Comorbidities and factors associated with mortality among children under five years admitted with severe acute malnutrition in the nutritional unit of Jinja Regional Referral Hospital
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Date
2020-01
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Kampala International University
Abstract
Background: Mortality among children with severe acute malnutrition remains an immense health concern in the hospitals in Africa, but its attributes are not fully known various hospital settings. This study determined the proportion of mortality, the Comorbidities and factors associated with in-hospital mortality among children under five years of age admitted with severe acute malnutrition at Jinja Regional Referral Hospital.
Methods: This was a hospital-based analytical descriptive prospective cohort study conducted at in the nutritional unit of Jinja Regional Referral Hospital. This study was performed from July to October 2019 with children under five years of age admitted with severe acute malnutrition and their caregivers from and their caregivers. A total of 338 children and their caretakers who met the criteria were consecutively enrolled into the study. Children were followed until discharge from the nutritional unit or until death. Data collected from questionnaires, WHO chart and culture media were entered into Microsoft Excel version 10 and imported into Stata 12 for data analysis. Descriptive statistics were used to each of the independent factors and comorbidities were subjected to Chi-square test followed by logistic regression analysis to assess its association incidence of mortality among children. All independent variables with p-values ≤0.05 were entered into a multivariate model for factors and comorbidities independently. Factors and Comorbidities with p-values ≤0.05 were considered as associates of mortality of mortality among children.
Results: Of the 338 children under 5 years of age enrolled, 49(14.5%) died. Although the majority children were diagnosed with dehydration, 128(37.9%) and pneumonia, 127(37.6%) and malaria, 87(25.7%).Anemia (aRR=2.9, 95%CI: 1.23-6.62, p=0.01), bacteremia (aRR=10.0, 95%CI: 3.62-29.01, p=0.01), HIV (aRR=4.8, 95%CI: 1.42-16.30, p<0.01), TB (aRR=4.3, 95%CI: 1.28-14.49, p <0.02) and shock (aRR=60.9, 95%CI: 9.05-410.28, p <0.01) were the Comorbidities significantly associated with a likelihood of mortality.
Conclusions: This study has shown that there was a relatively high in hospital mortality of 14.5% among children under 5 years of age admitted with Severe Acute Malnutrition, with an increased risk among males, those admitted for less than 72 hours and presenting anemia, bacteremia, HIV, TB and shock. An implication of the findings is that children admitted with severe acute malnutrition need to be followed up from admission to discharge and the health workers are recommended to focus on the critical comorbidities identified especially among males.
Description
A dissertation submitted in partial fulfillment of the requirements for the award of the degree of Master of Medicine in Paediatrics and Child Health of Kampala International University