Abstract
Background Ethiopia is one of the countries in sub-Saharan Africa with the highest rates of severe acute malnutrition. Early recovery is a performance indicator for severe acute malnourished children for the therapeutic feeding. Despite the available interventions to tackle nutritional problems, there is scarce information on time to recovery and its determinants among children with SAM in Ethiopia. Objective The study is aimed at assessing time to recovery from severe acute malnutrition and its predictors among admitted children aged 6-59 months at the therapeutic feeding center of Pawi General Hospital, northwest Ethiopia, from January 2013 to December 2017. Methods An institution-based retrospective follow-up study was conducted among 398 children aged 6-59 months. The data were collected by using data extraction sheet. The data were cleaned and entered using EpiData version 4.2.0.0 and exported to Stata version 14 statistical software for further analysis. Kaplan-Meier survival curve was used to estimate median nutritional recovery time after initiation of inpatient treatment, and log-rank test was used to compare time to recovery between groups. The Cox proportional regression model was used to identify the predictors of recovery time. Adjusted hazard rate with its 95% CI was reported to show strength of relationship. Results The recovery rate was 5.3 per 100 person-day observations, and the median recovery time was 14 days (95% CI: 13–15). The lower chance of early recovery was found among children who were not fully vaccinated (AHR: 0.73 (95% CI: 0.56, 0.96)), while high chance of recovery was found among children who had no anemia (AHR: 1.66 (95% CI: 1.23, 2.23)), TB (AHR: 2.03 (95% CI: 1.11, 3.71)), and malaria infection (AHR: 1.54 (95% CI: 1.09, 2.17)) at admission. Conclusion and Recommendation. The overall nutritional recovery rate was below the accepted minimum standard. Children not fully vaccinated and children without malaria, anemia, and TB comorbidities at admission had a higher chance of recovering early from severe acute malnutrition. Hence, treating comorbidities is vital for prompt nutritional recovery.
Highlights
Severe acute malnutrition (SAM) is defined as very low weight for height < 70%, visible severe wasting, or the presence of nutritional edema
In children aged 6–59 months, mid-upper arm circumference (MUAC) less than 115 mm is indicative of severe acute malnutrition [1, 2]
This study is aimed at determining the time to recovery from severe acute malnutrition and its predictors among children aged 6-59 months admitted to Pawi General Hospital, northwest Ethiopia
Summary
Severe acute malnutrition (SAM) is defined as very low weight for height < 70%, visible severe wasting, or the presence of nutritional edema. Most of the children with SAM live in South Asia and sub-Saharan Africa It is the most common cause of hospital admissions, accounting for 20% of pediatric hospital admissions in Ethiopia [3]. Ethiopia is still one of the countries with the highest rates of severe acute malnutrition despite a small decline from 12% to 10% over the last 15 years. Ethiopia is one of the countries in sub-Saharan Africa with the highest rates of severe acute malnutrition. The study is aimed at assessing time to recovery from severe acute malnutrition and its predictors among admitted children aged 6-59 months at the therapeutic feeding center of Pawi General Hospital, northwest Ethiopia, from January 2013 to December 2017. Children not fully vaccinated and children without malaria, anemia, and TB comorbidities at admission had a higher chance of recovering early from severe acute malnutrition.
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