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Incidence of severe acute malnutrition after treatment: A prospective matched cohort study in Sokoto, Nigeria
Severe acute malnutrition (SAM) among children in Nigeria is tackled through the outpatient therapeutic programme (OTP) of the Community‐based Management of Acute Malnutrition (CMAM) programme. CMAM is evidently effective in resolving SAM, but little evidence exists on the remaining risk of SAM rela...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729648/ https://www.ncbi.nlm.nih.gov/pubmed/32761792 http://dx.doi.org/10.1111/mcn.13070 |
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author | Adegoke, Olufemi Arif, Shafique Bahwere, Paluku Harb, Jana Hug, Julia Jasper, Paul Mudzongo, Paul Nanama, Simeon Olisenekwu, Gloria Visram, Aly |
author_facet | Adegoke, Olufemi Arif, Shafique Bahwere, Paluku Harb, Jana Hug, Julia Jasper, Paul Mudzongo, Paul Nanama, Simeon Olisenekwu, Gloria Visram, Aly |
author_sort | Adegoke, Olufemi |
collection | PubMed |
description | Severe acute malnutrition (SAM) among children in Nigeria is tackled through the outpatient therapeutic programme (OTP) of the Community‐based Management of Acute Malnutrition (CMAM) programme. CMAM is evidently effective in resolving SAM, but little evidence exists on the remaining risk of SAM relapse for children discharged as cured from the OTP. We aimed to measure and compare the 6‐month incidence of SAM among OTP‐cured and community control children and identify factors associated with SAM relapse. We conducted a prospective matched cohort study that tracked 553 OTP‐cured and 526 control children in Sokoto State, Northern Nigeria. Outcomes and covariates were measured fortnightly in up to 12 home visits. We used multivariate Cox and accelerated failure time models to identify significant risk correlates, where the covariates to be tested for correlation with relapse were selected using domain knowledge and automatic feature selection methods. SAM incidence rates were 52 times higher in the OTP‐cured cohort (0.204/100 child‐days) than in the community control cohort (0.004/100 child‐days). Children with lower mid‐upper arm circumference at OTP admission, with lower height/length‐for‐age z‐scores, whose household head did not work over the full year, who lived in an area previously affected by environmental shocks, who were female and who had diarrhoea before the visit had a significantly higher relapse risk. Our study shows that OTP‐cured children remain at a significantly excess risk of SAM. To improve long‐term health outcomes of these children, programmes adopting a CMAM approach should strengthen follow‐up care and be integrated with other preventive services. |
format | Online Article Text |
id | pubmed-7729648 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77296482020-12-13 Incidence of severe acute malnutrition after treatment: A prospective matched cohort study in Sokoto, Nigeria Adegoke, Olufemi Arif, Shafique Bahwere, Paluku Harb, Jana Hug, Julia Jasper, Paul Mudzongo, Paul Nanama, Simeon Olisenekwu, Gloria Visram, Aly Matern Child Nutr Original Articles Severe acute malnutrition (SAM) among children in Nigeria is tackled through the outpatient therapeutic programme (OTP) of the Community‐based Management of Acute Malnutrition (CMAM) programme. CMAM is evidently effective in resolving SAM, but little evidence exists on the remaining risk of SAM relapse for children discharged as cured from the OTP. We aimed to measure and compare the 6‐month incidence of SAM among OTP‐cured and community control children and identify factors associated with SAM relapse. We conducted a prospective matched cohort study that tracked 553 OTP‐cured and 526 control children in Sokoto State, Northern Nigeria. Outcomes and covariates were measured fortnightly in up to 12 home visits. We used multivariate Cox and accelerated failure time models to identify significant risk correlates, where the covariates to be tested for correlation with relapse were selected using domain knowledge and automatic feature selection methods. SAM incidence rates were 52 times higher in the OTP‐cured cohort (0.204/100 child‐days) than in the community control cohort (0.004/100 child‐days). Children with lower mid‐upper arm circumference at OTP admission, with lower height/length‐for‐age z‐scores, whose household head did not work over the full year, who lived in an area previously affected by environmental shocks, who were female and who had diarrhoea before the visit had a significantly higher relapse risk. Our study shows that OTP‐cured children remain at a significantly excess risk of SAM. To improve long‐term health outcomes of these children, programmes adopting a CMAM approach should strengthen follow‐up care and be integrated with other preventive services. John Wiley and Sons Inc. 2020-08-05 /pmc/articles/PMC7729648/ /pubmed/32761792 http://dx.doi.org/10.1111/mcn.13070 Text en © 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Adegoke, Olufemi Arif, Shafique Bahwere, Paluku Harb, Jana Hug, Julia Jasper, Paul Mudzongo, Paul Nanama, Simeon Olisenekwu, Gloria Visram, Aly Incidence of severe acute malnutrition after treatment: A prospective matched cohort study in Sokoto, Nigeria |
title | Incidence of severe acute malnutrition after treatment: A prospective matched cohort study in Sokoto, Nigeria |
title_full | Incidence of severe acute malnutrition after treatment: A prospective matched cohort study in Sokoto, Nigeria |
title_fullStr | Incidence of severe acute malnutrition after treatment: A prospective matched cohort study in Sokoto, Nigeria |
title_full_unstemmed | Incidence of severe acute malnutrition after treatment: A prospective matched cohort study in Sokoto, Nigeria |
title_short | Incidence of severe acute malnutrition after treatment: A prospective matched cohort study in Sokoto, Nigeria |
title_sort | incidence of severe acute malnutrition after treatment: a prospective matched cohort study in sokoto, nigeria |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729648/ https://www.ncbi.nlm.nih.gov/pubmed/32761792 http://dx.doi.org/10.1111/mcn.13070 |
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