Nicolette Nabukeera-Barungi1,2, Benedikte Grenov3, Betty Lanyero3,4, Hanifa Namusoke4, Ezekiel Mupere5, Vibeke Brix Christensen3,6, Kim F Michaelsen3, Christian Mølgaard3, Maren Johanne Rytter3, Henrik Friis3. 1. Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-1958, Frederiksberg C, Denmark. nicolettebarungi@gmail.com. 2. Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda. nicolettebarungi@gmail.com. 3. Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-1958, Frederiksberg C, Denmark. 4. Mwanamugimu Nutrition Unit, Department of Paediatrics, Mulago National Referral Hospital, Kampala, Uganda. 5. Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda. 6. Department of Paediatrics and Adolescent Medicine, Rigshospitalet, DK-2100, Copenhagen Ø, Denmark.
Abstract
BACKGROUND: We determined the predictors of mortality among children admitted with severe acute malnutrition (SAM). METHODS: This was a prospective study nested in a randomized trial among 6-59-month-old children admitted with SAM. Socio-demographic and medical history data were collected using questionnaires and clinical examination, anthropometry and laboratory tests were performed. They were monitored daily until discharge or death during hospitalization while receiving care according to national guidelines. Predictors of death were assessed using Cox regression. RESULTS: Of 400 children, 9.8% (n = 39) died during hospitalization. Predictors of mortality included diarrhoea at admission [hazard ratio [HR] 2.19, 95% confidence interval (CI): 1.06; 4.51], lack of appetite [HR 4.50, 95% CI: 1.76; 11.50], suspected sepsis [HR 2.23, 95% CI: 1.18; 4.24] and skin ulcers [HR 4.23, 95% CI: 1.26; 4.17]. Chest indrawing [HR 5.0, 95% CI: 1.53; 16.3], oxygen saturation below 94% [HR 3.92, 95% CI: 1.42; 10.83] and confirmed HIV infection [HR 3.62, 95% CI: 1.69; 7.77] also predicted higher mortality. CONCLUSION: Infections were major contributors to mortality. This underscores the need for improved prevention and management of these infections among children with severe malnutrition.
RCT Entities:
BACKGROUND: We determined the predictors of mortality among children admitted with severe acute malnutrition (SAM). METHODS: This was a prospective study nested in a randomized trial among 6-59-month-old children admitted with SAM. Socio-demographic and medical history data were collected using questionnaires and clinical examination, anthropometry and laboratory tests were performed. They were monitored daily until discharge or death during hospitalization while receiving care according to national guidelines. Predictors of death were assessed using Cox regression. RESULTS: Of 400 children, 9.8% (n = 39) died during hospitalization. Predictors of mortality included diarrhoea at admission [hazard ratio [HR] 2.19, 95% confidence interval (CI): 1.06; 4.51], lack of appetite [HR 4.50, 95% CI: 1.76; 11.50], suspected sepsis [HR 2.23, 95% CI: 1.18; 4.24] and skin ulcers [HR 4.23, 95% CI: 1.26; 4.17]. Chest indrawing [HR 5.0, 95% CI: 1.53; 16.3], oxygen saturation below 94% [HR 3.92, 95% CI: 1.42; 10.83] and confirmed HIV infection [HR 3.62, 95% CI: 1.69; 7.77] also predicted higher mortality. CONCLUSION:Infections were major contributors to mortality. This underscores the need for improved prevention and management of these infections among children with severe malnutrition.
Authors: Jolly G K Kamugisha; Betty Lanyero; Nicolette Nabukeera-Barungi; Christian Ritz; Christian Mølgaard; Kim F Michaelsen; André Briend; Ezekiel Mupere; Henrik Friis; Benedikte Grenov Journal: Curr Dev Nutr Date: 2021-09-25
Authors: Damalie Nalwanga; Victor Musiime; Samuel Kizito; John Baptist Kiggundu; Anthony Batte; Philippa Musoke; James K Tumwine Journal: BMC Pediatr Date: 2020-04-24 Impact factor: 2.125
Authors: Josué L Castro-Mejía; Sinéad O'Ferrall; Łukasz Krych; Elaine O'Mahony; Hanifa Namusoke; Betty Lanyero; Witold Kot; Nicolette Nabukeera-Barungi; Kim Fleischer Michaelsen; Christian Mølgaard; Henrik Friis; Benedikte Grenov; Dennis S Nielsen Journal: Gut Microbes Date: 2020-01-20