Determinants of Mortality Among Severely Malnourished Children in Northern Nigeria.

IF 1.5 Q3 HEALTH POLICY & SERVICES
Health Services Research and Managerial Epidemiology Pub Date : 2021-12-21 eCollection Date: 2021-01-01 DOI:10.1177/23333928211064089
Shafique Sani Nass, Nafisa Sani Nass, Zubairu Iliyasu, Bello Suleiman, Shamsuddeen Yahaya, Bala Habibu, Murtala Isa Bindawa, Aminu Sani, Medinat Suleiman, Adamu Suleiman Gachi
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Abstract

Objectives: Severe Acute Malnutrition is a significant cause of mortality in children under the age of 5 years in low-resource settings, including Northern Nigeria. The study aimed to determine the associations between selected risk factors and mortality outcomes in children admitted with SAM in a facility in Katsina State, Northern Nigeria.

Methods: A prospective observational cohort of 201 children aged 6 to 59 months who were admitted with severe acute malnutrition (SAM) in stabilization centers in Katsina State, Northern Nigeria between May 18, 2021, and July 20, 2021, (63 days) were assessed followed up. Outcomes were analyzed using Kaplan-Meir analysis to estimate time to death, and Cox proportional-hazard regression model was used to determine predictors of mortality.

Results: The log-rank test showed significant differences in the probability of death between categories of diarrheal status (log-rank statistic = 9.760, P = .021) and presence of existing disease (comorbidity) (log-rank statistic = 5.338, P = .021). The study identified that severely malnourished children admitted with comorbidities showed significant association with time to event (death) (AHR: 4.109, 95% CI: 1.51, 32.60). The estimated mean time until death was 57.9 days (±3.0) for children without comorbidities and 20.1 (±3.0) days for children with comorbidities. The median survival time was 18 days for children with comorbidities.

Conclusion: The presence of comorbidities was significantly associated with mortality. Severely malnourished children with comorbidities had 4 times higher mortality risk than severely malnourished children admitted without comorbidities. Clinicians and health workers should give due emphasis to the early detection and effective management of comorbidities in children with severe acute malnutrition.

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尼日利亚北部严重营养不良儿童死亡率的决定因素。
目标:严重急性营养不良是包括尼日利亚北部在内的资源匮乏地区5岁以下儿童死亡的一个重要原因。该研究旨在确定尼日利亚北部卡齐纳州一家医院收治的SAM患儿中选定的风险因素与死亡结果之间的关系。方法:对2021年5月18日至2021年7月20日(63天)期间在尼日利亚北部卡齐纳州稳定中心因严重急性营养不良(SAM)入院的201名6至59个月儿童进行前瞻性观察队列评估和随访。结果分析采用Kaplan-Meir分析法估计死亡时间,采用Cox比例风险回归模型确定死亡预测因子。结果:经log-rank检验,腹泻状态类别(log-rank统计量= 9.760,P = 0.021)与存在疾病(共病)类别(log-rank统计量= 5.338,P = 0.021)的死亡概率差异有统计学意义。研究发现,伴有合并症的严重营养不良儿童与事件发生(死亡)的时间有显著相关性(AHR: 4.109, 95% CI: 1.51, 32.60)。无合并症患儿平均死亡时间为57.9天(±3.0天),有合并症患儿平均死亡时间为20.1天(±3.0天)。有合并症的儿童的中位生存时间为18天。结论:合并症的存在与死亡率显著相关。有合并症的严重营养不良儿童的死亡率比没有合并症的严重营养不良儿童高4倍。临床医生和卫生工作者应适当重视早期发现和有效管理严重急性营养不良儿童的合并症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.60
自引率
6.20%
发文量
32
审稿时长
12 weeks
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