Observational studyEuropean journal of clinical nutrition2023
Risk factors for inpatient mortality among children with severe acute malnutrition in Zimbabwe and Zambia.
Observational study in European journal of clinical nutrition, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07752628 (Safety Trial of F-60 Among Children Hospitalized With Severe Acute Malnutrition), which is not on this map. Cited by 17 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Safety Trial of F-60 Among Children Hospitalized With Severe Acute Malnutrition
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Prevalence and risk factors of under-five mortality due to severe acute malnutrition in Africa: a systematic review and meta-analysis.Systematic reviews · 2025Pooled it
- Pooled it
- The gut microbiota in malnutrition.Nature reviews. Microbiology · 2026Review
- Restoration of anti-bacterial innate immune cell function lags behind nutritional recovery among children convalescing from complicated severe acute malnutrition.Nature communications · 2026Article
- Co-occurrence patterns of malnutrition indicators among children in sub-Saharan Africa.Communications medicine · 2026Article
- Incidence and Risk Factors of Mortality Among Under Five Children with Severe Acute Malnutrition Admitted at Hoima Regional Referral Hospital in Uganda.Pediatric health, medicine and therapeutics · 2026Article
- Article
- Article
- Time to stabilization among under-five children with severe acute malnutrition in Ethiopia: a retrospective cohort study.BMC public health · 2025Article
- Adaptive Responses in Severe Acute Malnutrition: Endocrinology, Metabolomics, Mortality, and Growth.Nutrients · 2025Review
- Malaria and malnutrition in tribal areas of India: implications for paediatric health.Frontiers in gastroenterology (Lausanne, Switzerland) · 2025Review
- Multidimensional poverty and the co-occurrence of undernutrition and intestinal parasitic infections in Ecuadorian infants: a geospatial analysis.Frontiers in public health · 2025Article
- Prediction of inpatient mortality in hospitalised children in low- and middle-income countries: An external validation of paediatric mortality risk scores.Journal of global health · 2024Article
- Identification of risk factors for inpatient mortality in infants and children with severe wasting and/or nutritional oedema-what next?European journal of clinical nutrition · 2024Article
- Novel gastrointestinal tools (GI Tools) for evaluating gut functional capacity in adults with environmental enteropathy in Zambia and Zimbabwe: A cross-sectional study protocol.F1000Research · 2024Article
- Article
- Trends and long-term variation explaining nutritional determinants of child linear growth: analysis of Bangladesh Demographic and Health Surveys 1996-2018.Public health nutrition · 2023Article
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Authors and funding
17 authors at 4 institutions in 3 countries.
Funding
Abstract
BACKGROUND/
objectivesMalnutrition underlies 45% of deaths in children under-5 years annually. Children hospitalised with complicated severe acute malnutrition (SAM) have unacceptably high mortality. We aimed to identify variables from early hospital admission (baseline factors) independently associated with inpatient mortality in this cohort to identify those most at risk. SUBJECTS/
methodsObservational study of 745 children aged 0-59 months admitted with complicated SAM at three hospitals in Zimbabwe/Zambia. Children underwent anthropometry and clinical assessment by a study physician within 72 h of enrolment, and caregivers provided sociodemographic data. Children were followed-up daily until discharge/death. A multivariable survival analysis identified the baseline factors independently associated with mortality.
results70/745 (9.4%) children died in hospital. Age between 6-23 months [aHR 6.53, 95%CI 2.24-19.02], higher mid-upper arm circumference [aHR 0.73, 95%CI 0.59-0.89], presence of oedema [aHR 2.22, 95%CI 1.23-4.05], shock [aHR 8.18, 95%CI 3.79-17.65], sepsis [aHR 3.13, 95%CI 1.44-6.80], persistent diarrhoea [aHR 2.27, 95%CI 1.18-4.37], lack of a toilet at home [aHR 4.35, 95%CI 1.65-11.47], and recruitment at one Harare site [aHR 0.38, 95%CI 0.18-0.83] were all independently associated with inpatient mortality. Oedematous children had a significantly higher birthweight [2987 g vs 2757 g, p < 0.001] than those without oedema; higher birthweight was weakly associated with mortality [aHR 1.50 95%CI 0.97-2.31].
conclusionsChildren with oedema, low MUAC, baseline infections, shock and lack of home sanitation had a significantly increased risk of inpatient mortality following hospitalisation for complicated SAM. Children with high-risk features may require additional care. A better understanding of the pathophysiology of SAM is needed to identify adjunctive interventions.
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