PDF(Pubmed)
Abstract：
Lost from follow-up, after starting moderate acute malnutrition (MAM) is an ongoing challenge of public health until the admitted children reached the standard weight of a reference child. Thus, the present study aimed to assess the rate and estimated time to attrition after under-five children started treatment for MAM in the Gubalafto district. A facility-based retrospective cohort study was employed among 487 participant children who had been managed targeted therapeutic feeding from 1 June 2018 to 1 May 2021. The overall mean (±sd) age of the participants\' children was 22⋅1 (±12⋅6) months. At the end of the study period, 55 (11⋅46 %) under-five children developed attrition from the treatment after starting ready use of therapeutic feeding. After checking all assumptions, a multivariable Cox regression model was used to claim independent predictors for time to attritions. The median time of attrition after starting treatment of MAM was 13 (IQR ±9) weeks, with the overall incidence of attrition rate reported at 6⋅75 children Per Week (95 % CI 5⋅56, 9⋅6). In the final model of multivariable Cox regression, the hazard of attrition was significantly higher for children from rural residence (AHR 1⋅61; 95 % CI 1⋅18, 2⋅18; P = 0⋅001), and caregivers with their dyads did not get nutritional counselling at baseline (AHR 2⋅78; 95 % CI 1⋅34, 5⋅78; P = 0⋅001). The findings of the present study showed that nearly one in every eleven under-five children was attrition (lost to follow-up) in a median time of 13 (IQR ±9) weeks. We strongly recommended for caregivers provisions of diversification of daily nutrition supplementation of their dyads.
摘要：
失去了随访，开始中度急性营养不良(MAM)后,一直是公共卫生面临的挑战,直到入院儿童达到参考儿童的标准体重.因此，本研究旨在评估Gubalafto地区5岁以下儿童开始接受MAM治疗后的减员率和预计减员时间.一项基于设施的回顾性队列研究在2018年6月1日至2021年5月1日接受针对性治疗性喂养的487名参与者儿童中进行。参与者儿童的总体平均（±sd）年龄为22·1（±12·6）个月。在研究期结束时，55名（11·46％）五岁以下儿童在开始使用治疗性喂养后从治疗中减员。在检查了所有假设之后，我们使用多变量Cox回归模型对自然减员时间进行了独立预测.MAM开始治疗后的中位磨耗时间为13（IQR±9）周，报告的流失率总发生率为每周6·75名儿童(95%CI5·56，9·6)。在多变量Cox回归的最终模型中，农村儿童的自然减员风险明显更高(AHR1·61；95%CI1·18，2·18；P=0·001)，和他们的双元照顾者在基线时没有得到营养咨询(AHR2·78;95%CI1·34,5·78;P=0·001)。本研究的结果表明，在13（IQR±9）周的中位时间内，每11名五岁以下儿童中就有近1名被减员（失去随访）。我们强烈建议护理人员提供多样化的日常营养补充他们的二元体。
