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: A Retrospective Follow-Up Study

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.

A cohort analysis of survival and outcomes in severely anaemic children with moderate to severe acute malnutrition in Malawi

“…One study in Ethiopia reported that there was no significant difference in recovery among severe malnourished children with anaemia compared to those without anaemia [ 26 ]. On the other hand another study in Ethiopia found that children with SAM and anaemia had less chance of recovering compared to those who had SAM and no anaemia [ 27 ], which was similar to findings of a study in Kenya (Kwambai et al, Unpublished). However, this study did not have a comparison group.…”

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“…Weight gain and length of staying were in line with the international standard and Ethiopian protocol for management of SAM. These results are concordant with those of a similar research conducted in Northwest Ethiopia [76]. Comorbidities in the enrolled population may elucidate the low recovery rate [76].…”

“…These results are concordant with those of a similar research conducted in Northwest Ethiopia [76]. Comorbidities in the enrolled population may elucidate the low recovery rate [76]. Other explanations may be related to therapeutic milk intake and high rates of mortality.…”

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

“…According to the sphere standards, the recovery time of children hospitalized in stabilization centers should be less than four weeks and it is alarming if it takes longer than 6 weeks [ 14 ]. Even though sphere standards recommend shorter recovery times, most of the studies in Ethiopia showed that the median time to recovery was high and ranges from 14 days to 8.7 weeks [ 15 , 16 ], respectively. But, children, due to various factors, do not get cured on time.…”