Title : Undernutrition and Management Outcomes of Hospitalized Children Before and After 2015 Armed Crisis in Aden
Introduction: In 2015, Yemen spiraled into armed crisis and the ongoing fighting, which has been dating back to 2011 with low level of conflict, has escalated and pushing Yemen to the brink of famine. The study aimed to describe the pattern of undernutrition and outcome indicators among hospitalized children during three time periods: 2010 (before the 2011 revolution), 2014 and 2016 (before and after 2015-armed crisis).
Methods: This is a retrospective observational study used data generated from registry records of Severe Acute Malnourished (SAM) children admitted in the Therapeutic Feeding Centers (TFC) of Al-Sadaka General Teaching Hospital, Aden. Variables included were age, gender, address, weight (kg), length/height (cm), mid-upper arm circumference (cm), presence of bilateral pitting edema, standard deviation of weight for height, weight for age, height for age, and management outcomes (recovery, death, defaulter, and transfer out & medical transfer).
Result: A total of 803 new complicated SAM patients were included in the study, of which 22.7%, 32.0%, and 45.3% were admitted during 2010, 2014, and 2016 respectively. Compared to 2010, the frequency of severe wasting, underweight, and stunting were significantly high in 2016. There was no significant gender difference. The majority of children were from Shikh Othman and Dar Sa’ad districts. Increasing percentages of patient in 2016 found from Altawahi, Almualla, Khourmakser districts, which were the scene of armed clashes during 2015. Poor outcome indicators were noted during 2016.
Conclusion: Poor nutritional and outcome indicators were encountered after the 2015-armed crisis. It is incumbent on pediatricians, public health professionals, and policy makers to seriously address undernutrition in the context of conflict as critical and priority issue. Children must be counted.
Keywords: Conflict, SAM, Outcome Indicators, Yemen, Hospital.
- War and crisis destroy infrastructure, resources, impede production, hamper market relationships, reduce income, and lead to poverty, food insecurity, and malnutrition.
- Frequency of severe wasting, underweight, and stunting increased significantly after crisis as well as poor outcomes indicators. These negative health outcomes could be attributed to the damaging effect of the armed conflict, and or through accentuation and exacerbation of the country's endemic humanitarian problems.
- It is incumbent on pediatricians, public health professionals, and policy makers to seriously address undernutrition in the context of conflict as critical and priority issue. They are required to heightened their effort to cope with the emerging challenges that interfere with delivery of food and food determinants, and to intensify their work at the community and outpatient programs to manage acute malnutrition before developing complication and the need to inpatient care.