Abstract
Background Malnutrition has been among the most common public health problems in the world, especially in developing countries including Ethiopia. Even though the Ethiopian government launched stabilization centers in different hospitals, there are limited data on how long children will stay in treatment centers to recover from severe acute malnutrition. This study aimed to assess the time to recovery and its predictors among children 6–59 months with severe acute malnutrition admitted to public hospitals in East Amhara, Northeast Ethiopia. Methods Institution-based, prospective cohort study was conducted in seven public hospitals in East Amhara and a total of 341 children were included in the study. The results were determined by Kaplan–Meier procedure, log-rank test, and Cox-regression to predict the time to recovery and to identify the predictors of recovery time. Variables having P value ≤0.2 during binary analysis were entered into multivarable Cox proportional hazards regression analysis. P value <0.05 was considered statistically significant. Results The nutritional recovery rate was 6.9 per 100 person-days with a median nutritional recovery time of 11 days (an interquartile range of 6). The independent predictors like using NG tube for feeding (AHR = 0.44, 95% CI: 0.27–0.71), not entering phase 2 on day 10 (AHR = 0.19, 95% CI: 0.12–0.29), and being admitted to referral hospitals (AHR = 0.52 95% CI: 0.37–0.73) were associated with longer periods of nutritional recovery time. Conclusion Both the recovery rate and the recovery time were within the acceptable minimum standards. But, special attention has to be given to children who failed to enter phase 2 on day 10, for those who needed NG tube for feeding, and for those admitted to referral hospitals during inpatient management.
Highlights
Malnutrition has been among the most common public health problems in the world, especially in developing countries including Ethiopia
Malnutrition can be acute or chronic while acute malnutrition is further classified into severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) [3]
Study Setting. e study was conducted from February 28 to May 02, 2019, in East Amhara Hospitals. ere are a total of 34 hospitals in East Amhara, which provide services for an estimated population of million. e study was conducted in seven public hospitals including Tefera Hailu Memorial Hospital of Sekota, Woldia Hospital, Mekaneselam Hospital, Hidar hospitals, Dessie Referral Hospital, Kemise Hospital, and Debre Berhan Referral Hospital
Summary
Malnutrition is a state in which the physiological functioning of the child’s body is impaired due to either undernutrition or overnutrition [1]. Health professionals unknowingly use practices that are highly dangerous for severely malnourished children [8, 11] To solve such problems, WHO has developed guidelines for managing SAM [12] which was adopted later on to our context [13] and defined that inpatient management should include stabilization, transition, and phase 2 until full recovery at home. Most of the studies were retrospective and lack the most important variables such as the wealth and food security status of the families and institutional factors which could affect the recovery time of children with SAM [18, 19]. Erefore, this study tried to assess time to recovery and its predictors among children 6–59 months admitted with SAM prospectively
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