Factors associated with treatment outcomes of severe acute malnutrition among under-five children admitted at Queen Elizabeth Central Hospital (QECH) nutrition unit. A retrospective cross-sectional study
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Date
2021-12-10
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Kamuzu University of Health Sciences
Abstract
Type of the study: A retrospective cross-sectional study.
Problem to be studied: Malnutrition is a physiological condition that results from energy,
protein and other nutrient deficiencies leading to growth impairment or excess intake of
nutrients causing obesity. There are immediate, underlying and basic causes of malnutrition.
Under-nutrition may be caused by diseases and or inadequate intake of
macronutrients/micronutrients. Severe acute malnutrition is defined as weight for height/
length of <-3z score or MUAC<11.5cm or bilateral pitting oedema of +2 to +3 in children aged
6 to 59 months. Children with severe acute malnutrition are more susceptible to diseases which
increases their mortality. Much of the research in severe acute malnutrition has focused on
treatment options to improve treatment outcomes. However, mortality estimates in severe
acute malnutrition have remained high in Malawi despite government’s effort to reduce child
mortality.
Objectives of the study are:
Broad objective
• To assess factors associated with treatment outcomes of severe acute malnutrition among
children aged 1 month to 59 months admitted for nutrition feeding at Queen Elizabeth
Central Hospital (QECH).
Specific objectives
I. To determine whether the admission category (new / readmission) is associated with
treatment outcomes of severe acute malnutrition among children aged 1 to 59 months
admitted at QECH nutrition unit.
II. To determine whether the presence of a particular medical comorbidity (pneumonia,
anaemia, TB, diarrhoea, malaria, sepsis and neural disability such as cerebral palsy) is
associated with treatment outcomes of severe acute malnutrition among children aged
1 month to 59 months admitted at QECH nutrition unit.
III. To determine whether socio-demographic characteristics (age, sex, and primary care
taker) of the children aged 1 month to 59 months admitted at QECH nutrition unit are
associated with treatment outcomes of severe acute malnutrition.
Methodology: This will be a retrospective cross-sectional study to be conducted at QECH
nutrition unit from July 1, 2017 to July 31, 2020. The study population will be all malnourished
children aged 1 month to 59 months admitted at QECH nutrition unit. All children with
surgical and orthopedic conditions will be excluded from the study. A sample size of 312 will
be used for the study to achieve 90% power at 5% significance level. Data will be extracted
from inpatient registration book and patient medical records. The study population will be
divided into two strata, namely; recovered and not recovered. Proportionate will be calculated
for each stratum based on total number of study population. The desired sample size will be multiplied by the proportion of units in each stratum. Finally, systematic random sampling will
be used where every kth unit will be selected from each stratum.
Expected findings and dissemination: Recovery rates and death rates of SAM children aged 1
month to 59 months will be established. Factors associated with the outcomes will be identified
and association described. Results of this study will be shared with Kamuzu University of
Health Sciences (KUHeS), COMREC, and QECH. Dissemination of the results will also be
done in conferences and peer reviewed publications.