article · PLoS ONE
Severe acute malnutrition remains a major cause of illness and death among children under five years old in Ethiopia. A retrospective study examined health facility records across a five-year period in Hadiya Zone to assess the frequency and predictors of relapse following discharge from treatment. The overall relapse rate among discharged children was found to be 9.6 percent. Key factors influencing relapse risk included age, clinical presentation at initial admission, and physical recovery markers at discharge. Children aged six to eleven months faced a considerably higher risk of relapse, as did those who presented with oedema during their first admission. Conversely, a higher mid-upper arm circumference at discharge was associated with a reduced likelihood of relapse, suggesting the importance of assessing lean tissue accretion when evaluating discharge readiness.
Treating severe malnutrition is vital, but children remain vulnerable to repeated life-threatening episodes after leaving care. Identifying which children face the highest risk of relapse, particularly infants and those admitted with oedema, helps healthcare providers adjust discharge protocols and target post-treatment monitoring to keep children healthy over the long term.
The findings could inform clinical decision-support tools, screening guidelines, or specialised discharge monitoring protocols for health post workers and public health agencies managing acute malnutrition. This represents applied epidemiological research that can directly guide protocol revisions, but the abstract does not indicate a commercial product pathway.
AI-generated from the published abstract. Always read the original work before citing.
BACKGROUND: Severe acute malnutrition is a common cause of morbidity and mortality among under five children in Ethiopia. A child may experience more than one episode of SAM depending on the improvement of the underlying factors. However, there is no study that determined the frequency of relapse of SAM cases after discharge in Ethiopia. OBJECTIVE: To identify the frequency of relapse and associated factors among children discharged after undergoing treatment for SAM in Hadiya Zone, South, Ethiopia. METHODS: An institution based retrospective cohort study was done among children admitted to health posts for treatment of SAM from 2014/2015-2019/2020 under-five children's after discharge in health post for severe acute malnutrition in the last five years in Hadiya zone, SNNPR, Ethiopia. Both first admission data and relapse data were abstracted from the records of the SAM children from Aguste 1-30 /2020 Using a data collection format. Data were coded and edited manually, then doubly entered into Epi-Data statistical software version 3.1 and then exported to SPSS for windows version 26. After checking all the assumptions finally Negative binomial regression for poison has been used. All tests were two sided and P values <0.05 were used to declare statistical significance. RESULTS: In the last five year there were the proportion of relapsed cases were 9.6%, 95% CI: (7.7%, 11.7%) On multivariable negative binomial regression model, after adjusting for background variables relapse of severe acute undernutrition was significantly associated with having edema during admission with (IRR = 2.21, 95% CI:1.303-3.732), being in the age group of 6-11 months (IRR = 4.74,95% CI:1.79-12.53), discharge MUAC for the first admission (P = 0.001, IRR = 0.37, 95% CI:0.270-0.50) increase the risk of incidence rate ratio(IRR) relapse case of severe acute under nutrition. CONCLUSION: Frequency of SAM relapse was positively associated with age, having edema during admission, while it was negatively associated with discharge MUAC. The results imply the need for reviewing the discharge criteria taking into account the recovery of MUAC as a marker for lean tissue accretion, especially in edematous children and those in the younger age.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.1371/journal.pone.0249232
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
