A meta-analysis of inpatient treatment outcomes of severe acute malnutrition and predictors of mortality among under-five children in Ethiopia
Abstract 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 a...
Main Authors: | , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2019-08-01
|
Series: | BMC Public Health |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s12889-019-7466-x |
id |
doaj-c294073906ee4f24ae1feb65daf058d1 |
---|---|
record_format |
Article |
spelling |
doaj-c294073906ee4f24ae1feb65daf058d12020-11-25T03:49:36ZengBMCBMC Public Health1471-24582019-08-0119111110.1186/s12889-019-7466-xA meta-analysis of inpatient treatment outcomes of severe acute malnutrition and predictors of mortality among under-five children in EthiopiaFasil Wagnew0Getenet Dessie1Wubet Worku Takele2Aster Tadesse3Sheikh Mohammed Shariful Islam4Henok Mulugeta5Dessalegn Haile6Ayenew Negesse7Amanuel Alemu Abajobir8College of Health Science, Debre Markos UniversityCollege of Health Sciences, Bahirdar UniversityCollege of Health Science, University of GondarCollege of Health Science, Debre Markos UniversityInstitute for Physical Activity and Nutrition (IPAN), Deakin UniversityCollege of Health Science, Debre Markos UniversityCollege of Health Science, Debre Markos UniversityCollege of Health Science, Debre Markos UniversityFaculty of Medicine/school of Public Health, The University of QueenslandAbstract 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.http://link.springer.com/article/10.1186/s12889-019-7466-xSevere acute malnutritionTreatment outcomesMeta-analysisAnd Ethiopia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Fasil Wagnew Getenet Dessie Wubet Worku Takele Aster Tadesse Sheikh Mohammed Shariful Islam Henok Mulugeta Dessalegn Haile Ayenew Negesse Amanuel Alemu Abajobir |
spellingShingle |
Fasil Wagnew Getenet Dessie Wubet Worku Takele Aster Tadesse Sheikh Mohammed Shariful Islam Henok Mulugeta Dessalegn Haile Ayenew Negesse Amanuel Alemu Abajobir A meta-analysis of inpatient treatment outcomes of severe acute malnutrition and predictors of mortality among under-five children in Ethiopia BMC Public Health Severe acute malnutrition Treatment outcomes Meta-analysis And Ethiopia |
author_facet |
Fasil Wagnew Getenet Dessie Wubet Worku Takele Aster Tadesse Sheikh Mohammed Shariful Islam Henok Mulugeta Dessalegn Haile Ayenew Negesse Amanuel Alemu Abajobir |
author_sort |
Fasil Wagnew |
title |
A meta-analysis of inpatient treatment outcomes of severe acute malnutrition and predictors of mortality among under-five children in Ethiopia |
title_short |
A meta-analysis of inpatient treatment outcomes of severe acute malnutrition and predictors of mortality among under-five children in Ethiopia |
title_full |
A meta-analysis of inpatient treatment outcomes of severe acute malnutrition and predictors of mortality among under-five children in Ethiopia |
title_fullStr |
A meta-analysis of inpatient treatment outcomes of severe acute malnutrition and predictors of mortality among under-five children in Ethiopia |
title_full_unstemmed |
A meta-analysis of inpatient treatment outcomes of severe acute malnutrition and predictors of mortality among under-five children in Ethiopia |
title_sort |
meta-analysis of inpatient treatment outcomes of severe acute malnutrition and predictors of mortality among under-five children in ethiopia |
publisher |
BMC |
series |
BMC Public Health |
issn |
1471-2458 |
publishDate |
2019-08-01 |
description |
Abstract 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. |
topic |
Severe acute malnutrition Treatment outcomes Meta-analysis And Ethiopia |
url |
http://link.springer.com/article/10.1186/s12889-019-7466-x |
work_keys_str_mv |
AT fasilwagnew ametaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT getenetdessie ametaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT wubetworkutakele ametaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT astertadesse ametaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT sheikhmohammedsharifulislam ametaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT henokmulugeta ametaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT dessalegnhaile ametaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT ayenewnegesse ametaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT amanuelalemuabajobir ametaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT fasilwagnew metaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT getenetdessie metaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT wubetworkutakele metaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT astertadesse metaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT sheikhmohammedsharifulislam metaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT henokmulugeta metaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT dessalegnhaile metaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT ayenewnegesse metaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia AT amanuelalemuabajobir metaanalysisofinpatienttreatmentoutcomesofsevereacutemalnutritionandpredictorsofmortalityamongunderfivechildreninethiopia |
_version_ |
1724494542232616960 |