Short Term Outcomes Among Children From 6 Months to 59 Months of Age Admitted for Severe Acute Malnutrition at Prince Regent Charles Hospital, Bujumbura

Abstract

Background: Severe Acute Malnutrition (SAM) remains one of the major global health problems, contributing to childhood morbidity and mortality throughout the world. Regardless of the availability of standard protocol for the management of SAM, the casefatality rate in sub-Saharan Africa remains unacceptably high. Objectives: The objectives were to determine the mortality rate and length of hospital stay among children aged from 6 months to 59 months admitted for Severe Acute Malnutrition at Prince Regent Charles hospital (Bujumbura-Burundi) and to determine the factors associated with mortality. Study methodology: This was a retrospective cross-sectional study of children from 6 months to 59 months of age admitted in the nutritional care center for Severe Acute Malnutrition at Prince Regent Charles Hospital (Bujumbura-Burundi) from 1st January 2015 to 31st December 2019. All the medical records of children aged from 6 months to 59 months of age admitted from 1st of January 2015 to 31st December 2019 with Severe Acute Malnutrition were reviewed. The variables of interest were: Patient’s characteristics (Sex, Age, anthropometric measurements (MUAC, Weight, Height), HIV status, breastfeeding status, signs and symptoms at admission, comorbidities at admission, length of hospital stay) and outcome (discharged or died). Results: A total of 168 records were reviewed and analyzed. The mortality was found to be at 10.1% [95% CI, 6-16%] (n=17) with 35.3% (n=6) of all deaths occurring in the first 3 days of admission. The median duration of hospitalization was 8 days (IQR: 6,12). Vomiting was associated with a statistically significant increase in the risk of mortality [OR 5.46(1.45-20.6), p=0.022). Also, high risk of mortality was associated with gastroenteritis [OR 3.2(1.15-8.87), p=0.044]. There was an increased risk of death in the first 72 hours of admission [OR 14.45(8.17-25.56), p=0.001]. Conclusion: Mortality was found to be at 10.1% among children admitted with severe acute malnutrition. Median duration of hospitalization was 8 days. Gastroenteritis, more specifically vomiting, was significantly associated with increased risk of mortality. The first 72 hours of admission were also significantly associated with a high risk of death. As recommendation, severely malnourished children presenting with vomiting should be sub-triaged earlier for more intensive care to further decrease mortality rate.