under-five children with SAM are lower than the World Health Organization (WHO) standard, where mortality is being predicted by comorbidities at admission. Children with SAM need to be treated for diarrhea, dehydration and anemia at the primary point of care to reduce mortality.

Project description:BackgroundDiabetes is one of the biggest worldwide health emergencies of the 21st century. A major goal in the management of diabetes is to prevent diabetic complications that occur as a result of poor glycemic control. Identification of factors contributing to poor glycemic control is key to institute suitable interventions for glycemic control and prevention of chronic complications.MethodsA hospital-based cross-sectional study was conducted among 305 adult type 2 diabetic patients at public hospitals in Hadiya zone from March 1-30, 2019. The study participants were selected by systematic sampling technique. Data were collected using a pretested structured questionnaire and patient chart review; anthropometric and blood pressure measurements were taken. Multivariable logistic regression analysis was used to identify factors associated with poor glycemic control. Adjusted odds ratios (AOR) with respective 95% Confidence Interval (CI) and p < 0.05 were used to set statistically significant variables.ResultsOut of 305 diabetic patients, 222 (72.8%) were found to have poor glycemic control. Longer duration of diabetes (5-10 years) [AOR = 2.24, 95% CI: 1.17-4.27], lack of regular follow-up [AOR = 2.89, 95% CI: 1.08-7.71], low treatment adherence [AOR = 4.12, 95% CI: 1.20-8.70], use of other alternative treatments [AOR = 3.58, 95% CI: 1.24-10.36], unsatisfactory patient physician relationship [AOR = 2.27, 95% CI: 1.27-4.04], and insufficient physical activity [AOR = 4.14, 95% CI: 2.07-8.28] were found to be independent predictors of poor glycemic control. Diabetes Mellitus (DM) complications were slightly higher among participants with poor glycemic control (39.2%), duration of DM 10 and above years (41.9%), low medication adherence (48.5%), taking oral anti-diabetics (54.3%), and DM patients having unsatisfactory patient provider relationship (72.4%).ConclusionA significant proportion of diabetic patients had poor glycemic control and DM complications. Therefore, appropriate interventions are required to maintain optimal glycemic control and prevent the development of life-threatening complications among DM patients.

Dataset Information

Mortality and morbidity trends and predictors of mortality in under-five children with severe acute malnutrition in Hadiya zone, South Ethiopia: a four-year retrospective review of hospital-based records (2012-2015).

Publications

Mortality and morbidity trends and predictors of mortality in under-five children with severe acute malnutrition in Hadiya zone, South Ethiopia: a four-year retrospective review of hospital-based records (2012-2015).

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