Survival Status and Its Associated Factors among Under-Five Children Admitted with Complicated Severe Acute Malnutrition in Hospitals of Wolaita Zone, South Ethiopia: Retrospective Cohort Study

Abstract

Background: Complicated severe acute malnutrition is the common reason for pediatric hospital admission in many poor countries, which pauses additional burden on limited resources. In hospitals, it remains poorly managed which led to mortality rate of under-five children became higher than the acceptable level as different studies revealed. However, survival status and its associated factors for complicated severe acute malnutrition were yet not get attention to halt its sequels. Objective: This study aims at assessing survival status and its associated factors among under-five children admitted with complicated severe acute malnutrition to stabilization centers of Hospitals in Wolaita Zone. Method: A retrospective cohort study comprised of 340 under-five children admitted for treatment of complicated severe acute malnutrition in two hospitals of Wolaita Zone in past 39 months. From the study period, the data were collected using the structured checklist, then entered and cleaned by Epi info version 3. 5. 4 and analyzed by SPSS version 20. Descriptive statistics was used to summarize child characteristics and treatment outcomes; cure rate, death rate, defaulters, and non-responders. Variables that were having P-value < 0.25 in bivariate analysis were entered into a multivariable Cox-proportional regression model to identify the predictors of mortality. Level of statistical significance was declared at p-value < 0.05. Results: From a total of 30 deaths occurred at SC 13, 8, and 6 deaths occur within 72 hours, 4-6 days and 7-9 days after admission respectively. The majority of death 63.3 % occurred in children age < 12 months and the same magnitude 10 % for 13-24 and 23-36 months of age groups. Being septic at admission with their respective 95 % confidence interval were 2.9(1.03, 8.40), being hypothermic 11.8(3.77, 37.02) and not giving antibiotics at admission 3.7(1.55, 8.64) were an independent predictors of death. Conclusion: Preventing hypothermia, treating sepsis and providing antibiotics at admission has a major effect in saving the life of children with complicated severe acute malnutrition in the stabilization centers. Thus, special attention should be gven for children with hypothermia, sepsis and provision of antibiotics for further reduction of death within the first few days of admission is faramaunt important.