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To present evidence on the burden and results of comorbidities among severely malnourished children (SAM) admitted to outpatient therapeutic program centers (OTP) in the conflict environment of Borno, Nigeria.
Retrospective review of the medical chart.
Study based on facilities.
Children from 6 to 59 months of age with SAM enrolled in OTP between June and November 2016 whose medical records were analyzed. Only pneumonia and diarrhea were examined due to data limitations. The Stata software was used for descriptive, multivariate and survival analysis.
The records of 396 children with a median age of 15 months were identified and analyzed from the date of registration until the exit of the Office of the Prosecutor. The average duration of stay in OTP was 61d, with children with coinfected SAMs who had a shorter stay (P = 0 · 006). Of the total, 148 (37 · 4%) had at least one comorbidity (pneumonia or diarrhea), of which thirty-nine (26 · 4%) had both. The cumulative mortality rate during the follow-up time was 9.5 (95% CI: 6, 0, 15, 1) per 10,000 child-days; Children with SAM with comorbidity were ten times more likely to die than those who did not (risk index = 10.2, 95% CI 3, 4, 31, 0). In the multivariate analysis, comorbidity (P = 0 · 01), edema (P = 0 · 003), dehydration (P = 0 · 02) and weight at admission (P = 0 · 01) were associated with mortality. Both recovery rates and non-compliance rates (57 · 8 and 36 · 1%, respectively) did not meet the SPHERE standards.
Children with SAM and comorbidities are less likely to survive, which presents a significant barrier to improving child survival. The findings require integrated OTP models that incorporate clinical algorithms and ensure rapid reference for children with comorbid SAM
High burden of comorbidity and mortality among severely malnourished children admitted to outpatient therapeutic program centers in Borno, Nigeria: a retrospective review