Abstract:
Background: Severe acute malnutrition is defined as weight for height below minus three World
health organization growth standards or middle upper arm circumference less than 115mm for a
child greater than six months and/or presence of bilateral edema. It is the reason for 20% of
pediatrics hospital admissions. Despite, a bilateral effort being done at outpatient and inpatient
therapeutic programs, time to recovery from severe acute malnutrition remains alarming in
Ethiopia. A better understanding of predictors of recovery is important to design appropriate
interventions at rehabilitation centers.
Objective: To assess time to recovery and its predictors among under-five children with severe
acute malnutrition admitted at rehabilitation centers in Metekele Zone, Northwest Ethiopia,
2022.
Methods: Facility-based retrospective cohort study was conducted from May 29 to June 21,
2022, among 512 under-five children with severe acute malnutrition admitted at rehabilitation
centers in Metekele Zone from 2017-2021. A simple random sampling technique was used to
select the samples from the registration log book. Data were collected from medical record
numbers and registrations using a structured checklist. The data were entered into Epi-data and
exported to STATA for analysis. A Kaplan-Meir curve was used to estimate median survival
time. Cox proportional hazard regression model used to identify predictors of time to recovery.
Results: In this study, 68.38% of children recovered from severe acute malnutrition with an
overall nutritional recovery rate of 6.04 per 100 children-days observation (95% CI: 5.75-7.09).
The overall median time of nutritional recovery was 13days (interquartile range10-16). Children
with no tuberculosis(AHR)=1.78, 95% CI:1.08-2.92), no human immunodeficiency virus (AHR=
2.98, 95% CI:1.62-5.48), absence of inpatient complication (AHR= 3.71, 95%CI:1.29-10.32),
intake of F-100 (AHR= 0.37, 95% CI: 0.16-0.89), plumpy nut (AHR= 4.23, 95%CI: 1.58-11.31),
and amoxicillin (AHR= 1.86 95%CI: 1.17-2.94)were significantly predictors of time to
recovery.
Conclusion and recommendation: Median time of nutritional recovery was in an acceptable
range, while the rate of recovery was low compared to the sphere standard. Special attention
should be given to those children who had tuberculosis, HIV, inpatient complication, and did not
receive (F-100, plump nut, and amoxicillin) during admission. Efforts should be strengthened to
facilitate early recovery by considering the identified predictors of time to recovery.
