Abstract:
Background: Treatment at stabilization center is an important intervention to avert the huge
burden of mortality for children with complicated severe acute malnutrition (SAM). Despite the
improvement in hospital coverage, and the development of standardized WHO treatment
guideline, recent reviews indicated a wide range in recovery rate (34-88%) due to several
context-specific factors. This study assessed the contextual predictors of recovery.
Objective: This study aimed to estimate time to recovery and to determine predictors of time to
recovery among children aged 6-59 month with severe acute malnutrition.
Method: An institution based retrospective cohort study design was used among 375 children
aged 6-59 months admitted in Jimma university medical center, from September 2014 to
September 2016, Jimma. All eligible children were enrolled and assessed using pretested
questionnaire. Kaplan Meir estimate and survival curve was used to compare the time to
recovery using log-rank test among different characteristics. Cox Proportional Hazard Model
was used to identify significant predictors of time to recovery. A p value less than 0.05 was
declared statistically significant.
Results: The rate of recovery was 4.06 per 100 person days. Median time of recovery for cohort
of SAM children’s was 19 days (95%CI: 17.95-20.05). Independent predictors of time to
recovery were: Play stimulation (AHR=1.93, 95%CI: 1.23-3.03), vaccination status (AHR=2.26,
95% CI: 1.12-4.57), TB (AHR= 0.48, 95% CI: 0.27-0.87), malaria (AHR=0.34,95%CI:0.13-
0.88), use of amoxicillin (AHR=1.54, 95%CI: 0.008-2.34), deworming (AHR=1.8, 95%CI: 1.18-
2.73) and shock (AHR=0.18, 95%CI: 0.05-0.59).
Conclusion and recommendation: The findings of this study showed that average length of
stay on treatment and median time for recovery are within the sphere standard. So appropriate
provision of routine medication, psychosocial stimulation and management of medical comorbidity as per the national SAM management protocol is needed to promote fast recovery.
