Time to recovery from severe acute malnutrition and its predictors: a multicentre retrospective follow-up study in Amhara region, north-west Ethiopia.

OBJECTIVES: This study aimed to determine the time to recovery from severe acute malnutrition (SAM) and its predictors in selected public health institutions in Amhara Regional State, Ethiopia. DESIGN: An institution-based retrospective follow-up study was conducted using data extracted from 1690 patient cards from September 2012 to November 2016. SETTING: Selected government health institutions in the Amhara region, Ethiopia. PARTICIPANTS: Children treated in therapeutic feeding units for SAM were included. OUTCOME MEASURES: Time to recovery from SAM. RESULTS: One thousand and fifty children have recovered from SAM, 62.13% (95% CI 59.8% to 64.5%). The median time to recovery was 16 days (IQR=11-28). Female gender (adjusted HR (AHR)=0.81, 95% CI 0.67 to 0.98), oedematous malnutrition (AHR=0.74 95% CI 0.59 to 0.93), pneumonia (AHR=0.66, 95% CI 0.53 to 0.83), tuberculosis (AHR=0.53, 95% CI 0.36 to 0.77), HIV/AIDS (AHR=0.47, 95% CI 0.28 to 0.79), anaemia (AHR=0.73, 95% CI 0.60 to 0.89) and receiving vitamin A (AHR=1.43, 95% CI 1.12 to 1.82) were notably associated with time to recovery. CONCLUSIONS: The time to recovery in this study was acceptable but the proportion of recovery was far below the minimum standard. Special emphasis should be given to the prevention and treatment of comorbidities besides the therapeutic feeding. Supplementing vitamin A would also help to improve the recovery rate.

Time to recovery and determinants of severe acute malnutrition among 6-59 months children treated at outpatient therapeutic programme in North Gondar zone, Northwest Ethiopia: a prospective follow up study.

BACKGROUND: Despite the available interventions to tackle nutritional problems, there is scarce information on time to recovery and its determinants among children with SAM in Ethiopia. OBJECTIVE: This study was aimed at finding the time to recovery and determinants among 6-59 months children with severe acute malnutrition treated at an outpatient therapeutic programme in North Gondar zone, northwest Ethiopia. METHODS: Facility based prospective follow up study was conducted from March 24 to May 24, 2017. A total of 408 children with the age of 6-59 months were included in the study. Structured interviewer administered questionnaire was used. Anthropometric measurements were conducted every week. The median time of recovery, Kaplan Meier (KM) curve, and log rank test were computed. Both bi-variable and multivariable Cox regression model was fitted. To establish an association between time to recovery and its determinants 95% confidence interval (CI) and p-value < 0.05 were used. Proportional hazard assumption was checked graphically and using Schoenfeld residual test. RESULTS: Out of 389 children, 254 (65.3%) recovered. The median time to recovery was 38.5 ± IQR of 14 days. Children with diarrhoea AHR = 0.81 with 95% CI (0.73, 0.99), children taken amoxicillin AHR = 2.304 with 95% CI (1.68-3.161), and had vomiting at admission AHR = 0.430 with 95% CI (0.205, 0.904) were significant predictors of time to recovery. CONCLUSIONS AND RECOMMENDATIONS: The overall time to recovery has not met the minimum sphere international standard which was lower than 75%. It is advisable to give emphasis to patients with diarrhoea and vomiting.