解决资产管理指标的双重缺陷;在受冲突影响的也门,从住院到门诊的差距和见解;回顾性研究。

IF 3.1 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Mohammed Abdullah Al Amad, Yahia Ahmed Raja'a, Khaled Algendari
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引用次数: 0

摘要

背景:在受冲突影响的环境中,严重急性营养不良(SAM)仍然是一项重大的公共卫生挑战,在这些环境中,儿童面临着更大的脆弱性。体重身高比z得分(WHZ < -3)和中上臂围(MUAC)的双重缺陷方法:回顾性分析使用2023年9月至2024年11月萨那市tfc收治的复杂SAM儿童的前瞻性纵向研究数据。结果:188例合并合并SAM的患儿中,56%(105例)为女性,53%(100例)为6岁。结论:需要将WHZ和MUAC纳入出院标准,以防止过早出院,确保全面康复。修订世卫组织规程和在受冲突影响的环境中加强对假药的管理对于改善治疗结果至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Addressing dual deficiencies of SAM indicators; gaps and insights from inpatient admission to outpatient discharge, in conflict-affected Yemen; a retrospective study.

Background: Severe acute malnutrition (SAM) remains a critical public health challenge in conflict-affected settings, where children face heightened vulnerability. Dual deficiencies in weight-for-height z-score (WHZ < -3) and mid-upper arm circumference (MUAC < 11.5 cm) indicate a more severe form of SAM, yet current admission protocols prioritize WHZ-based criteria for inpatient therapeutic feeding centers (TFCs). This approach may exclude children with MUAC deficiencies from optimal inpatient care, potentially impacting recovery outcomes in outpatient therapeutic programs (OTPs). In Yemen, prolonged conflict has exacerbated SAM burdens, leading to an expansion of TFC and OTP services since 2015. The aim is to determine whether existing WHO recovery criteria adequately support comprehensive recovery and prevent premature discharge.

Method: A retrospective analysis was conducted using data from a prospective longitudinal study of children admitted with complicated SAM to TFCs in Sana'a City from September 2023 to November 2024. Children were categorized based on SAM diagnostic criteria (WHZ < -3, MUAC < 11.5 cm, or both) and analyzed under four discharge scenarios: (1) WHZ recovery, (2) MUAC recovery, (3) recovery by either WHZ or MUAC, and (4) recovery of both indicators. Chi-square and Kruskal-Wallis tests were used to assess differences between groups, and P < 0.05 was used to determine statistical significance.

Results: Among 188 children admitted with complicated SAM, 56% (105) were female, 53% (100) were aged 6-<12 months, and 59% (111/188) presented with dual deficiencies. Admission based on WHZ criteria accounted for 82% (154/188) of admissions, of whom 72% also had MUAC < 11.5 cm. At OTP discharge, 96% met WHO recovery criteria, yet only 38% achieved full recovery (WHZ ≥ -2 and MUAC ≥ 12.5 cm). Full recovery was significantly lower among children with dual deficiencies at TFC admission than those with single deficiencies in MUAC or WHZ (31% vs. 47% and 51%, respectively, p = 0.032).

Conclusions: These findings underscore the need to integrate WHZ and MUAC into discharge criteria to prevent premature discharge and ensure comprehensive recovery. Revising WHO protocols and enhancing SAM management in conflict-affected settings are critical to improving treatment outcomes.

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来源期刊
Conflict and Health
Conflict and Health Medicine-Public Health, Environmental and Occupational Health
CiteScore
6.10
自引率
5.60%
发文量
57
审稿时长
18 weeks
期刊介绍: Conflict and Health is a highly-accessed, open access journal providing a global platform to disseminate insightful and impactful studies documenting the public health impacts and responses related to armed conflict, humanitarian crises, and forced migration.
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