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Abstract：
Globally, severe acute malnutrition (SAM) accounts for >1/3-0⋅5 of deaths in children <5 years, and approximately 54 % deaths in developing countries. The minimum international standard set for the management of SAM is a cure rate of at least 75 % and death rate <10 %. The present study was conducted to determine treatment outcome and associated factors among children 1-5 years hospitalised with SAM in Lacor and Gulu Regional Referral Hospital (GRRH) in 2017. A retrospective observational method supplemented with a qualitative inquiry was done. A total of 317 patients\' records were reviewed in either hospital; checklist data were analysed using SPSS version 16 with P-values <0⋅05 considered for statistical significance. The case fatality rate (CFR) was 12⋅6 % (GRRH) and 9⋅5 % (Lacor). The average length of stay (LOS) was 14⋅69 d (GRRH) and 14⋅10 d (Lacor). There was statistical significance between Human Immunodeficiency Virus (HIV) status, blood transfusion, type of SAM, treatment provision at admission, antibiotics, mid-upper arm circumference (MUAC), hospital category and treatment outcome. In total, ten key informants were interviewed and they reported the presence of co-infections and severity of SAM complications as having an important bearing on treatment outcome. A significant proportion of patients were discharged not cured 19⋅9 % (Lacor) v. 16⋅4 % (GRRH). The CFR in GRRH was higher than the WHO recommendation. The LOS in both hospitals was within recommended. These results provide a generalisable problem in most African hospitals and could explain the persistently high rates of SAM in Africa.
摘要：
全球范围内,严重急性营养不良(SAM)占5岁以下儿童死亡的>1/3-0·5，发展中国家约有54%的人死亡。SAM管理的最低国际标准是至少75%的治愈率和<10%的死亡率。本研究旨在确定2017年在Lacor和Gulu地区转诊医院（GRRH）住院的1-5岁儿童的治疗结果和相关因素。进行了回顾性观察方法，并进行了定性调查。在两家医院共审查了317名患者的记录；使用SPSS版本16对清单数据进行了分析，P值<0·05被认为具有统计学意义。病死率（CFR）为12·6％（GRRH）和9·5％（Lacor）。平均住院时间（LOS）为14·69d（GRRH）和14·10d（Lacor）。人类免疫缺陷病毒（HIV）状态之间有统计学意义，输血,SAM的类型,入院时提供治疗，抗生素,中上臂圆周(MUAC),医院类别和治疗结果。总的来说,我们采访了10名关键线人,他们报告了合并感染的存在和SAM并发症的严重程度,这对治疗结局有重要影响.很大一部分患者出院未治愈19·9%(Lacor)诉16·4%(GRRH)。GRRH的CFR高于WHO的建议。两家医院的LOS均在建议范围内。这些结果为大多数非洲医院提供了一个普遍的问题，可以解释非洲SAM的持续高发病率。
