article · Pediatric Health Medicine and Therapeutics
A prospective cohort study evaluated mortality and risk factors among children aged under five years admitted with severe acute malnutrition to Hoima Regional Referral Hospital in Midwestern Uganda. Out of 146 enrolled children, 144 completed a six-week follow-up. Overall mortality reached 8.3 percent, with 12 recorded deaths. The vast majority of these fatalities, accounting for 83.3 percent, occurred within the first 48 hours of hospital admission. Over half of the participants were between 13 and 36 months of age. Multivariable analysis identified vomiting, lower respiratory tract infections, malaria, and hypoglycemia as independent risk factors significantly linked to fatal outcomes. The findings demonstrate that clinical vulnerability is highest immediately after admission, indicating that prompt identification and management of these concurrent conditions are critical for improving survival in regional hospital settings.
Severe acute malnutrition remains a major cause of child mortality in regional healthcare facilities. Demonstrating that the vast majority of deaths take place within the first two days of hospital care highlights an urgent operational need for immediate triage and rapid clinical response. Specifically targeting common co-morbidities like malaria and hypoglycemia during intake could substantially reduce early fatalities.
The abstract does not indicate an application pathway, focusing instead on clinical risk factors to inform early hospital management.
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Introduction: Studies conducted in Northern, Central, and Eastern Uganda revealed concerning case fatality rates for children with severe acute malnutrition (SAM). However, there is a lack of research specifically addressing mortality rates among children with SAM in Western Uganda. This study aimed to assess the mortality rates, weight change trends and risk factors for mortality among children with SAM in Midwestern Uganda. Methods: This was a prospective cohort at Hoima Regional Referral Hospital in which children aged below five years admitted with SAM were enrolled and followed up for 6 weeks. The relevant data was obtained via history taking, physical examination and laboratory investigations. The percentage of children that died within 6 weeks was computed. Poisson regression was done to determine the independent predictors. P-values <0.05 were considered significant. Findings: In this study, 146 participants were enrolled. About half of the participants were aged 13-36 months (50.7%). Of the 144 that completed the 6 week follow up, 12 died, expressing a mortality of 8.3% (83 per 1000 children); with majority of deaths (83.3%) occurring in the first 48 hours of admission. In the multivariable analysis, the independent risk factors for mortality were vomiting, lower respiratory tract infection, malaria and hypoglycemia (P<0.05 for all). Conclusion: Mortality among children with SAM in Western Uganda remains high, with most deaths occurring within 48 hours. Early detection and management of vomiting, respiratory infections, malaria, and hypoglycemia are critical to reducing mortality. The relevant data was obtained via history taking, physical examination and laboratory investigations. Bi-variable and multivariate was used, and Poisson regression was done to determine the independent predictors. P-values <0.05 were considered significant.
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DOI: 10.2147/phmt.s586641
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