Abstract:
Background: Complicated severe acute malnutrition is the common reason for pediatric
hospital admission in many poor countries, which pauses additional burden on limited
resources. In hospitals, it remains poorly managed which led to mortality rate of under-five
children became higher than the acceptable level as different studies revealed. However,
survival status and its associated factors for complicated severe acute malnutrition were yet
not get attention. In these study tries to determine predictors and assess treatment outcome
among children with severe acute malnutrition admitted in stabilization center at SNNPRS,
Ethiopia,2023.
Objective: To assess survival status and predictors of mortality with severe acute
malnutrition children 6-59 months of age admitted to pediatric ward selected comprehensive
specialized hospital, SNNPRS Ethiopia, 2023.
Methods: Multi- center Institution -based retrospective follow-up study was conducted at
selected comprehensive specialized hospitals, SNNPRS Ethiopia, 2023, from January 2019 to
December 30, 2021. Participants were selected using a systematic random sampling
technique. Data was collected by trained data collectors using a pre-structured data collection
checklist. Different Predictors of mortality were analyzed by the Cox proportional hazard
model, hazard ratio, 95% CI and P < 0.25 level in bivariable analysis were entered final Cox regression hazard model, a statistical test considered as significant at P value less than 0.05.
Result: A total of 622 severely malnourished children chart were reviewed 6834-person day
of observation, 89 (14.3%) had died. The median time for occurrence of an event(death) was
10 days with(95%CI=8.33-11.74). The overall incidence rate was 13 cases per 1000 person days. Types of admission(readmission)AHR: 2.17(95%CI=1.20-3.90), presence of shock
AHR: 2.11(95%CI=1.04-4.27), immunization status AHR: 2.12(95%CI=1.00-4.49), vitamin
A supplementation AHR: 3.06(95%CI=1.37-6.85), Naso-gastric tube feeding AHR:
2.61(95%CI=1.23-5.53) and blood transfusion AHR: 2.22(95%CI=1.06-4.65) were
independent determinants of mortality for severe acute malnutrition.
Conclusion and recommendation: In this study, mortality rate for severely malnourished
children was higher than global SPHERE and national protocol. Therefore, an intervention
that focuses on the identified predictors could have a paramount effect in reducing child
mortality related to severe acute malnutrition.
Key words: Survival status, under-five children, mortality, determinants, SAM, SNNPRS
