SURVIVAL STATUS AND DETERMINANTS OF MORTALITY AMONG SEVERELY MALNOURISHED CHILDREN AGED 0-59 MONTHS ADMITTED IN JINKA HOSPITAL, SOUTH OMO ZONE, ETHIOPIA

Abstract

Sever acute malnutrition remains a major public health problem contributing to children aged 0-59 monthsmorbidity and mortality. Worldwide 17 million severely malnourished and 3·1 million children under-fiveyears die every year from undernutrition. Ethiopia accounts halfof children under-fivedeathsare attributed to undernutrition. However, little is known about the survival status and determinants of mortality among severely malnourished children aged 0-59 months admitted to stabilization centers in low income countries like Ethiopia. Objective: to assess survival status and determinants of mortality among severely malnourished children aged 0-59 months admitted to stabilization centerin Jinka general hospital from September 1, 2014 to August 30, 2018. Methods: Hospitalbased retrospective cohort study was conducted among 588 severely malnourished children aged 0-59 months admitted in Jinka general hospital stabilization center from March 20-30, 2019.Simple randomsampling method was used to select medical records of study participants. Proportional hazard assumption over time was checked by global test. The Kaplan-Meier survival curve with log-rank test was used to compare survival acrossgroups. Bivariable and multivariable Cox proportional hazard regression was used to see the association between each independent variables and the outcome variable. Level of statistical significance was declared at p value less than 0.05. Result: A total of 588 severely malnourished children followed for 7920 person day of observation; 62(10.54%) of children had died during follow up, the cumulative survival rates at the end of first, second and third weeks was 93.5%, 90.6% and 85.4% respectively. The overall survival time was 38 days 95% CI :( 36.3, 39.7).Urban residence [AHR=2.24, 95% CI: (1.17, 4.30)], presence of dehydration[AHR =3.94, 95% CI:(1.89, 8.22)], presence of shock [AHR=4.15, 95% CI:(2.01, 8.55)], altered body temperature[AHR= 2.01, 95% CI:(1.01, 3.91)], failure to take F100 milk [AHR= 4.87, 95% CI:(2.75, 8.63)], failure to take oral antibiotics[AHR=3.57, 95% CI:(1.88, 6.77)] were independent determinants of mortality for severe acute malnutrition. Conclusion: In this study, mortality rate for severely malnourished children was higher thanglobalSPHERE and national protocol. Urban residence, presence of shock, dehydration, altered body temperature; failure to take F100 formula milk and oral antibiotics were determinant of mortality. Further intervention to reduce death focus on altered clinical conditions and comorbidities/infections