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

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.

Time to recovery from severe acute malnutrition and its predictors among children aged 6–59 months at Asosa general hospital, Northwest Ethiopia. A retrospective follow up study

“…This reduced incidence of recovery with increased duration of hospital stay might be attributable to inpatient complications and increased risk of nosocomial infections. It is comparable with the study findings from Addis Ababa (4.6) [24], Southern Ethiopia (3.61) [15], Jimma (4.06) [18], East Amhara Hospitals(6.9) [10], Pawi, Benishangul Gumuz(5.3) [22]. This might be due to the relative similarity in readiness of health care facilities and socio economic characteristics of the study subjects.…”

“…However, the median time of recovery in this study is far faster than the median recovery time reported in Dire Dawa (61 days) [12], Arba Minch(49 days) [16], and Southern Ethiopia(26 days) [15] and a bit faster than recovery time reported in Jimma(19 days) [18]. However, it is a bit longer duration compared to recovery time reported in the Amhara region [10,11]. The present study found an overall incidence rate of 5.28 per 100 child day's observation with the highest incidence of recovery during 15-20 days((20.06 per 100 child days' followup) followed by 20-25 days(13.63 per 100 child days' observations).…”

“…of Gonder comprehensive specialized hospital)27l 69.2% [3], and in selected health institutions of Amhara region 62.13 [29]. Moreover, the finding is lower than the study finding from Yekatit 12 Hospital in Ethiopia 81.3% [30], SNNP of Ethiopia 87% [8], Addis Ababa, 79%, [24], East Amhara Hospitals 74.49% [10], Meta-analysis in Ethiopia 70.5% [31] and Shebedino, Southern Ethiopia 79.6% [32]. The discrepancy might be due to differences in socioeconomic status, and quality of health care provided to Children in the stabilization center.…”

“…As per the international sphere standard recommendation, the recovery time of children admitted to stabilization center should be less than one month [9]. However, literature has showed that longer recovery time varying from 11 days to 8.7 weeks in Ethiopia [10][11][12]. Furthermore, according to the standard, the expected proportion of recovered children from SAM should exceed 75%.…”

Achievement of adequate weight gain among infants and children with complicated severe acute malnutrition receiving treatment in therapeutic feeding centers of South Sudanese refugee camps in Ethiopia

“…The sample size was calculated for both objectives (prevalence of achieving adequate weight gain and factors associated with it); the larger sample size was found by using a single population proportion formula for calculation of prevalence, taking the proportion of treated children with SAM who achieved adequate average weight gain as 71.3%, 17 a significance level of 0.05, a 95% confidence interval (CI), a margin of error of 5% and a 10% incompleteness rate. The final calculated sample size was 332.…”