Treatment outcomes among children treated for uncomplicated severe acute malnutrition: a retrospective study in Accra, Ghana.

Autor:	Takyi A; Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana., Tette E; Department of Community Health, University of Ghana Medical School, Accra, Ghana., Goka B; Department of Child Health, University of Ghana Medical School, Accra, Ghana., Insaidoo G; Department of Paediatrics, Holy Family Hospital, Eastern Region, Ghana., Alhassan Y; Department of Biostatistics, School of Public Health, College of Health Science, University of Ghana,Accra, Ghana., Nyarko MY; Emergency Department, Princess Marie Louise Children's Hospital, Accra, Ghana., Stepniewska K; WorldWide Antimalarial Resistance Network (WWARN), Oxford, UK.; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
Jazyk:	angličtina
Zdroj:	Public health nutrition [Public Health Nutr] 2021 Aug; Vol. 24 (12), pp. 3685-3697. Date of Electronic Publication: 2020 Aug 12.
DOI:	10.1017/S1368980020002463
Abstrakt:	Objectives: The objectives of the study were to describe outcomes of children with uncomplicated severe acute malnutrition (SAM) attending community-based management of acute malnutrition (CMAM) treatment centres in Accra Metropolitan Area (AMA) and explore factors associated with non-adherence to clinic visits and defaulting from the treatment programme. Design: A retrospective cohort study analysing routinely collected data on children with uncomplicated SAM enrolled into CMAM in 2017 was conducted. Setting: Study was conducted at seven sites comprising Princess Marie Louise Children's Hospital, three sub-metropolitan health facilities and three community centres, located in five sub-metropolitan areas in AMA. Participants: Children with uncomplicated SAM aged 6-59 months, enrolled from community-level facilities (pure uncomplicated SAM, PUSAM) or transferred after completing inpatient care (post-stabilisation uncomplicated SAM, PSSAM), participated in the study. Results: Out of 174 cases studied (105 PUSAM, sixty-nine PSSAM), 56·3 % defaulted, 34·5 % recovered and 8·6 % were not cured by 16 weeks. No deaths were recorded. Mid-upper arm circumference (MUAC) increased by 2·2 (95 % CI 1·8, 2·5) mm/week with full compliance and 0·9 (95 % CI 0·6, 1·2) mm/week with more than two missed visits. In breast-feeding children, MUAC increased at a slower rate than in other children by 1·3 (95 % CI 1·0, 1·5) mm/week. Independent predictors of subsequent missed visits were diarrhoea and fever, while children with MUAC < 110 mm on enrolment were at increased risk of defaulting. Conclusion: A high default rate and a long time to recovery are challenges for CMAM in AMA. Efforts must be made to improve adherence to treatment to improve outcomes.
Databáze:	MEDLINE
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