Time to recovery from malnutrition and its predictors among human immunodeficiency virus positive children treated with ready-to-use therapeutic food in low resource setting area: A retrospective follow-up study.

Abstract

Malnutrition is a serious public health issue and a frequent impact of human immunodeficiency virus (HIV) infection, which raises the risk of morbidity and mortality in affected people. Despite the World Health Organization's (WHO) support for the use of ready-to-use therapeutic foods (RUTF) to treat malnutrition, research on the length of time it takes for children with HIV infection to recover from malnutrition and the factors that predict it is lacking, particularly Ethiopia. An institution-based retrospective follow-up study was carried out in the Amhara regional state referral hospitals in Northern Ethiopia. From 2013 to 2018, a total of 478 children who received RUTF treatments were chosen using a simple random sampling technique. To calculate the likelihood of recovery and the median recovery period, incidence and Kaplan-Meier survival analyses were performed. The Cox regression model was used to identify predictors of time to recovery from malnutrition. The multivariable model only included variables with a p value below 0.2. While factors were deemed to be substantially linked with the outcome variable if their p value was less than 0.05. The median recovery duration was 5 months (95% confidence interval [CI] = 4-5 months), and the nutritional recovery rate was 64.64% (95% CI = 60.2-68.9). Moderate acute malnutrition (adjusted hazard ratio [AHR] = 4.60, 95% [CI] = 2.85-7.43), WHO clinical stage I (AHR = 4.01, 95% CI = 1.37-11.77), absence of opportunistic infection (AHR = 1.76, 95% CI = 1.19-2.61), haemoglobin (Hgb) count above the threshold (AHR = 1.36, 95% CI = 1.01-1.85) and family size of 1-3 (AHR = 2.38, 95% CI = 2.38-5.00) were significantly linked to rapid recovery from malnutrition. In comparison to the period specified by the national guideline (3 months for moderate and 6 months for severe acute malnutrition), the median time to recovery was lengthy. Acute malnutrition, clinical stage, opportunistic infection, Hgb count, and family size were statistically associated with early recovery from malnutrition.