Nutrition status and morbidity of Ethiopian children after recovery from severe acute malnutrition: Prospective matched cohort study.

Autor: Girma T; Department of Pediatrics and Child Health, Jimma University, Jimma, Ethiopia., James PT; Valid International, Oxford, United Kingdom.; Emergency Nutrition Network, Kidlington, United Kingdom., Abdissa A; Department of Laboratory Sciences, Jimma University, Jimma, Ethiopia.; Armauer Hansen Research Institute, Addis Ababa, Ethiopia., Luo H; Valid International, Oxford, United Kingdom.; Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America., Getu Y; Valid International, Oxford, United Kingdom.; Department of Physiology, Jimma University, Jimma, Ethiopia., Fantaye Y; Valid International, Oxford, United Kingdom.; Alameda County Public Health Department, Oakland, CA, United States of America., Sadler K; Valid International, Oxford, United Kingdom., Bahwere P; Valid International, Oxford, United Kingdom.; Center for Epidemiology, Biostatistics, and Clinical Research, School of Public Health, Free University of Brussels, Brussels, Belgium.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 Mar 10; Vol. 17 (3), pp. e0264719. Date of Electronic Publication: 2022 Mar 10 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0264719
Abstrakt: After recovery, children with severe acute malnutrition (SAM) remain vulnerable to sub-optimal growth and malnutrition relapse. Although there is an increased interest in understanding these problems, data are scarce, and contextual factors can cause variability. We prospectively followed a cohort of Ethiopian children (215 post-SAM cases and 215 non-wasted controls), monthly for one year. The post-SAM cases were: age 6-59 months at admission into the community management of acute malnutrition (CMAM) program and being successfully discharged from CMAM (MUAC>11.0cm, weight gain of 20%, absence of oedema and clinically stable for two consecutive weeks). The controls were apparently healthy children from same village who had no history of an episode of AM and were matched 1:1 to a post-SAM child by age and sex. The primary outcomes were: cumulative incidence of acute malnutrition; growth trajectory; cumulative incidence of reported common morbidities, and cumulative proportion and incidence of deaths. The burden of common morbidities was higher among post-SAM than controls; post-SAM children had more frequent illness episodes (Incidence Rate Ratio of any illness 1.39, 95% CI: 1.14, 1.71; p<0.001). The prevalence of SAM was consistently higher among post-SAM cases than the control group, having a 14 times higher risk of developing SAM (Incidence Rate Ratio: 14.1; 95% CI: 3.5, 122.5; p<0.001). The divergence in weight and growth trajectory remained the same during the study period. Our results advocate for the design of post-discharge interventions that aim to prevent the reoccurrence of acute malnutrition, reduce morbidity and promote catch-up growth. Research is needed to define the appropriate package of post-discharge interventions.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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