Incidence and Risk Factors of Mortality Among Under Five Children with Severe Acute Malnutrition Admitted at Hoima Regional Referral Hospital in Uganda

Abstract

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.