Time to Discharge and its predictors among children age 1-60 months with Severe Acute Malnutrition Admitted to Therapeutic Feeding Center in Gondar University Comprehensive Specialized Hospital, North West Ethiopia from June 2018 to December 2020

Abstract

ABSTRACT Introduction: Childhood malnutrition is one of the leading causes of morbidity and mortality in Sub–Saharan Countries. The standard treatment of severe acute malnutrition with medical complications or failed appetite test is stabilization at inpatient therapeutic feeding centers where complications get treated, children are stabilized and discharged for rehabilitation at the Outpatient treatment program. Even though there are many studies regarding time to recovery, there is limited information regarding the time to discharge from an inpatient ITFC. Therefore, this study was conducted to investigate the time to discharge after stabilization and its predictors. Objective: To assess the time to discharge and its predictors among children 1-60 months of age with Severe acute malnutrition admitted to Therapeutic Feeding center at University of Gondar Comprehensive Specialized Hospital. Methodology: The Hospital Based retrospective follow-up study was conducted in GUCSH among 282 patients aged 1 to 60 months who were admitted to inpatient Therapeutic Feeding Center from June 2018 to December 2020. Simple random sampling was used to select these patients. Data was entered on EPI Data 3.1 and exported to STATA version 14 for analysis. Time to discharge from ITFC was estimated using the Kaplan-Meir procedure and the Log Rank test was used to test whether the observed difference between covariates. A Stratified Cox regression model was used to identify predictors of time to discharge. Results: Among 282 children 242 (85.82%) were discharged improved and 40 (14.18%) were censored. The median age was 15 months, The median time to discharge was 13 days (IQR: 9-18) days and the Incidence of discharge was 6.4 per 100 person-day observations. Lesser chance of being discharged earlier was found among children with kwash-dermatosis (AHR= 0.41, 95% CI: 0.20-0.85), anemia (AHR=0.58, 95% CI: 0.37-0.90), pneumonia (AHR=0.61, 95% CI: 0.37-0.98) and hospital acquired infection (AHR=0.22, 95%CI: 0.12-0.41). Conclusion: length of stay at UOGCSH stabilization center was delayed. Pneumonia, anemia, kwash dermatosis, and Nosocomial infection were significant predictors of time to discharge. Hence measures should be taken to reduce the length of stay and morbidity related to hospital stay and infection prevention precautions should be strictly followed. Keywords: SAM, time to discharge, predictors, inpatient therapeutic feeding center