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Tesfay W, Abay M, Teklehaimanot BF, Gebremedhin A. Stabilizing time and its predictors among 1-59 months old children managed for severe acute malnutrition during the humanitarian crisis in Tigray regional state of Ethiopia, 2023: a prospective cohort study. BMC Pediatr 2024; 24:221. [PMID: 38561711 PMCID: PMC10983702 DOI: 10.1186/s12887-024-04711-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Higher rate of acute malnutrition is observed in emergencies compared to non-emergency settings and severe acute malnutrition upsurges alarmingly and become deadly in humanitarian crises due to lack of food, lack of quality water supply and insufficient healthcare. Research is one learning tool by identifying strength and areas of improvement. However, little is known about outcomes of therapeutic feeding programmes in comparison with the standard indicators set in humanitarian setting. METHODS Health facility based prospective cohort study was conducted using routinely collected programme data of children hospitalized to the inpatient therapeutic feeding center in suhul general hospital from January 1st, 2023 to June 30, 2023. Data was collected using a form developed relating to the federal ministry of health standard management protocols for severe acute malnutrition then it was cleaned, coded and entered to EpiData version 4.2.0 and then exported to SPSS version 25 for analysis. RESULTS From 184 children, 96.2% were stabilized while the remaining 3.8% were censored with overall median stabilizing time of 8 days. Weight gain was used as one of the discharging criteria for infants less than six months and their mean weight gain found to be 12.89 g per kilogram daily. Appetite test (AHR = 0.338; 95% CI: 0.221-0.518), blood transfusion (AHR = 5.825; 95% CI: 2.568-13.211), IV fluid resuscitation (AHR = 2.017; 95% CI: 1.094-3.717), IV antibiotics (AHR = 2.288; 95% CI: 1.164-4.500) and NG tube feeding (AHR = 1.485; 95% CI: 1.065-2.071) were identified as significant predictors of stabilizing time. CONCLUSION All the outcome indicators for stabilization center are consistent with the SPHERE association set of standards during humanitarian intervention. The hospital and other concerned humanitarian organizations should focus on sustaining these achievements as suhul hospital is the main treatment center for children suffering from severe acute malnutrition in the northwest zone of Tigray regional state. Further pre-post experimental studies which compare the stabilizing time before and after crisis are recommended.
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Affiliation(s)
- Wagnew Tesfay
- Medical Teams International (MTI), Shire Field Office, Nutrition Supervisor, Shire, Ethiopia.
| | - Mebrahtu Abay
- College of Health Sciences, Aksum University, Aksum, Ethiopia
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Mwamba GN, Kabamba M, Hoff NA, Mukadi PK, Musene KK, Gerber SK, Halbrook M, Sinai C, Fuller T, Voorman A, Mawaw PM, Numbi OL, Wemakoy EO, Mechael PN, Tamfum JJM, Mapatano MA, Rimoin AW, Lusamba Dikassa PS. Prediction Model with Validation for Polioseronegativity in Malnourished Children from Poliomyelitis Transmission High-Risk Area of the Democratic Republic of the Congo (DRC). Pragmat Obs Res 2023; 14:155-165. [PMID: 38146546 PMCID: PMC10749540 DOI: 10.2147/por.s437485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/11/2023] [Indexed: 12/27/2023] Open
Abstract
Background Malnutrition is identified as a risk factor for insufficient polio seroconversion in the context of a vaccine-derived poliovirus (VDPV) outbreak-prone region. In the Democratic Republic of Congo (DRC), underweight decreased from 31% (in 2001) to 26% (in 2018). Since 2004, VDPV serotype 2 outbreaks (cVDPV2) have been documented and were geographically limited around the Haut-Lomami and Tanganyika Provinces. Methods To develop and validate a predictive model for poliomyelitis vaccine response in malnourished infants, a cross-sectional household study was carried out in the Haut-Lomami and Tanganyika provinces. Healthy children aged 6 to 59 months (n=968) were enrolled from eight health zones (HZ) out of 27, in March 2018. We performed a bivariate and multivariate logistics analysis. Final models were selected using a stepwise Wald method, and variables were selected based on the criterion p < 0.05. The association between nutritional variables, explaining polio seronegativity for the three serotypes, was assessed using the receiver operating characteristic curve (ROC curve). Results Factors significantly associated with seronegativity to the three polio serotypes were underweight, non-administration of vitamin A, and the age group of 12 to 59 months. The sensitivity was 10.5%, and its specificity was 96.4% while the positive predictive values (PPV) and negative (PNV) were 62.7% and 65.3%, respectively. We found a convergence of the curves of the initial sample and two split samples. Based on the comparison of the overlapping confidence intervals of the ROC curve, we concluded that our prediction model is valid. Conclusion This study proposed the first tool which variables are easy to collect by any health worker in charge of vaccination or in charge of nutrition. It will bring on top, the collaboration between the Immunization and the Nutritional programs in DRC integration policy, and its replicability in other low- and middle-income countries with endemic poliovirus.
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Affiliation(s)
- Guillaume Ngoie Mwamba
- Department of Public Health, University of Kamina, Kamina, Haut-Lomami, Democratic Republic of the Congo
- Expanded Programme on Immunization, Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Michel Kabamba
- Department of Public Health, University of Kamina, Kamina, Haut-Lomami, Democratic Republic of the Congo
- Expanded Programme on Immunization, Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Nicole A Hoff
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Patrick K Mukadi
- National Institute of Biomedical Research (INRB), Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Kamy Kaminye Musene
- Health Research and Training Program, UCLA-DRC, Kinshasa, Democratic Republic of the Congo
| | - Sue K Gerber
- Polio eradication program, The Bill and Melinda Gates Foundation, Seattle, WA, 98109, USA
| | - Megan Halbrook
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Cyrus Sinai
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Trevon Fuller
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Arie Voorman
- Polio eradication program, The Bill and Melinda Gates Foundation, Seattle, WA, 98109, USA
| | - Paul Makan Mawaw
- Faculty of Medicine, University of Lubumbashi, Lubumbashi, Haut-Katanga, 1825, Democratic Republic of the Congo
| | - Oscar Luboya Numbi
- Faculty of Medicine, University of Lubumbashi, Lubumbashi, Haut-Katanga, 1825, Democratic Republic of the Congo
| | - Emile Okitolonda Wemakoy
- Department of Epidemiology and Biostatistics, School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Patricia N Mechael
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Jean Jacques Muyembe Tamfum
- National Institute of Biomedical Research (INRB), Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Mala Ali Mapatano
- Department of Nutrition, School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Anne W Rimoin
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Paul-Samson Lusamba Dikassa
- Department of Epidemiology and Biostatistics, School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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Horcas-Nieto JM, Versloot CJ, Langelaar-Makkinje M, Gerding A, Blokzijl T, Koster MH, Baanstra M, Martini IA, Coppes RP, Bourdon C, van Ijzendoorn SCD, Kim P, Bandsma RHJ, Bakker BM. Organoids as a model to study intestinal and liver dysfunction in severe malnutrition. Biochim Biophys Acta Mol Basis Dis 2023; 1869:166635. [PMID: 36581145 DOI: 10.1016/j.bbadis.2022.166635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/02/2022] [Accepted: 12/20/2022] [Indexed: 12/27/2022]
Affiliation(s)
- José M Horcas-Nieto
- Laboratory of Pediatrics, Center for Liver, Digestive and Metabolic Diseases, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Christian J Versloot
- Laboratory of Pediatrics, Center for Liver, Digestive and Metabolic Diseases, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Miriam Langelaar-Makkinje
- Laboratory of Pediatrics, Center for Liver, Digestive and Metabolic Diseases, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Albert Gerding
- Laboratory of Pediatrics, Center for Liver, Digestive and Metabolic Diseases, University of Groningen, University Medical Center Groningen, the Netherlands; Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Tjasso Blokzijl
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Mirjam H Koster
- Laboratory of Pediatrics, Center for Liver, Digestive and Metabolic Diseases, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Mirjam Baanstra
- Department of Biomedical Sciences of Cell & Systems, Section Molecular Cell Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Ingrid A Martini
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Robert P Coppes
- Department of Biomedical Sciences of Cell & Systems, Section Molecular Cell Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Céline Bourdon
- Translational Medicine, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada
| | - Sven C D van Ijzendoorn
- Department of Biomedical Sciences of Cell & Systems, Section Molecular Cell Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Peter Kim
- Translational Medicine, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada; Department of Biochemistry, University of Toronto, Toronto, ON, Canada
| | - Robert H J Bandsma
- Laboratory of Pediatrics, Center for Liver, Digestive and Metabolic Diseases, University of Groningen, University Medical Center Groningen, the Netherlands; Translational Medicine, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada.
| | - Barbara M Bakker
- Laboratory of Pediatrics, Center for Liver, Digestive and Metabolic Diseases, University of Groningen, University Medical Center Groningen, the Netherlands.
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Fahim SM, Islam MR, Rasul MG, Raihan MJ, Ali NM, Bulbul MMI, Ahmed T. A qualitative assessment of facility readiness and barriers to the facility-based management of childhood severe acute malnutrition in the public healthcare settings in Bangladesh. Public Health Nutr 2022; 25:2971-2982. [PMID: 36089747 PMCID: PMC9991555 DOI: 10.1017/s1368980022002014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 08/11/2022] [Accepted: 08/23/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess facility readiness and identify barriers to the facility-based management of childhood severe acute malnutrition (SAM) in public healthcare settings. DESIGN Qualitative methods were applied to assess readiness and identify different perspectives on barriers to the facility-based management of children with SAM. Data collection was done using in-depth interviews, key informant interviews, exit interviews and pre-tested observation tools. SETTINGS Two tertiary care and four district hospitals in Rangpur and Sylhet Divisions of Bangladesh. PARTICIPANTS Healthcare professionals and caregivers of children with SAM. RESULTS Anthropometric tools, glucometer, medicines, F-75, F-100 and national guidelines for facility-based management of childhood SAM were found unavailable in some of the hospitals. Sitting and sleeping arrangements for the caregivers were absent in all of the chosen facilities. We identified a combination of health system and contextual barriers that inhibited the facility-based management of SAM. The health system barriers include inadequate manpower, rapid turnover of staff, increased workload, lack of training and lack of adherence to management protocol. The major facility barriers were insufficient space and unavailability of required equipment, medicines and foods for hospitalised children with SAM. The reluctance of caregivers to complete the treatment regimen, their insufficient knowledge regarding proper feeding, increased number of attendants and poverty of parents were the principal contextual barriers. CONCLUSIONS The study findings provide insights on barriers that are curbing the facility-based management of SAM and emphasise policy efforts to develop feasible interventions to reduce the barriers and ensure the preparedness of the facilities for effective service delivery.
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Affiliation(s)
- Shah Mohammad Fahim
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka1212, Bangladesh
| | - Md Ridwan Islam
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka1212, Bangladesh
| | - Md Golam Rasul
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka1212, Bangladesh
| | - Mohammad Jyoti Raihan
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka1212, Bangladesh
| | - Nafi Mohammad Ali
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka1212, Bangladesh
| | - Md Mofijul Islam Bulbul
- National Nutrition Services, Institute of Public Health Nutrition, Ministry of Health and Family Welfare, Government of Bangladesh, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka1212, Bangladesh
- Office of the Executive Director, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Public Health Nutrition, James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
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Owusu SM, Chen J, Merz E, Fu C. Progressing towards nutritional health in Sub‐Saharan Africa: An econometric analysis of the effect of sustainable food production on malnutrition. Int J Health Plann Manage 2022; 37:2266-2283. [DOI: 10.1002/hpm.3468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 01/05/2022] [Accepted: 03/21/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
| | - Jianlin Chen
- School of Business Jinggangshan University Ji'an Jiangxi China
| | - Ellen Merz
- School of Business Jinggangshan University Ji'an Jiangxi China
| | - Chuanbo Fu
- School of Business Jinggangshan University Ji'an Jiangxi China
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Compaoré EWR, Kiemdé MEW, Souho T, Ouedraogo O, Pietra V, Agbokou K, Zagre N, Amouzou KE, Dicko MH. Discontinuation of healthcare and factors associated to mortality among severe acute malnourished children under five years in healthcare and nutritional care settings. Clin Nutr ESPEN 2021; 43:501-505. [PMID: 34024562 DOI: 10.1016/j.clnesp.2021.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Even if under-five children mortality tends to decrease considerably in developed countries, it remains a major concern in Sub-Saharan Africa. The purpose of the present study is to assess causes of healthcare discontinuation and factors associated with mortality among severe acute malnourished children under five years old in the health district of Gorom-Gorom in Burkina Faso. METHODS A descriptive retrospective study on healthcare discontinuation and deaths of severely acute malnourished children under five years old who registered from July to December 2018, in the health district of Gorom-Gorom in Burkina Faso. RESULTS A total of 377 records of children suffering from severe acute malnutrition were exploited. Children of age range 6-23 months were the most predominantly malnourished. Healthcare discontinuation was observed at rates around 24.4%.Deaths were recorded in 9.72% of children hospitalized in the CRNE and around 1% in children in the ambulatory care management. The severe acute malnutrition co-morbidity factors included oral candidiasis [OR = 14.8; (95%CI 1.128-194.285)], dehydration [OR = 11.46; (95%CI 1.085-121.038)] and malaria [OR = 8.32; (95%CI 1.915-36.191)]. CONCLUSION The risk of death of severe acute malnourished children is higher when the disease is associated with complications.
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Affiliation(s)
- Ella W R Compaoré
- Laboratory of Biochemistry, Biotechnology, Food Technology and Nutrition (LABIOTAN), Department of Biochemistry-Microbiology, University Joseph KI-ZERBO, 03 BP 7021 Ouagadougou 03, Ouagadougou, Burkina Faso.
| | - Michel Eric W Kiemdé
- Laboratory of Biochemistry, Biotechnology, Food Technology and Nutrition (LABIOTAN), Department of Biochemistry-Microbiology, University Joseph KI-ZERBO, 03 BP 7021 Ouagadougou 03, Ouagadougou, Burkina Faso
| | - Tiatou Souho
- Laboratoire de Biochimie des Aliments et Nutrition, Faculté des Sciences et Techniques, Université de Kara, Kara, Togo.
| | - Ousmane Ouedraogo
- Laboratory of Biochemistry, Biotechnology, Food Technology and Nutrition (LABIOTAN), Department of Biochemistry-Microbiology, University Joseph KI-ZERBO, 03 BP 7021 Ouagadougou 03, Ouagadougou, Burkina Faso
| | | | - Koffi Agbokou
- Laboratory of Biochemistry, Biotechnology, Food Technology and Nutrition (LABIOTAN), Department of Biochemistry-Microbiology, University Joseph KI-ZERBO, 03 BP 7021 Ouagadougou 03, Ouagadougou, Burkina Faso
| | - Noel Zagre
- UNICEF - Bureau pour l'Afrique de l'Ouest et du Centre au Sénégal, Immeuble Madjiguène, Route des Almadies, PO Box 29720, Dakar-Yoff, Senegal.
| | - Kou'santa Emile Amouzou
- Laboratoire de Biochimie des Aliments et Nutrition, Faculté des Sciences et Techniques, Université de Kara, Kara, Togo
| | - Mamoudou H Dicko
- Laboratory of Biochemistry, Biotechnology, Food Technology and Nutrition (LABIOTAN), Department of Biochemistry-Microbiology, University Joseph KI-ZERBO, 03 BP 7021 Ouagadougou 03, Ouagadougou, Burkina Faso
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