Cure Rate and Associated Factors for Children with Severe Acute Malnutrition Under the Out Patient Therapeutic Care Programme in the Health Centres of Kabale District in Southwestern Uganda. A Cross Sectional Study.

Abstract

\n BACKGROUND Severe Acute Malnutrition (SAM) is one of the leading causes of morbidity and mortality among children under the age of five. Globally, SAM affects 19 million children with sub-Saharan Africa being the most affected. In Uganda, Global acute malnutrition (GAM) affects 4% and SAM 1% children. Kabale district in South Western Uganda, located in Kigezi sub-region, has been reported to have a GAM prevalence of 3.8 % and SAM of 2.9% among children below five years. To ensure timely detection and management of SAM, the government of Uganda in collaboration with development partners introduced Out Patient Therapeutic Care (OTC) program in all health centre level III and IV in Kabale district. However, there is limited information about the Cure rate of children and associated factors under the OTC program in Kabale district. This study was therefore designed to assess the Cure rate and factors affecting it. METHODS: A retrospective cross-sectional study was carried out on records of children under five years of age (n=637), presenting with SAM and enrolled on OTC program in the health centres of Kabale district between 2013 and 2015. Data were collected from the nutrition registration logbook using a structured check list and cleaned using Microsoft Excel. Data were then exported into STATA 12 for analysis. Univariate and Bivariate analysis together with logistic regression were run to generate frequencies and factors associated with the recovery of children from SAM. RESULTS: The Cure rate was 36.3% (n=231 cases) with a median Recovery time of 21 days. The Default rate was 58.6% (n=373 cases) while the Non-response rate was 0.6% (n=4 cases). Bivariate and multivariate analyses revealed that source where the child was coming from at admission Adjusted Odds Ratio (AOR = 0.1, 95% CI 0.0, 0.7, p = 0.012), Weight at admission (AOR = 0.5, 95% CI 0.0, 0.9, p = 0.014) and Number of visits to the program (AOR = 14.9, 95% CI 9.3, 24.2, p = 0.040) were the major factors influencing the recovery of severely Malnourished children admitted in OTC programme in health centres in Kabale district.CONCLUSION: Overall the Cure rate and Default rate for the children under the OTC programme in Kabale district were found to be very unacceptable according to both the national and international standards. However, Death rate and Non-response rate were within the acceptable levels. To improve the Cure rates of children with SAM under the OTC programme in Kabale district, there is need for interventions aimed at encouraging caretakers to pay special attention to the number of visits to the programme.