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Mortality and morbidity patterns in under-five children with severe acute malnutrition (SAM) in Zambia: a five-year retrospective review of hospital-based records (2009–2013)

Overview of attention for article published in Archives of Public Health, May 2015
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Title
Mortality and morbidity patterns in under-five children with severe acute malnutrition (SAM) in Zambia: a five-year retrospective review of hospital-based records (2009–2013)
Published in
Archives of Public Health, May 2015
DOI 10.1186/s13690-015-0072-1
Pubmed ID
Authors

Tendai Munthali, Choolwe Jacobs, Lungowe Sitali, Rosalia Dambe, Charles Michelo

Abstract

Severe acute malnutrition has continued to be growing problem in Sub Saharan Africa. We investigated the factors associated with morbidity and mortality of under-five children admitted and managed in hospital for severe acute malnutrition. It was a retrospective quantitative review of hospital based records using patient files, ward death and discharge registers. It was conducted focussing on demographic, clinical and mortality data which was extracted on all children aged 0-60 months admitted to the University Teaching Hospital in Zambia from 2009 to 2013. Cox proportional Hazards regression was used to identify predictors of mortality and Kaplan Meier curves where used to predict the length of stay on the ward. Overall (n = 9540) under-five children with severe acute malnutrition were admitted during the period under review, comprising 5148 (54%) males and 4386 (46%) females. Kwashiorkor was the most common type of severe acute malnutrition (62%) while diarrhoea and pneumonia were the most common co-morbidities. Overall mortality was at 46% with children with marasmus having the lowest survival rates on Kaplan Meier graphs. HIV infected children were 80% more likely to die compared to HIV uninfected children (HR = 1.8; 95%CI: 1.6-1.2). However, over time (2009-2013), admissions and mortality rates declined significantly (mortality 51% vs. 35%, P < 0.0001). We find evidence of declining mortality among the core morbid nutritional conditions, namely kwashiorkor, marasmus and marasmic-kwashiorkor among under-five children admitted at this hospital. The reasons for this are unclear or could be beyond the scope of this study. This decline in numbers could be either be associated with declining admissions or due to the interventions that have been implemented at community level to combat malnutrition such as provision of "Ready to Use therapeutic food" and prevention of mother to child transmission of HIV at health centre level. Strategies that enhance and expand growth monitoring interventions at community level to detect malnutrition early to reduce incidence of severe cases and mortality need to be strengthened.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 375 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Ghana 1 <1%
Niger 1 <1%
South Africa 1 <1%
Unknown 372 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 93 25%
Student > Bachelor 43 11%
Student > Postgraduate 36 10%
Researcher 30 8%
Student > Ph. D. Student 23 6%
Other 44 12%
Unknown 106 28%
Readers by discipline Count As %
Medicine and Dentistry 121 32%
Nursing and Health Professions 55 15%
Agricultural and Biological Sciences 20 5%
Biochemistry, Genetics and Molecular Biology 11 3%
Social Sciences 11 3%
Other 40 11%
Unknown 117 31%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 May 2015.
All research outputs
#15,168,167
of 25,371,288 outputs
Outputs from Archives of Public Health
#598
of 1,144 outputs
Outputs of similar age
#138,591
of 278,911 outputs
Outputs of similar age from Archives of Public Health
#9
of 15 outputs
Altmetric has tracked 25,371,288 research outputs across all sources so far. This one is in the 38th percentile – i.e., 38% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,144 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.0. This one is in the 44th percentile – i.e., 44% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 278,911 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 48th percentile – i.e., 48% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 15 others from the same source and published within six weeks on either side of this one. This one is in the 33rd percentile – i.e., 33% of its contemporaries scored the same or lower than it.