Time to cure and predictors of recovery among children aged 6-59 months with severe acute malnutrition admitted in jimma university medical center, jimma, Ethiopia.

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.