Abstract:
Background: The mortality rate of children with complicated severe acute malnutrition that
receive treatment in inpatient set ups has remained unacceptably high. Such high mortality in
inpatient units has been attributed to either co-morbidity such as Human Immune Virus,
Tuberculosis, diarrhea and malaria or due to poor adherence to the World Health Organization
therapeutic guidelines for the management of severe acute malnutrition.
Objective: To assess survival status and identify the predictors of mortality among children
aged0-59 months with complicated severe acute malnutrition admitted to stabilization center in
Sekota hospital, Waghemra zone of Amhara region.
Method: A retrospective cohort was conducted on 415 children aged 0-59 months who were
admitted for complicated severe acute malnutrition at Sekota hospital from January1/2011 to
December 30/2013. The data collection was undertaken from March 15-25, 2014 using checklist.
Data were cleaned, edited and entered by Epi data version 3.1.and analyzed by SPSS version
16.0. Descriptive summary of child characteristics and outcome of interests were computed by
using tables, graphs and Kaplan Meier curves. After checking for assumptions Cox- proportional
regression model was used to identify the potential predictors of survival status. Finally variables
that had P-value < 0.25 in bivariate analysis were candidates for multivariate analysis to
determine independent predictors of mortality
Results: From 441 expected samples, the data were collected on 415 children with baseline
records. The most frequently 185(44.6%) associated co-morbid was diarrhea. Independent
predictors of mortality were Malaria (AHR=2.13, 95%CI = 1.12.7.15), severe anemia (AHR
=6.71, 95%CI: 3.22, 13.97). And TB (AHR= 2.88, 95%CI = 1.72, 4.65), children not
supplemented folic acid (AHR=2.30, 95%CI=1.54, 3.4), not supplemented for vitamin A (AHR=
1.53, 95%CI=1.05, 2.24) and children not managed by intravenous antibiotic (AHR=2.73,
95%CI =1.9, 4.0).
Conclusion: The overall mortality among children aged 0-59 months with complicated SAM
admitted to Sekota hospital was higher than the minimum SPHERE standard for stabilization
centers. The majority of death was attributed to malaria, severe anemia, TB and mismanagement
of complicated severe acute malnutrition. So improving this gap may have paramount effect on
child survival.
