Time to death and its predictors among children under 5 years of age with severe acute malnutrition hospitalized at Mulanje district hospital: A retrospective cohort study
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Date
2021-11-11
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kamuzu University of Health Sciences
Abstract
Type of the research study: Retrospective Cohort Study
Problem to be studied: Severe acute malnutrition (SAM) is defined by a weightfor-
height index <-3 z-score or by the presence of nutritional oedema. In children
aged 6-59 months, a mid-upper arm circumference <11.5 cm shows SAM. SAM
manifests itself in two forms; marasmus, characterized by severe wasting and
kwashiorkor, characterized by bilateral pitting oedema. Both marasmus and
kwashiorkor contribute significantly to high rates of hospital admission and
mortality in childhood. Malawi, has been equally affected by SAM. However, only
a handful of studies in Malawi have investigated time to death and its predictors
among children under 5 years of age with SAM.
Objectives of the study;
Broad objective
The broad objective of this study is to determine predictors of time to death in
children under 5 years of age with SAM admitted at Mulanje District Hospital.
Specific objectives
i. To determine time to death among children aged 0-59 months admitted between
January 2017-February 2021 in the pediatric ward and NRU at Mulanje District
Hospital.
ii. To compare time to death between admitted children aged 0-59 months who got a
SAM diagnosis and/or were managed in the NRU with admitted children who were
not diagnosed with SAM /or managed in the NRU at Mulanje District Hospital
iii. To identify predictors of time to death among admitted children aged 0-59 months
who got a SAM diagnosis and/or were managed in the NRU compared to admitted
children who were not diagnosed with SAM and /or managed in the NRU at
Mulanje District Hospital.
iv. To compare predictors of time to death between admitted children aged 0-59
months who got a SAM diagnosis and/or were managed in the NRU with admittedchildren who were not diagnosed with SAM/or managed in the NRU at Mulanje
District Hospital
Methodology: This is a retrospective cohort study. The study population is children
hospitalized at Mulanje District Hospital between January 2017 to February 2021.
We will compare the time to death and its predictors between the exposed group
and the unexposed group. The exposed group will contain admitted children who
were diagnosed with SAM and managed in NRU. The unexposed group will
contain admitted children who were never diagnosed with SAM or were never
managed in the NRU. We will collect the archived medical charts from the patient
record storage room. We will extract data from the medical charts using data
collection forms.
Expected findings: We expect children under 5 years of age with SAM to die
shortly following admission and will have a higher risk of dying as compared to
their counterparts. This is because patients suffering from SAM have nutritionalacquired
immune deficiency syndrome (NAIDS), and therefore do not positively
respond to medical treatment in the same way as their well-nourished counterparts
do.
Dissemination of the findings: We will share our findings with the Kamuzu
University of Health Sciences, COMREC, Mulanje District Health Office,
Communities in Mulanje, and the District Commission. We will also present our
findings at local and international research conferences, and in a peer-reviewed
publication.