mortality risk among children admitted in a large-scale nutritional program in niger, 2006儿童死亡率承认大规模的营养项目在尼日尔,2006.pdfVIP

Mortality Risk among Children Admitted in a Large-Scale Nutritional Program in Niger, 2006 1 1 2 1 1 ´ 1 Nael Lapidus , Andrea Minetti , Ali Djibo , Philippe J. Guerin , Sarah Hustache , Valerie Gaboulaud , Rebecca F. Grais1* 1 Epicentre, Paris, France, 2 Ministry of Health, Niamey, Niger Abstract ´ ` Background: In 2006, the Medecins sans Frontieres nutritional program in the region of Maradi (Niger) included 68,001 children 6–59 months of age with either moderate or severe malnutrition, according to the NCHS reference (weight-for- height,80% of the NCHS median, and/or mid-upper arm circumference,110 mm for children taller than 65 cm and/or presence of bipedal edema). Our objective was to identify baseline risk factors for death among children diagnosed with severe malnutrition using the newly introduced WHO growth standards. As the release of WHO growth standards changed the definition of severe malnutrition, which now includes many children formerly identified as moderately malnourished with the NCHS reference, studying this new category of children is crucial. Methodology: Program monitoring data were collected from the medical records of all children admitted in the program. Data included age, sex, height, weight, MUAC, clinical signs on admission including edema, and type of discharge (recovery, death, and default/loss to follow up). Additional data included results of a malaria rapid diagnostic test due to Plasmodium falciparum (ParacheckH) and whether the child was a resident of the region of Maradi or came from bordering Nigeria to seek treatment. Multivariate logistic regression was performed on a subset of 27,687 childre