Recovery time from severe acute malnutrition and associated factors among under-5 children in Yekatit 12 Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

Abstract

OBJECTIVES: Recovery time from severe acute malnutrition (SAM) is often a neglected topic despite its clinical impact. Although a few studies have examined nutritional recovery time, the length of hospitalization in those studies varied greatly. Therefore, the aim of this study was to determine the recovery time from SAM and to identify predictors of length of hospitalization among under-5 children.METHODS: A retrospective cohort study was conducted among 423 under-5 children with SAM who had been admitted to Yekatit 12 Hospital. Kaplan-Meier analysis was used to estimate time to nutritional recovery, and Cox proportional hazard regression analysis was performed to determine independent predictors.RESULTS: The nutritional recovery rate was 81.3%, and the median recovery time was 15.00 days (95% confidence interval [CI], 13.61 to 16.39). Age, daily weight gain per kilogram of body weight, vaccination status, and the existence of at least 1 comorbidity (e.g., pneumonia, stunting, shock, and deworming) were found to be significant independent predictors of nutritional recovery time. The adjusted hazard ratio (aHR) for nutritional recovery decreased by 1.9% for every 1-month increase in child age (aHR, 0.98; 95% CI, 0.97 to 0.99).CONCLUSIONS: The overall nutritional recovery time in this study was within the Sphere standards. However, approximately 13.0% of children stayed in the hospital for more than 28.00 days, which is an unacceptably large proportion. Daily weight gain of ≥8 g/kg, full vaccination, and deworming with albendazole or mebendazole reduced nutritional recovery time. Conversely, older age, pneumonia, stunting, and shock increased nutritional recovery time.

Risk factors for severe acute malnutrition among children aged 6–59 months: A community-based case-control study from Vellore, Southern India

“…[ 34 ] In a study done in Ethiopia, fully vaccinated children had a higher cause of getting recovered from SAM compared to partially or not vaccinated children. [ 35 ] The current study showed an increase in SAM among those who were partially immunized. This, however, was not statistically significant after adjusting for confounders.…”

Assessment, outcomes and implications of multiple anthropometric deficits in children

“…Adimasu et al studied effect of stunting on hospitalised children with SAM and found that many factors like associated pneumonia, stunting immunisation increased the recovery time and stay in the hospital. 15 There are no reports on the recovery time of stunted and wasted children without complications and managed in the community. This is the first report that suggests that the management of children with multiple anthropometric deficits can give rewarding results.…”

Time to Recovery and Its Predictors among Children 6–59 Months Admitted with Severe Acute Malnutrition to East Amhara Hospitals, Northeast Ethiopia: A Multicenter Prospective Cohort Study

“…By understanding this problem, the FMOH of Ethiopia established the National Nutrition Program (NNP) to improve the nutrition service delivery in health facilities [ 17 ]. Most of the studies were retrospective and also 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 ]. Therefore, this study tried to assess time to recovery and its predictors among children 6–59 months admitted with SAM prospectively.…”