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In children with severe acute malnutrition, is there a relationship between adherence to hospital discharge criteria and the rates of relapse thereafter
Thesis (MNutr)--Stellenbosch University, 2024.
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| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2025
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| _version_ | 1867613982132535296 |
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| access_status_str | Open Access |
| author | Burnett, Georgia Kirsten |
| author2 | Van Niekerk, Evette |
| author_browse | Burnett, Georgia Kirsten Van Niekerk, Evette |
| author_facet | Van Niekerk, Evette Burnett, Georgia Kirsten |
| author_sort | Burnett, Georgia Kirsten |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MNutr)--Stellenbosch University, 2024. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/131605 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:44:46.833Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/131605 In children with severe acute malnutrition, is there a relationship between adherence to hospital discharge criteria and the rates of relapse thereafter Burnett, Georgia Kirsten Van Niekerk, Evette Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition. Malnutrition in children -- Treatment -- Evaluation Patient compliance -- Evaluation Malnutrition in children -- Complications -- Relapse Hospital care -- Quality control UCTD Thesis (MNutr)--Stellenbosch University, 2024. Burnett, G. K. 2024. In children with severe acute malnutrition, is there a relationship between adherence to hospital discharge criteria and the rates of relapse thereafter. Unpublished masters thesis. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/a10bfe72-d645-47fc-87cc-8949a094a01e ENGLISH SUMMARY: Background: Despite global initiatives to combat malnutrition, severe acute malnutrition (SAM) remains a significant threat to children under five. The World Health Organization (WHO) protocol for SAM management suggests that a successful discharge complies with ten specific criteria. Post-discharge SAM relapse remains poorly defined and understudied. Therefore, standardised definitions of relapse are needed, as well as evidence-based research on long-term SAM recovery after discharge. Objectives: The study’s primary objective was to determine whether a relationship exists between adherence to hospital discharge criteria and rates of SAM relapse six months after discharge. The secondary objectives were (i) to determine whether a relationship exists between adherence to SAM discharge criteria and the rates of failure to thrive after discharge; (ii) to determine the incidence of SAM relapse (a) within six months after discharge, and (b) whether certain discharge criteria points have a greater impact on SAM relapse than others; (iii) to determine whether SAM is being correctly diagnosed on admission based on anthropometric criteria; and (iv) to make recommendations to the unit for future management of SAM, with a specific focus on ensuring adequate discharge criteria or procedures. Methods: A retrospective file review was conducted at Wesfleur Hospital Paediatric Ward in Cape Town, South Africa between 1 August 2022 and 31 July 2023. A total of 250 medical files were manually reviewed and 26 non-medical SAM participants were identified using inclusion and exclusion criteria. The drop-out rate was 11.5%, resulting in a final study population of 23 participants with SAM. Results: A total of 92.3% of diagnoses were correctly documented in the files, while 7.7% were missed—the patient was classified as having SAM based on diagnostic parameters, but the diagnosis was not made (95% CI: 73.4 – 98.7). The incidence of SAM relapse reached 75% among participants in the non-adherent group and 0% in the adherent group (p = 0.0001). The study found a statistically significant relationship between adherence to hospital discharge criteria and rates of SAM relapse (p = 0.001) and failure to thrive (p = 0.0001) after discharge. Higher adherence to discharge criteria is associated with a lower rate of SAM relapse. Non-adherence to four specific criteria—return of appetite**, adequate weight gain*, caregiver nutritional counselling *, and addressing social concerns*—was significantly associated with increased incidence of SAM (*p < 0.05; **p < 0.005). The average number of follow-up months per child until an observed SAM relapse was 2.4, indicating that relapse occurred early within the follow up period. Conclusion: A relationship exists between adherence to hospital discharge criteria and post-discharge outcomes in paediatric patients diagnosed with SAM. Although the ideal outcome is to obtain an adherent discharge score, it may not always be feasible in practice. It is therefore beneficial to understand how to utilise a low discharge score to anticipate future complications. This research provides motivation for services and resources to be prioritised equitably to patients who are discharged with a non-adherent score. AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar. Masters 2025-01-28T14:14:36Z 2025-01-28T14:14:36Z 2024-12 Thesis https://scholar.sun.ac.za/handle/10019.1/131605 en_ZA Stellenbosch University xvii, 114 pages : illustrations, includes annexures application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Malnutrition in children -- Treatment -- Evaluation Patient compliance -- Evaluation Malnutrition in children -- Complications -- Relapse Hospital care -- Quality control UCTD Burnett, Georgia Kirsten In children with severe acute malnutrition, is there a relationship between adherence to hospital discharge criteria and the rates of relapse thereafter |
| title | In children with severe acute malnutrition, is there a relationship between adherence to hospital discharge criteria and the rates of relapse thereafter |
| title_full | In children with severe acute malnutrition, is there a relationship between adherence to hospital discharge criteria and the rates of relapse thereafter |
| title_fullStr | In children with severe acute malnutrition, is there a relationship between adherence to hospital discharge criteria and the rates of relapse thereafter |
| title_full_unstemmed | In children with severe acute malnutrition, is there a relationship between adherence to hospital discharge criteria and the rates of relapse thereafter |
| title_short | In children with severe acute malnutrition, is there a relationship between adherence to hospital discharge criteria and the rates of relapse thereafter |
| title_sort | in children with severe acute malnutrition is there a relationship between adherence to hospital discharge criteria and the rates of relapse thereafter |
| topic | Malnutrition in children -- Treatment -- Evaluation Patient compliance -- Evaluation Malnutrition in children -- Complications -- Relapse Hospital care -- Quality control UCTD |
| url | https://scholar.sun.ac.za/handle/10019.1/131605 |
| work_keys_str_mv | AT burnettgeorgiakirsten inchildrenwithsevereacutemalnutritionistherearelationshipbetweenadherencetohospitaldischargecriteriaandtheratesofrelapsethereafter |