Abstract:
Severe Acute Malnutrition (SAM) is a leading cause of inpatient mortality in children in Sub-Saharan Africa (SSA). In Malawi, there is limited data that explains why this is the case. Therefore, this study determined the time to death and its predictors among under-five children with SAM admitted at mulanje district hospital. We conducted a retrospective cohort study by reviewing the medical charts of 454 randomly selected under-five children who were admitted to Mulanje District Hospital from January 2017 to February 2021.
We collected data using data collection forms and analyzed the data with STATA version 16. Cox proportional hazard regression was used to identify predictors of mortality. A statistical significance was declared at a p-value <0.05. A total of 7,685 under-five children were admitted to Mulanje District Hospital between January 2017 and February 2021. We enrolled and analyzed 454 cases, of which 227 were SAM children and the other 227 belonged to non-SAM children. The overall death rate was 14.8%. For SAM children, the death rate was 8.4%, compared to 21.2% for non-SAM children.
The median time to death was 5 days (IQR: 2–8) for SAM and 1 day (IQR: 1-2) for non-SAM children. Among SAM children, shock (AHR: 15.3; CI: 2.08–113.42) and not having received amoxicillin (AHR: 4.15; CI: 1.24–13.90) were significant predictors of death. Among non-SAM children, shock (AHR: 2.33; CI: 1.18–4.6), diarrhea (AHR: 2.07; CI: 1.00–2.30), oxygen therapy (AHR: 3.17; CI: 1.66–6.05), and not having received amoxicillin (AHR: 20.78; CI: 2.81–153.67) were significant predictors of death. Clinical and nursing interventions should therefore be more focused on predictors of mortality to address the high incidence of deaths among under-five children.
Audience Take Aways:
- The audience will be provided with valuable insights that would enable them to incorporate the lessons learnt and improve care in the management of children suffering from SAM.
- The audience will apply to develop interventions in the management of children suffering from SAM.
- It will provide new information to assist in a design problem.
- It will help policymakers to develop interventions to improve the management of SAM.
- It will help healthcare providers to improve medical and nursing care rendered to children suffering from SAM.
