Time to recovery from severe acute malnutrition and associated factors among under-5 children in public Health Centers in Jarso District, East Ethiopia: Retrospective Cohort Study

Severe acute malnutrition and associated factors among under-5 children

Abstract

Background: Severe acute malnutrition affects about 20 million children under five worldwide, and it increases the risk of morbidity and mortality with infectious diseases.  Despite its therapeutic interventions, Ethiopia has the highest rate of child mortality which is about 28% of all child fatalities among under-five children. Thus, this study aimed to determine the median time to recovery from severe acute malnutrition and associated factors among children admitted to health centers in Jarso District, East Ethiopia.

Methods: A retrospective cohort study was conducted in Jarso District from March 01 to April 30, 2022, with a total sample size of 440.  The pretested tools were used to collect the data. The nutritional recovery time was estimated using Kaplan-Meier analysis, and the significance of the observed difference in recovery time between various groups of predictor variables was assessed using the Log-rank test. Cox proportional-hazard regression analysis was used to determine the independent predictors.

Results: The nutritional recovery rate was 82.7%, and the median recovery time was 28 days (95% CI: 24.98–31.02). Age <24 months (AHR = 0.89, 95% CI: 0.78–0.99), daily weight gain <8 g/kg/day (AHR = 0.94, 95% CI: 0.91-0.96), not fully vaccinated (AHR = 0.12, 95% CI: 0.03-0.21), presence of pneumonia (AHR =0.93, 95% CI: 0.89–0.97), presence of stunting (AHR = 0.97, 95% CI: 0.96-0.98), presence of shock (AHR = 0.95, 95% CI: 0.93-0.98), and children received vitamin A (AHR = 1.08, 95% CI: 1.01–1.15) were the significant predictors of nutritional recovery time.

Conclusion: The nutritional recovery rate and median recovery time were found to be within the acceptable range of the minimum standard specified by the international standards value.  Interventions that targeted young age children, poor daily weight gain, not fully vaccinated, pneumonia infection, stunted children, children with shock, and lack of vitamin A supplementation are required to shorten time to recover from severe acute malnutrition among under-5 children.