Factors Associated with Recovery Rate Among Severely Malnourished Children Enrolled in Outpatient Therapeutic Program at Kitui County Hospital, Kenya
American Journal of Pediatrics
Volume 3, Issue 6, November 2017, Pages: 62-67
Received: Jan. 24, 2017;
Accepted: Feb. 17, 2017;
Published: Oct. 31, 2017
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Dorothy Mbaya, Department of Nursing, Chuka University, Chuka, Kenya
Lucy K. Gitonga, Department of Nursing, Chuka University, Chuka, Kenya
Advent of ready to use therapeutic food made it possible to treat children with severe acute malnutritionas outpatients. Studies have reported that recovery rate among children enrolled in outpatient therapeutic program is below the acceptable standard (<75%). The objective of the study was to determine the factors associated with recovery rate among children aged 6-59 months enrolled in outpatient therapeutic program at Kitui County Hospital. A cross sectionalstudy was carried out where we consecutively recruited104 children with severe acute malnutrition. Information was obtained from mothers/guardians regarding demographic, socio-economic, socio-cultural and medical related factors. Anthropometric measurements of the children were conducted at the fourth visit. Chi-square test and odds ratio were used to determine the association between recovery rate and independent variables. Binary logistic regression analysis was performed to determine predictors of recovery. The recovery rate was 73.3% [95% CI 64.6%–81.9%]. Significant predictors of recovery were absence of co-morbidity in the previous month [AOR=5.23; 95%CI=1.36-20.10; P=0.016], receiving antibiotic [AOR=13.06; 95%CI=3.01-56.65; P=0.001] and initiation ofcomplementary feeding at 6 months of age [AOR=8.86; 95%CI=2.20-35.68; P=0.002]. Being a house wife was an independent predictor of recovery [AOR=5.26; 95%CI=1.33-20.87; P=0.018]. The recovery rate was slightly below the acceptable standards. Special focus should be given on predictors of recovery rate like administration of antibiotics, prompt and appropriate management of co-morbidities with appropriate care during the illness and initiation of complementary feeding at the age of 6 months.
Lucy K. Gitonga,
Factors Associated with Recovery Rate Among Severely Malnourished Children Enrolled in Outpatient Therapeutic Program at Kitui County Hospital, Kenya, American Journal of Pediatrics.
Vol. 3, No. 6,
2017, pp. 62-67.
World Health Organization and United Nations Children’s Fund, ‘WHO child growth standards and the identification of severe acute malnutrition in infants and children: A joint statement by the World Health Organization and the United Nations Children’s Fund, 2008.
World Health Organization (WHO), World Food Programme (WFP), the United Nations Standing Committee on Nutrition (UN/SCN) and the United Nations Children’s Fund (UNICEF). Joint Statement. Community-based management of severe acute malnutrition, Geneva, WHO, 2007.
Collins S, Sadler K, Dent N, Khara T, Guerrero S, Myatt M, Saboya M, Walsh A. Key issues in the success of community-based management of severe malnutrition. Food Nutr Bull 2006; 27(suppl): S49–82.
Black R. E., Morris S. S., Bryce J. Where and why 10 million children are dying every year? Lancet child survival series 1, 2003; 361: 2226-2234.
Kenya National Bureau of Statistics (KNBS) and ICF Macro: Kenya Demographic and Health Survey 2008-09 report Calverton, Maryland, U.S.A; 2010.
UNICEF, (2012). Evaluation of Integrated Management of Acute Malnutrition (IMAM): Kenya Country Case Study. New York.
Ciliberto MA, Sandige H, Ndekha MJ, Ashorn P, Briend A, Ciliberto HM, and Manary MJ. Comparison of home-based therapy with ready-to-use therapeutic food with standard therapy in the treatment of malnourished Malawian children: a controlled, clinical effectiveness trial. American Journal of Clinical Nutrition, 2005, 81: 864–870.
Khanum S, Ashworth A, Huttly SR. Controlled trial of three approaches to the treatment of severe malnutrition. Lancet, 1994, 344: 1728–1732.
Nalwa G. M. Outcomes of severely malnourished children aged 6 to 60 months on outpatient management, Nairobi, Kenya. 2012.
Israel, G. D. Sampling: The Evidence of Extension Program Impact. Program Evaluation and Organizational Development, IFAS, University of Florida; PEOD-5, 1992; Retrieved from http://edis.ifas.ufl.edu/pdffiles/PD/PD00500.pdf3/6/2011.
Macallan D. Malnutrition and infection. Medicine. 2005, 33(3): 14–16.
Golden MH. In Garrow JS, James WPT, Ralph A. Human nutrition and dietetics. Tenth edition. Churchill Livingston. London 2000.
Pelletier DL, Frongillo EA Jr, Schroeder DG, Habicht JP. The effects of malnutrition on child mortality in developing countries. Bull World Health Organ 1995; 73: 443-8.
Shils M, Shike M, Ross C, Cballero B, Cousins R (2006) Modern Nutrition in Health and Disease. Lippincott Williams & Wilkins, 10th ed.
WHO/UNICEF. Complementary feeding of young children in developing countries: a review of current scientific knowledge (WHO/Nut/98.1) Geneva: world Health organisation, 1998.
Kikafunda, J. K., Walker, A. F., and Tumwine, J. Weaning foods and Practices in Central Uganda; Cross sectional studies. African Journal of Food, Agriculture, Nutrition and Development, 2003, 3(2) 1-18.
Greer, F., Sicherer, S.& Burks, A. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics, 2008, 121, 183–191.
Lipton, M., de Kadt, E. Agriculture-Health Linkage. WHO Offset Publication No 104. WHO Geneva, 1998.