Abstract:
Background: World Health Organization recommends outpatient therapeutic feeding
program as a standard treatment protocol for the management of uncomplicated severe
acute malnutrition. This program has been decentralized to health post in Ethiopia.
However, time to recovery from severe acute malnutrition under this program varies.
Objective: This study identified determinants of time to recovery from severe acute
malnutrition
Methods: Three years institution based retrospective cohort study was conducted in Girar
Jarso district from January 2015 to December, 2017. Six of 17 health posts, selected by
lottery method and 363 charts of children were selected by simple random sampling. Data
extracted retrospectively by checklist and data collectors were nurses. The study variable
includes; socio-demographic characteristics, anthropometries, co-morbid conditions and
routine medications. Difference in rate of survival for grouped factors was assessed by
Kaplan-Meier curves with log-rank test. Cox-proportional hazard regression was used to
identify predictor factors. Proportionality of hazard over time was assessed graphically by
log minus log survival. Effect was reported by adjusted hazard ratio with its 95%CI at pvalue <0.05.
Results: Total 342 charts of children included in this study. Proportion of recovery,
defaulter, and not-responded to treatment were 85.1%, 6.4%, 8.5% respectively with no
death. The median time to recovery was 42 days. Children, who received vitamin A (AHR=
2.9, 95% CI, 1.6- 5.2), referred by community volunteers for treatment (AHR =1.3, 95%CI,
1.01-1.7), vaccinated (AHR= 2.0, 95%CI, 1.3- 3.1), family travel ≤ 30 minute to treatment
site (AHR =1.5, 95%CI 1.13 -1.9), without diarrhea (HR=1.36, 95%CI 1.01-1.86), and
without pneumonia (HR=1.8, 95%CI, 1.2-2.6), recovered by higher rate at any unit time
during follow-up period than their counter group.
Conclusions: Receiving Vitamin A, being vaccinated, referred by community volunteer for
treatment and not having diarrhea and pneumonia were significant predictors of time to
recovery from severe acute malnutrition. Community referral and routine immunization
should be strengthened. The service providers should adhere to guide line to prevent comorbid condition.
