SURVIVAL AND PREDICTORS OF MORTALITY AMONG UNDER-FIVE CHILDREN WITH SEVERE ACUTE MALNUTRITION ADMITTED TO UNIVERSITY OF GONDAR COMPREHENSIVE SPECIALIZED HOSPITAL, NORTHWEST ETHIOPIA, 2017

Abstract

Background: - Globally, approximately 19 million children under 5 years are suffering from Severe Acute Malnutrition. Severe acute malnutrition is a significant cause of morbidity and mortality in low income countries, notably Ethiopia. Despite the fact that little is known about survival and predictors of mortality among children with severe acute malnutrition. Objective: - The study was aimed to assess survival and predictors of mortality among under-five children with severe acute malnutrition admitted to a stabilization center at university of Gondar comprehensive specialized hospital, 2017. Method: - A retrospective follow up study was conducted in 527 under five children who were admitted for severe acute malnutrition at the University of Gondar comprehensive specialized hospital from 2014 to 2017. Data were collected from a randomly selected chart after getting ethical clearance. Data were cleaned, coded and entered to Epi-info 7 and analyzed by STATA 14. Descriptive summary and outcomes were computed by using tables, graphs and Kaplan Meier curves. Multivariable Cox proportional hazards model was fitted to identify predictors of mortality. Result: A total of 570 records, 527 were included in the analysis. The median follow up period was 10 days. At the end of the follow up, 66(12.52%) were died. The cumulative probability of survival at the 5th, 10th and 15th day was 90.2%, 84.7% and 80.9%, respectively. Children with anemia AHR: 2.37(95% CI: 1.24, 4.51), Shock AHR: 7.95(95% CI: 3.72, 16.76), NGT therapy AHR: 2.71(95% CI: 1.47 , 5.02), children who failed to take routine antibiotics AHR: 2.35(95% CI: 1.25 , 4.4), IV-Fluid AHR: 3.21(95% CI: 1.75, 5.88), those failed to take of F75 AHR: 6.58(95% CI: 2.95, 14.68), not intake of F100 AHR: 3(95% CI: 1.67, 5.41) and those with altered pulse rate at admission AHR: 2.39(95% CI: 1.24, 4.61), were independent predictors of mortality. Conclusion: - In this study the mortality rate was generally high. Altered general conditions, shock, anemia, not adhering to nutritional and medical therapy were identified predictors of mortality. Therefore, improving this gap may have a paramount effect on child survival.