Author:
ssekajja Vincent,Wamani Henry,Kitutu Freddy Eric,Atukwase Abel
Abstract
Abstract
Background
Severe acute malnutrition (SAM) is one of the leading causes of morbidity and mortality among children below five years with sub-Saharan Africa being the most affected. In Kabale district, SAM affects 2.9% children under the age of five. Uganda government introduced Outpatient therapeutic care (OTC) programme in all health centre level III and IV of Kabale. However, there was limited information about the cure rate and its associated factors among children under the programme hence the cause for the study.
Methods
A retrospective cross-sectional study was carried out on records of children 6–59 months (n = 637), presenting with SAM on OTC programme in the health centres of Kabale between 2013 and 2015. Data on cure rate (outcome) and other independent factors were collected, cleaned in excel and then exported into STATA 12 for analysis. Univariate, bivariate and logistic regression analysis was run to generate frequencies and factors associated.
Results
The cure rate was 36.3% (n = 231 cases) with a median recovery time of 21 days. The default rate was 58.6% (n = 373 cases) while the non-response and death rate were 0.6% (n = 4) and 1.1% (n = 7) respectively. Source at admission (Adjusted Odds Ratio [AOR] = 0.1, 95% CI 0.0, 0.7, p = 0.012), Weight at admission (AOR = 0.5, 95% CI 0.0, 0.9, p = 0.014) and Number of visits to the program (AOR = 14.9, 95% CI 9.3, 24.2, p = 0.040) were positively associated with cure rate of SAM children on OTC programme in Kabale.
Conclusion
Overall the cure and default rate for children on OTC programme in Kabale were significantly higher than national and international standards making the findings quite alarming. However, the weight of the child at admission, the number of visits to the programme to receive services and the source where the child was coming from were very important determinants of cure rate. To improve the cure rates of SAM children in Kabale, there is need for policy makers and programme implementers to think about a community based management of severe acute malnutrition program approach.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,Nutrition and Dietetics,Endocrinology, Diabetes and Metabolism,Medicine (miscellaneous)
Reference32 articles.
1. ACF, 2011. Coverage assessment of the integrated therapeutic feeding program supported by ACF Uganda. Final report. https://www.actionagainsthunger.org/sites/default/files/publications/Final_Report-Coverage_Assessment_of_the_Integrated_Therapeutic_Feeding_Program_07.2011.pdf.
2. Alemneh Kabeta and Gezahegn Bekele, 2017. Factors Associated with Treatment Outcomes of Under-five Children with Severe Acute Malnutrition Admitted to Therapeutic Feeding Unit of Yirgalem Hospital. https://doi.org/10.4172/2090-7214.1000260. Clinics in Mother and Child Health.
3. Anna Taylor, 2001. Outpatient therapeutic programme (OTP): an evaluation of a new SC UK venture in North Darfur, Sudan (2001). https://www.ennonline.net/fex/16/outpatient.
4. Ben Hobbs and Anne Bush, 2014. Acute Malnutrition. An everyday emergency. A 10 point plan for tackling acute malnutrition in the under-five. Burkina Faso case-study. www.ennonline.net/acutemalnutritionaneverydayemergencya10pointplanfortacklingacutemalnutritioninunderfives.
5. Atnafe B, Roba KT, Dingeta T. Time of recovery and associated factors of children with severe acute malnutrition treated at outpatient therapeutic feeding program in Dire Dawa. Eastern Ethiopia. 2019. https://doi.org/10.1371/journal.pone.0217344.PlosOne.