Abstract：
Recommendations for the management of malnutrition among infants aged less than 6 months (<6 m) are based on limited evidence. This study aimed to describe the characteristics, treatment outcomes and outcome-associated factors among malnourished infants <6 m admitted at Médecins Sans Frontières (MSF) inpatient and ambulatory therapeutic feeding centres (ITFC and ATFC) in North-East Nigeria, 2019-2022. We conducted a descriptive analysis of the cohorts and logistic regression to measure the association between two selected outcomes-inpatient mortality and defaulting from the ambulatory programme-and possible factors associated. In total, 940 infants <6 m were admitted at ITFC. Most of them presented severe acute malnutrition and comorbidities, with diarrhoea being the most frequent. On discharge, 13.3% (n = 125) of infants were cured, 72.9% (n = 684) stabilized (referred to ATFC), 6.5% (n = 61) left against medical advice and 4.2% (n = 39) died. The median length of hospital stay was 10 days [IQR 7-14]. A hospital stay shorter than 10 days was significantly associated with inpatient mortality (aOR = 12.51, 95% confidence interval [CI] = 3.72-42.11, p ≤ 0.01). Among 561 infants followed up at the ATFC, only 2.8% reported comorbidities. On discharge, 80.9% (n = 429) were cured, 16.2% (n = 86) defaulted and 1.1% (n = 6) died. Male sex (aOR = 1.94, 95% CI = 1.15-3.27, p = 0.01), internally displaced status (aOR = 1.70, 95% CI = 1.05-2.79, p = 0.03) and <-3 WLZ (aOR = 1.95, 95% CI = 1.05-3.63, p = 0.03) were significantly associated with programme defaulting. Stabilization and recovery rates among malnourished infants <6 m in the studied project align with acceptable standards in this humanitarian setting. Notable defaulting rates from outpatient care should be further explored.
摘要：
关于6个月以下（<6米）婴儿营养不良管理的建议是基于有限的证据。本研究旨在描述其特点，尼日利亚东北部无国界医生(MSF)住院和流动治疗性喂养中心(ITFC和ATFC)收治的6米以下营养不良婴儿的治疗结果和结果相关因素,2019-2022年。我们对队列和逻辑回归进行了描述性分析，以衡量两个选定的结局之间的关联-住院患者死亡率和门诊计划的违约-以及可能的相关因素。总的来说,940名<6m的婴儿在ITFC入院。他们中的大多数表现为严重的急性营养不良和合并症，腹泻是最常见的。出院时，13.3%(n=125)的婴儿治愈，72.9%(n=684)稳定(参考ATFC)，6.5%(n=61)不建议就医，4.2%(n=39)死亡。平均住院时间为10天[IQR7-14]。住院时间短于10天与住院患者死亡率显着相关（aOR=12.51，95％置信区间[CI]=3.72-42.11，p≤0.01）。在ATFC随访的561名婴儿中，只有2.8%报告合并症。出院时，80.9%(n=429)被治愈，16.2%(n=86)违约，1.1%(n=6)死亡。男性（aOR=1.94，95%CI=1.15-3.27，p=0.01），内部流离失所状态（aOR=1.70，95％CI=1.05-2.79，p=0.03）和<-3WLZ（aOR=1.95，95％CI=1.05-3.63，p=0.03）与计划违约显着相关。在所研究的项目中，营养不良婴儿的稳定和恢复率<6m符合人道主义背景下的可接受标准。应进一步探讨门诊护理的显着违约率。
