Am J Med Public Health | Volume 4, Issue 5 | Research Article | Open Access

Predictors of Survival Among 6 to 59 Months Old Children with Severe Acute Malnutrition: A Retrospective Cohort

Abate M1, Gebre A2, Bekele BT3 and Dinkashe FT4*

1Health System Strengthening and Special Support Directorate, Ministry of Health Ethiopia, Ethiopia 2Department of Public Health, College of Medical and Health Sciences, Samara University, Ethiopia 3Monitoring, Evaluation and Quality Improvement, Zewditu Memorial Hospital, Ethiopia 4St. Paul’s Hospital Millennium Medical College, Ethiopia

*Correspondance to: Fantaye Teka Dinkashe 

Fulltext PDF


Background: Undernutrition among children is a significant contributor to the global disease burden and a leading cause of child mortality. Ethiopia, home to more than 16 million children under 5 years old, is one of the countries that have high levels of wasting. In Ethiopia, the prevalence of child wasting decreased over time though it’s higher than the regional average. Afar is the second highest region in the local burden of severe acute malnutrition. The aim of this study was to assess survival status and predictors of mortality among children with severe acute malnutrition admitted to Dubti Zonal Referral hospital from January 1st, 2016 to September 30th, 2018. Methods: Facility-based retrospective cohort was conducted among 331 severely acutely malnourished children in the stabilization centers in Dubti Zonal Referral Hospital. Data were collected from SAM management registration, individual patient cards and multi-charts admitted from January 1st, 2016 to September 30th, 2018. Data were entered using Epi Data version 3 and exported to SPSS version 23 for analysis. Cox-regression was used to further characterize survival within the cohort and to estimate the effect of specific variables while controlling for potential confounders. The hazard ratio was used as a measure of the outcome. P-value less than 0.05 with a 95% confidence interval was considered statistically significant to identify independent predictors in multivariable analysis. Result: The median age of study participants was 18 months and males were 187(56%). About half of 160 (48.3%) respondents were with co-morbidities during admission: Diarrhea (44%) and pneumonia (26%) were the major co-morbidities. From a total of 331 SAM children, 255(77%) were recovered, 34(10%) died, and 40(12%) have defaulted from treatment. The main risk factors for earlier death of severely malnourished children were rural residence (AHR=1.6, 95% CI= 0.745- 3.493), being onIVinfusion (AHR=2.5, 95% CI= 1.12-4.18), anemia during admission (AHR=6.27, 95% CI =2.41-16.36) & pneumonia (AHR=0.27, 95% CI =0.11-0.68). Conclusion: The death rate was 10% which is close to the minimum SPHERE standard & national management protocol for SAM. Predictors for earlier hospital deaths were rural residence,IVinfusion, Anemia, and Pneumonia.


Severe acute malnutrition; Survival; Hazard ratio


Abate M, Gebre A, Bekele BT, Dinkashe FT. Predictors of Survival Among 6 to 59 Months Old Children with Severe Acute Malnutrition: A Retrospective Cohort. Am J Med Public Health. 2023; 4(5): 1057..

Subscribe to Our Newsletter