Determinants of time to recovery among children with severe acute malnutrition admitted to goba refferal hospital, bale, Ethiopia

Abstract

Background: Malnutrition remains to be one of the most common causes of morbidity and mortality among children in developing countries. Children with severe acute malnutrition often die because doctors unknowingly use practices that are suitable for most children, but highly dangerous for severely malnourished children. In Ethiopia management of severe acute malnutrition guide line, training material and management protocol were developed and being updated continuously to improve outcome of treatment. Despite these efforts, recent review indicated that the average time to recovery during severe acute malnutrition inpatient treatment ranged from 11-79 days compared to minimum international standards recommendation of less than 30 days. Objective: To assess the determinants of time to recovery among children with severe acute malnutrition admitted to Goba Referral Hospital, Bale, Ethiopia. Methods: Institution based retrospective cohort study was conducted among 306 children with severe acute malnutrition who were admitted to Goba Referral Hospital from September2014 to September2017. Data analysis was conducted using SPSS version 23 for windows. The time to recovery during SAM treatment was estimated using the Kaplan-Meier survival curve and the Cox proportional-hazard model was fitted to identify the determinant factors of time to recovery from SAM. Result. From a total of 332 records assessed analysis was based on 306 (92.2%) cases with complete base line data. Children who achieved nutritional recoveries were 58.2% and the median recovery time was 15 days with Inter Quartile Range (IQR) of 10(15, 20). After adjustment for important covariates in multivariable model, the time to recovery during SAM treatment was significantly shorter for children who received vitamin A supplementation compared to those who did not receive. (AHR=1.67; 95%CI; 1.129-2.470), and children who had no comorbidity of tuberculosis at admission had shorter time to recovery compared to those who had. (AHR=0.21; 95%CI; 0.052-0.881). Conclusion and Recommendation: In this study Children who achieved nutritional recoveries were 58.2% with a median recovery time of 15 days .Determinant factors for time to recovery from SAM among children admitted to nutritional rehabilitation unit in Goba Referral Hospital were vitamin A supplementation and the presence of comorbidity of tuberculosis at admission. Thus emphasis given to children with comorbidity of tuberculosis at admission and vitamin A supplementation at admission will have a positive effect on treatment duration.