High burden of co-morbidity and mortality among severely malnourished children admitted to outpatient therapeutic programme facilities in the conflict setting of Borno, Nigeria
A retrospective review
Bibliographic Data
| ID | 15094333 |
|---|---|
| Authors | Dick Chamla (0000-0001-7149-8684, United Nations Children's Fund, corresponding author), Olusola Oladeji (0000-0002-5672-7933, University of Juba), Ifeanyi Maduanusi (United Nations Children's Fund), Sule Mele (National Primary Health Care Development Agency), Helni Mshelia (National Primary Health Care Development Agency), Naqibullah Safi (United Nations Children's Fund) |
| Year | 2019 |
| Volume | 22 |
| Issue | 10 |
| Pages | 1786-1793 |
| Publication date | 2019-07-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Public Health Nutrition (JOURNAL) |
| Journal identifiers | ISSN: 1368-9800 • E-ISSN: 1475-2727 |
| Publisher | Cambridge University Press (CUP) (PUBLISHER) |
| DOI | 10.1017/s1368980018003968 |
| PMID | 30741140 |
| OpenAlex | W2912084554 |
| Language | EN |
| References cited | 37 |
Objective To present evidence on the burden and outcomes of co-morbidities among severely malnourished (SAM) children admitted to outpatient therapeutic programme (OTP) facilities in the conflict setting of Borno, Nigeria. Design Retrospective medical chart review. Setting Facility-based study. Participants Children aged 6–59 months with SAM enrolled in OTP between June and November 2016 whose medical records were analysed. Only pneumonia and diarrhoea were examined due to data limitations. Stata software was used for descriptive, multivariate and survival analyses. Results Records of 396 children with median age of 15 months were identified and analysed from the date of enrolment to exit from OTP. Mean length of stay in OTP was 61d, with co-infected SAM children having shorter stay ( P =0·006). Of the total, 148 (37·4 %) had at least one co-morbidity (pneumonia or diarrhoea), of which thirty-nine (26·4 %) had both. Cumulative rate of mortality during follow-up time was 9·5 (95 % CI 6·0, 15·1) per 10 000 child-days; SAM children with co-morbidities were ten times more likely to die than those without (hazard ratio=10·2; 95 % CI 3·4, 31·0). In multivariable analysis, co-morbidity ( P =0·01), oedema ( P =0·003), dehydration ( P =0·02) and weight on admission ( P =0·01) were associated with mortality. Both recovery and defaulter rates (57·8 and 36·1 %, respectively) did not meet SPHERE standards. Conclusions Children with SAM and co-morbidities are less likely to survive, presenting a significant barrier in improving child survival. The findings call for integrated OTP models that incorporate clinical algorithms and ensure prompt referral for SAM children with co-morbidity
Confidence interval · Hazard ratio · Malnutrition · Medical record · Pneumonia · Proportional hazards model · Retrospective cohort study · Severe Acute Malnutrition · Child Nutrition and Water Access · Disaster Response and Management · Global Maternal and Child Health · Medicine · Emergency Medicine · Internal Medicine · Pediatrics
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| Highly cited | No |
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