Outpatient therapeutic feeding program outcomes and determinants in treatment of severe acute malnutrition in tigray, northern ethiopia: a retrospective cohort study
Outpatient Therapeutic feeding Program (OTP) brings the services for management of Severe Acute Malnutrition (SAM) closer to the community by making services available at decentralized treatment points within the primary health care settings, through the use of ready-to-use therapeutic foods, commun...
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| description | Outpatient Therapeutic feeding Program (OTP) brings the services for management of Severe Acute Malnutrition (SAM) closer to the community by making services available at decentralized treatment points within the primary health care settings, through the use of ready-to-use therapeutic foods, community outreach and mobilization. Little is known about the program outcomes. This study revealed the levels of program outcome indictors and determinant factors to recovery rate.
A retrospective cohort study was conducted on 628 children who had been managed for SAM under OTP from April/2008 to January/2012. The children were selected using systematic random sampling from 12 health posts and 4 health centers. The study relied on information of demographic characteristics, anthropometries, Plumpy'Nut, medical problems and routine medications intakes. The results were estimated using Kaplan-Meier survival curves, log-rank test and Cox-regression.
The recovery, defaulter, mortality and weight gain rates were 61.78%, 13.85%, 3.02% and 5.23 gm/kg/day, respectively. Routine medications were administered partially and children with medical problems were managed inappropriately under the program. As a child consumed one more sachet of Plumpy'Nut, the recovery rate from SAM increased by 4% (HR = 1.04, 95%-CI = 1.03, 1.05, P |
| doi_str_mv | 10.1371/journal.pone.0065840 |
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A retrospective cohort study was conducted on 628 children who had been managed for SAM under OTP from April/2008 to January/2012. The children were selected using systematic random sampling from 12 health posts and 4 health centers. The study relied on information of demographic characteristics, anthropometries, Plumpy'Nut, medical problems and routine medications intakes. The results were estimated using Kaplan-Meier survival curves, log-rank test and Cox-regression.
The recovery, defaulter, mortality and weight gain rates were 61.78%, 13.85%, 3.02% and 5.23 gm/kg/day, respectively. Routine medications were administered partially and children with medical problems were managed inappropriately under the program. As a child consumed one more sachet of Plumpy'Nut, the recovery rate from SAM increased by 4% (HR = 1.04, 95%-CI = 1.03, 1.05, P<0.001). The adjusted hazard ratios to recovery of children with diarrhea, appetite loss with Plumpy'Nut and failure to gain weight were 2.20 (HR = 2.20, 95%-CI = 1.31, 3.41, P = 0.001), 4.49 (HR = 1.74, 95%-CI = 1.07, 2.83, P = 0.046) and 3.88 (HR = 1.95, 95%-CI = 1.17, 3.23, P<0.001), respectively. Children who took amoxicillin and de-worming had 95% (HR = 1.95, 95%-CI = 1.17, 3.23) and 74% (HR = 1.74, 95%-CI = 1.07, 2.83) more probability to recover from SAM as compared to those who didn't take them.
The OTP was partially successful. Management of children with comorbidities under the program and partial administration of routine drugs were major threats for the program effectiveness. The stakeholders should focus on creating the capacity of the OTP providers on proper management of SAM to achieve fully effective program.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0065840</identifier><identifier>PMID: 23755286</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Amoxicillin ; Appetite ; Appetite loss ; Behavioral sciences ; Care and treatment ; Child ; Child mortality ; Child Nutrition Disorders - therapy ; Child, Preschool ; Children ; Children & youth ; Cohort analysis ; Communities ; Demographics ; Demography ; Diarrhea ; Drugs ; Ethiopia ; Feeding ; Female ; Food ; Health aspects ; Health care ; Health sciences ; Humans ; Infant ; Male ; Malnutrition ; Management ; Medical personnel ; Medicine ; Mortality ; Nutrition ; Outpatients ; Pediatrics ; Primary care ; Primary health care ; Program Evaluation ; Public health ; Random sampling ; Rankings ; Recovery ; Retrospective Studies ; Statistical analysis ; Treatment Outcome ; Weight Gain</subject><ispartof>PloS one, 2013-06, Vol.8 (6), p.e65840-e65840</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013. This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-a1c1d69ce4e115f52a10287779edd132671643e4d162438b5063930563600d6e3</citedby><cites>FETCH-LOGICAL-c692t-a1c1d69ce4e115f52a10287779edd132671643e4d162438b5063930563600d6e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3675046/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3675046/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23755286$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Bhutta, Zulfiqar A.</contributor><creatorcontrib>Yebyo, Henock Gebremedhin</creatorcontrib><creatorcontrib>Kendall, Carl</creatorcontrib><creatorcontrib>Nigusse, Daniel</creatorcontrib><creatorcontrib>Lemma, Wuleta</creatorcontrib><title>Outpatient therapeutic feeding program outcomes and determinants in treatment of severe acute malnutrition in tigray, northern ethiopia: a retrospective cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Outpatient Therapeutic feeding Program (OTP) brings the services for management of Severe Acute Malnutrition (SAM) closer to the community by making services available at decentralized treatment points within the primary health care settings, through the use of ready-to-use therapeutic foods, community outreach and mobilization. Little is known about the program outcomes. This study revealed the levels of program outcome indictors and determinant factors to recovery rate.
A retrospective cohort study was conducted on 628 children who had been managed for SAM under OTP from April/2008 to January/2012. The children were selected using systematic random sampling from 12 health posts and 4 health centers. The study relied on information of demographic characteristics, anthropometries, Plumpy'Nut, medical problems and routine medications intakes. The results were estimated using Kaplan-Meier survival curves, log-rank test and Cox-regression.
The recovery, defaulter, mortality and weight gain rates were 61.78%, 13.85%, 3.02% and 5.23 gm/kg/day, respectively. Routine medications were administered partially and children with medical problems were managed inappropriately under the program. As a child consumed one more sachet of Plumpy'Nut, the recovery rate from SAM increased by 4% (HR = 1.04, 95%-CI = 1.03, 1.05, P<0.001). The adjusted hazard ratios to recovery of children with diarrhea, appetite loss with Plumpy'Nut and failure to gain weight were 2.20 (HR = 2.20, 95%-CI = 1.31, 3.41, P = 0.001), 4.49 (HR = 1.74, 95%-CI = 1.07, 2.83, P = 0.046) and 3.88 (HR = 1.95, 95%-CI = 1.17, 3.23, P<0.001), respectively. Children who took amoxicillin and de-worming had 95% (HR = 1.95, 95%-CI = 1.17, 3.23) and 74% (HR = 1.74, 95%-CI = 1.07, 2.83) more probability to recover from SAM as compared to those who didn't take them.
The OTP was partially successful. Management of children with comorbidities under the program and partial administration of routine drugs were major threats for the program effectiveness. The stakeholders should focus on creating the capacity of the OTP providers on proper management of SAM to achieve fully effective program.</description><subject>Amoxicillin</subject><subject>Appetite</subject><subject>Appetite loss</subject><subject>Behavioral sciences</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Child mortality</subject><subject>Child Nutrition Disorders - therapy</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Children & youth</subject><subject>Cohort analysis</subject><subject>Communities</subject><subject>Demographics</subject><subject>Demography</subject><subject>Diarrhea</subject><subject>Drugs</subject><subject>Ethiopia</subject><subject>Feeding</subject><subject>Female</subject><subject>Food</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health sciences</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Malnutrition</subject><subject>Management</subject><subject>Medical personnel</subject><subject>Medicine</subject><subject>Mortality</subject><subject>Nutrition</subject><subject>Outpatients</subject><subject>Pediatrics</subject><subject>Primary care</subject><subject>Primary health care</subject><subject>Program Evaluation</subject><subject>Public health</subject><subject>Random sampling</subject><subject>Rankings</subject><subject>Recovery</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Treatment Outcome</subject><subject>Weight 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therapeutic feeding program outcomes and determinants in treatment of severe acute malnutrition in tigray, northern ethiopia: a retrospective cohort study</title><author>Yebyo, Henock Gebremedhin ; Kendall, Carl ; Nigusse, Daniel ; Lemma, Wuleta</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-a1c1d69ce4e115f52a10287779edd132671643e4d162438b5063930563600d6e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Amoxicillin</topic><topic>Appetite</topic><topic>Appetite loss</topic><topic>Behavioral sciences</topic><topic>Care and treatment</topic><topic>Child</topic><topic>Child mortality</topic><topic>Child Nutrition Disorders - therapy</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Children & youth</topic><topic>Cohort 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Carl</au><au>Nigusse, Daniel</au><au>Lemma, Wuleta</au><au>Bhutta, Zulfiqar A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outpatient therapeutic feeding program outcomes and determinants in treatment of severe acute malnutrition in tigray, northern ethiopia: a retrospective cohort study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-06-06</date><risdate>2013</risdate><volume>8</volume><issue>6</issue><spage>e65840</spage><epage>e65840</epage><pages>e65840-e65840</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Outpatient Therapeutic feeding Program (OTP) brings the services for management of Severe Acute Malnutrition (SAM) closer to the community by making services available at decentralized treatment points within the primary health care settings, through the use of ready-to-use therapeutic foods, community outreach and mobilization. Little is known about the program outcomes. This study revealed the levels of program outcome indictors and determinant factors to recovery rate.
A retrospective cohort study was conducted on 628 children who had been managed for SAM under OTP from April/2008 to January/2012. The children were selected using systematic random sampling from 12 health posts and 4 health centers. The study relied on information of demographic characteristics, anthropometries, Plumpy'Nut, medical problems and routine medications intakes. The results were estimated using Kaplan-Meier survival curves, log-rank test and Cox-regression.
The recovery, defaulter, mortality and weight gain rates were 61.78%, 13.85%, 3.02% and 5.23 gm/kg/day, respectively. Routine medications were administered partially and children with medical problems were managed inappropriately under the program. As a child consumed one more sachet of Plumpy'Nut, the recovery rate from SAM increased by 4% (HR = 1.04, 95%-CI = 1.03, 1.05, P<0.001). The adjusted hazard ratios to recovery of children with diarrhea, appetite loss with Plumpy'Nut and failure to gain weight were 2.20 (HR = 2.20, 95%-CI = 1.31, 3.41, P = 0.001), 4.49 (HR = 1.74, 95%-CI = 1.07, 2.83, P = 0.046) and 3.88 (HR = 1.95, 95%-CI = 1.17, 3.23, P<0.001), respectively. Children who took amoxicillin and de-worming had 95% (HR = 1.95, 95%-CI = 1.17, 3.23) and 74% (HR = 1.74, 95%-CI = 1.07, 2.83) more probability to recover from SAM as compared to those who didn't take them.
The OTP was partially successful. Management of children with comorbidities under the program and partial administration of routine drugs were major threats for the program effectiveness. The stakeholders should focus on creating the capacity of the OTP providers on proper management of SAM to achieve fully effective program.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23755286</pmid><doi>10.1371/journal.pone.0065840</doi><tpages>e65840</tpages><oa>free_for_read</oa></addata></record> |
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| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Amoxicillin Appetite Appetite loss Behavioral sciences Care and treatment Child Child mortality Child Nutrition Disorders - therapy Child, Preschool Children Children & youth Cohort analysis Communities Demographics Demography Diarrhea Drugs Ethiopia Feeding Female Food Health aspects Health care Health sciences Humans Infant Male Malnutrition Management Medical personnel Medicine Mortality Nutrition Outpatients Pediatrics Primary care Primary health care Program Evaluation Public health Random sampling Rankings Recovery Retrospective Studies Statistical analysis Treatment Outcome Weight Gain |
| title | Outpatient therapeutic feeding program outcomes and determinants in treatment of severe acute malnutrition in tigray, northern ethiopia: a retrospective cohort study |
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