A meta-analysis of inpatient treatment outcomes of severe acute malnutrition and predictors of mortality among under-five children in Ethiopia

Wagnew, Fasil, Dessie, Getenet, Takele, Wubet Worku, Tadesse, Aster, Islam, Sheikh Mohammed Shariful, Mulugeta, Henok, Haile, Dessalegn, Negesse, Ayenew and Abajobir, Amanuel Alemu 2019, A meta-analysis of inpatient treatment outcomes of severe acute malnutrition and predictors of mortality among under-five children in Ethiopia, BMC public health, vol. 19, pp. 1-11, doi: 10.1186/s12889-019-7466-x.

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Title A meta-analysis of inpatient treatment outcomes of severe acute malnutrition and predictors of mortality among under-five children in Ethiopia
Author(s) Wagnew, Fasil
Dessie, Getenet
Takele, Wubet Worku
Tadesse, Aster
Islam, Sheikh Mohammed SharifulORCID iD for Islam, Sheikh Mohammed Shariful orcid.org/0000-0001-7926-9368
Mulugeta, Henok
Haile, Dessalegn
Negesse, Ayenew
Abajobir, Amanuel Alemu
Journal name BMC public health
Volume number 19
Article ID 1175
Start page 1
End page 11
Total pages 11
Publisher BMC
Place of publication London, Eng.
Publication date 2019-08
ISSN 1471-2458
Keyword(s) And Ethiopia
Meta-analysis
Severe acute malnutrition
Treatment outcomes
Summary Background: Severe forms of malnutrition have drastic effects on childhood morbidity and mortality in sub-Saharan countries, including Ethiopia. Although few studies have previously estimated treatment outcomes of severe acute malnutrition (SAM) in Ethiopia, the findings were widely varied and inconsistent. This study thus aimed to pool estimates of treatment outcomes and identify predictors of mortality among children with SAM in Ethiopia. Methods: A systematic review was carried out to select 21 eligible articles from identified 1013 studies (dating from 2000 to 2018) that estimated treatment outcomes and predictors of mortality among SAM children. Databases including PubMed, CINHAL, Web of Sciences; Cochrane, Psych INFO and Google Scholar were comprehensively reviewed using medical subject headings (MESH) and a priori set criteria PRISMA guideline was used to systematically review and meta-analyze eligible studies. Details of sample size, magnitude of effect sizes, including Hazard Ratio (HRs) and standard errors were extracted. Random-effects model was used to calculate pooled estimates in Stata/se version-14. Cochran's Q, I2, and meta-bias statistics were assessed for heterogeneity and Egger's test for publication bias. Result: Twenty-one studies were included in the final analysis, which comprised 8057 under-five children with SAM in Ethiopia. The pooled estimates of treatment outcomes, in terms of death, recovery, defaulter and transfer out and non-response rates were 10.3% (95% CI: 8.3, 12.3), 70.5% (95% CI: 65.7, 72.2), 13.8% (95% CI: 10.8, 16.9) and 5.1% (95% CI: 3.3, 6.9), respectively. Diarrhea (HR: 1.5, 95% CI: 1.1, 2.2), dehydration (HR: 3.1, 95% CI: 2.3, 4.2) and anemia (HR: 2.2, 95% CI: 1.5, 3.3) were statistically significant predictors of mortality among these children. No publication bias was detected. Conclusion: Treatment outcomes in under-five children with SAM are lower than the World Health Organization (WHO) standard, where mortality is being predicted by comorbidities at admission. Children with SAM need to be treated for diarrhea, dehydration and anemia at the primary point of care to reduce mortality.
Language eng
DOI 10.1186/s12889-019-7466-x
Indigenous content off
Field of Research 1117 Public Health and Health Services
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2019, The Author(s)
Persistent URL http://hdl.handle.net/10536/DRO/DU:30129337

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