Abstract
Background: Severe acute malnutrition (SAM) occurs due to a recent rapid weight loss or failure to gain weight. Despite implementation of comprehensive treatment approaches, mortality attributed to SAM remains high in low-income countries, and little is known about underlying clinical conditions contributing to this in the context of Ethiopia. This study aimed to assess clinical conditions influencing the treatment outcomes of SAM in under-five children in South Ethiopia.
Methods: We conducted an institution-based cross-sectional study by retrospectively reviewing medical records of under-five children admitted with SAM to selected hospitals in South Ethiopia between November, 2017 and November, 2019. Data regarding socio-demographic and clinical characteristics were retrieved from Therapeutic Feeding Unit (TFU) registration logbooks and medical records. Logistic regression was used to determine clinical conditions associated with treatment outcomes of SAM in terms of death and cure. A significant association was determined at a P value of <0.05 with 95% confidence interval. Data were analysed using SPSS version 24.
Results: Of 417 children whose medical records were reviewed, 230 (55%) were male with the majority (66%) of them being in the age group of greater than 24 months. Regarding the outcomes of SAM treatment, 374 (90%) children were cured and 43 (10%) were dead. Admission with hypothermia (AOR: 3.02; CI: 1.33-6.83), tuberculosis infection (AOR: 4.13; CI: 1.78-9.62), anaemia (AOR: 3.25; CI: 1.29-8.20), shock (AOR: 2.88; CI: 1.23-6.72) and dehydration (AOR: 2.93: CI: 1.12-7.69) were independently associated with death due to SAM.
Conclusions: This study revealed the prevalence of SAM associated under-five death above the minimum acceptable standard. Several underlying clinical conditions contributed to the occurrence of death suggesting the need for strengthening management of the conditions.