Treatment Outcome of Severe Acute Malnutrition Among Children (6-59 Months) in Outpatient Therapeutic Feeding Program in Gursum District, Somali Region, Ethiopia
Science Journal of Public Health
Volume 8, Issue 2, March 2020, Pages: 36-42
Received: Feb. 5, 2020;
Accepted: Feb. 27, 2020;
Published: Mar. 17, 2020
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Abdulahi Bedel Budul, Department of Public Health, Jigjiga University, Jigjiga, Ethiopia
Alinoor Mohamed Farah, Department of Public Health, Jigjiga University, Jigjiga, Ethiopia
Tahir Yusuf Nour, Department of Public Health, Jigjiga University, Jigjiga, Ethiopia
Severe Acute Malnutrition (SAM) is one of public health problems in developing countries which mainly affect under five children. Ethiopia is one of the countries with uppermost under-five child mortality rate, in which malnutrition contributes to 57% of all children’s death. This study provides an insight based on management of SAM and help to improve the management of severe acute malnutrition in outpatient therapeutic program (OTP). This study aimed to assess treatment outcomes of severe acute malnutrition and associated factors among children treated at outpatient program in Gursum woreda, Eastern Ethiopia. Facility-based retrospective cross-sectional study was conducted in outpatient program records of 350 children, treated at twelve health facilities obtained from January 1, 2016 to December 31, 2018. Proportional allocation was conducted to get sample size for each selected health facility and outpatient program sites within woreda. Individual cards of children were selected by systematic random sampling. Data were entered using Epi data software version 3.1 and exported to SPSS version 22 for cleaning and further analysis. Crude and Adjusted odd ratio along with the 95% confidence interval were estimated by using bivariate and multivariate logistic regressions to identify factors associated with treatment outcome. Level of significance was declared at P-value less or equal to 0.25 and 0.05 respectively. The recovery rate of sever acute malnutrition was 81.7%. Death rate, defaulter rate, weight gain, and length of stay were 0%, 12.6%, 3.8g/kg/day and 6.7 weeks respectively. The odd of recovery was 2.5 times higher for children with kwashiorkor than children with marasmus (AOR: 2.877, 95% CI: 1.141, 7.255, P=0.025), and those children with self-referral were 57.4% more likely to recover than their counterpart. The average weight gain and length of stay were not in acceptable range of international SPHERE Standard. Also Type of malnutrition and self-referral were factors identified as significant associated with treatment outcome of severe acute malnutrition. Capacity building of OTP service providers, regular monitoring of service provision based on the severe acute management protocol and awareness creation of community were recommended.
Abdulahi Bedel Budul,
Alinoor Mohamed Farah,
Tahir Yusuf Nour,
Treatment Outcome of Severe Acute Malnutrition Among Children (6-59 Months) in Outpatient Therapeutic Feeding Program in Gursum District, Somali Region, Ethiopia, Science Journal of Public Health.
Vol. 8, No. 2,
2020, pp. 36-42.
Hobbs B and B. A., Acute malnutrition: an everyday emergency; a 10-point plan for tackling acute malnutrition in under-fives.. Generation nutrition campaign report, 2014.
WHO, Updates on the management of severe acute malnutrition in infants and children. 2013, Geneva: World Health Organization.
HTP., Technical notes on management of severe acute malnutrition. Vol. Module 13. 2011.
K., S., Community-based therapeutic care: treating severe acute malnutrition in sub-Saharan Africa. London: University College London, 2010.
Central Statistical Agency Ethiopia, Ethiopia Demographic and Health Survey, and ICF., Central Stastical Agency (Ethiopia), ICF International. Ethiopian Demographic and Health Survey in Rockville, Maryland, USA: CSA and ICF. 2016: Addis Ababa, Ethiopia.
Organization, W. H. and UNICEF, Community-based management of severe acute malnutrition: a joint statement by the World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and the United Nations Children's Fund. 2007.
Teferi, E., et al., Treatment outcome of children with severe acute malnutrition admitted to therapeutic feeding centers in Southern Region of Ethiopia. Ethiopian Journal of Health Development, 2010. 24 (3).
UNICEF, Evaluation of community management of acute malnutrition (CMAM). Ethiopia: Federal Ministry of Health, Government of Ethiopia and UNICEF Country Office, 2012.
Akparibo, R., et al., Severe acute malnutrition in children aged under 5 years can be successfully managed in a non‐emergency routine community healthcare setting in Ghana. Maternal & child nutrition, 2017. 13 (4): p. e12417.
Kabalo, M. Y. and M. M. Shanka, Seasonal variations of admission and survival status of children treated for severe acute malnutrition (SAM) at outpatient therapeutic program (OTP) in Wolaita Zone, Southern Ethiopia. International Journal of Collaborative Research on Internal Medicine & Public Health, 2016. 8 (9): p. 512-526.
Yebyo, H. G., et al., Outpatient therapeutic feeding program outcomes and determinants in treatment of severe acute malnutrition in tigray, Northern Ethiopia: a retrospective cohort study. Plos one, 2013. 8 (6): p. e65840.
Fanzo, J., et al., 2018 Global Nutrition Report: Shining a light to spur action on nutrition. 2018.
UNICEF, Management of Severe Acute Malnutrition in children. 2015.
UNICEF, Annual Report-Ethiopia. 2013.
Heikens GT, et al., Case management of HIV-infected severely malnourished children: challenges in the area of highest prevalence. lancet, 2008. 7.
Commission., F. D. R. o. E. P. C., Summary and Statistical report of the 2007 population and housing census. Addis Ababa, Ethiopia.. 2008 Dec.
Kabalo MY and S. CN., Treatment outcomes of severe acute malnutrition in children treated within Outpatient Therapeutic Program (OTP) at Wolaita Zone, Southern Ethiopia: retrospective cross-sectional study. Journal of Health, Population and Nutrition, Dec 2017 36 (1): p. 7.
E., F., Protocol for the management of severe acute malnutrition Federal Ministry of health. 2007, Addis Ababa.
Golden M and G. Y., Protocol for the management of severe acute malnutrition. MOH. 2007, Ethiopia.
Al Amad, M., et al., Evaluation of outpatient therapeutic programme (OTP) for treatment of severe acute malnutrition in Yemen: a focus on treatment default and its risk factors. Journal of evaluation in clinical practice, 2017. 23 (6): p. 1361-1366.
Asres, D. T., R. P. Prasad, and T. A. Ayele, Recovery time and associated factors of severe acute malnutrition among children in Bahir Dar city, Northwest Ethiopia: an institution based retrospective cohort study. BMC Nutrition, 2018. 4 (1): p. 17.
Fikrie, A., A. Alemayehu, and S. Gebremedhin, Treatment outcomes and factors affecting time-to-recovery from severe acute malnutrition in 6–59 months old children admitted to a stabilization center in Southern Ethiopia: A retrospective cohort study. Italian journal of pediatrics, 2019. 45 (1): p. 46.
Kabalo, M. Y. and C. N. Seifu, Treatment outcomes of severe acute malnutrition in children treated within Outpatient Therapeutic Program (OTP) at Wolaita Zone, Southern Ethiopia: retrospective cross-sectional study. Journal of Health, Population and Nutrition, 2017. 36 (1): p. 7.
Mbaya, D., et al., Outcomes of severely malnourished children aged 6-59 months on outpatient management program in Kitui County hospital, Kenya. Open Journal of Pediatrics, 2015. 5 (04): p. 326.
Mengesha, M. M., et al., Treatment outcome and factors affecting time to recovery in children with severe acute malnutrition treated at outpatient therapeutic care program. Global health action, 2016. 9 (1): p. 30704.
Muftah, S., Outpatient management of severe acute malnutrition among children under five years old, in Yemen: a retrospective cohort study. International Journal of Contemporary Pediatrics, 2016. 3 (2): p. 445.
Shanka, N., S. Lemma, and D. Abyu, Recovery rate and determinants in treatment of children with severe acute malnutrition using outpatient therapeutic feeding program in Kamba District, South West Ethiopia. J Nutr Disord Ther, 2015. 5 (2): p. 155.
Liben, M. L., A. G. Wuneh, and R. Shamie, Factors associated with child survival in children admitted to outpatient therapeutic program at public health institutions in Afar Regional State, Ethiopia: a prospective cohort study. Journal of Health, Population and Nutrition, 2019. 38 (1): p. 35.
Yebyo HG, et al., Outpatient Therapeutic Feeding Program Outcomes and Determinants in Treatment of Severe Acute Malnutrition in Tigray, Northern Ethiopia A Retrospective Cohort Study. PloS one 2013.
Teshome, G., T. Bosha, and S. Gebremedhin, Time-to-recovery from severe acute malnutrition in children 6–59 months of age enrolled in the outpatient treatment program in Shebedino, Southern Ethiopia: a prospective cohort study. BMC Pediatrics, 2019. 19 (1): p. 33.
H., C., Minimum standards in food security and nutrition. In: sphere hand book. 2011.
Saaka, M., et al., Treatment outcome of severe acute malnutrition cases at the tamale teaching hospital. Journal of nutrition and metabolism, 2015. 2015.
Shanka NA, Lemma S, and A. DM., Recovery rate and determinants in treatment of children with severe acute malnutrition using outpatient therapeutic feeding program in Kamba District, South West Ethiopia.. Journal of Nutritional Disorders & Therapy., 2015.