Open Access Library Journal
How to cite this paper: Gebremichael, M., Bezabih, A.M. and Tsadik, M. (2014) Treatment Outcomes and Associated Risk
Factors of Severely Malnourished under Five Children Admitted to Therapeutic Feeding Centers of Mekelle City, Northern
Ethiopia. Open Access Library Journal, 1: e446. http://dx.doi.org/10.4236/oalib.1100446
Treatment Outcomes and Associated Risk
Factors of Severely Malnourished under Five
Children Admitted to Therapeutic Feeding
Centers of Mekelle City, Northern Ethiopia
Melaku Gebremichael
1
, Afework Mulugeta Bezabih
2*
, Mache Tsadik
2
1
Benishangul Bureau of Health, Assosa, Ethiopia
2
Mekelle University, Mekelle, Ethiopia
Email:
*
afework.mulugeta@gmail.com
Received 8 April 2014; revised 18 May 2014; accepted 5 July 2014
Copyright © 2014 by authors and OALib.
This work is licensed under the Creative Commons Attribution International License (CC BY).
http://creativecommons.org/licenses/by/4.0/
Abstract
Background: Despite presence of clinical management protocols for treating severe acute malnu-
trition, its case fatality rate remains high in health facilities from developing countries. Objectives:
To assess treatment outcomes and associated risk factors for death of children aged 6 - 59 months
with complicated severe acute malnutrition. Methods: A cohort of 469 children aged 6 - 59 months
with complicated severe acute malnutrition admitted to nutritional rehabilitation units of Mekelle
City were followed retrospectively. Data on nutritional status, socio-demographic factors, admis-
sion medical conditions and management characteristics were collected. Median test, Chi-square
test and Cox’s proportional hazard regression were used for statistical analysis. Results: Overall
case fatality rate was 12.8%. The median length of stay and median weight gain was 17 days and
12.1 g/kg/day, respectively. Two third of the deaths occurred during the first week of admission.
Diarrhea (HR: 2.45, 95% CI: 1.23 - 4.89), IV antibiotic (HR: 5.87, 95% CI: 1.73 - 19.87), blood
transfusion (HR: 3.05, 95% CI: 1.51 - 6.17) and IV infusion (HR: 2.52, 95% CI: 1.25 - 5.07) were
found to be associated with time to death. Conclusion: Unacceptably high case fatality rate was
observed at the therapeutic feeding units of Mekelle City. Diarrhea, IV antibiotic, blood transfusion
and IV infusion were the risk factors for death of severely malnourished under five children. Ap-
propriate clinical management of severe acute malnutrition in the first week of inpatient stay with
frequent monitoring for signs associated with clinical deterioration of children hospitalized with
complicated SAM is most critical to the survival of the children.
Keywords
Severe Acute Malnutrition, Hospitalized Death, Treatment Outcome, Nutritional Rehabilitation
Units, Mekelle
*
Corresponding author.