TIME-TO-RECOVERY FROM SEVERE ACUTE MALNUTRITION AND ITS PREDICTORS AMONG UNDER FIVE CHILDREN ADMITTED TO STABILIZATION CENTERS OF MIESO WOREDA, EASTERN ETHIOPIA

Abstract

Severe acute malnutrition (SAM) is a life-threatening condition that is responsible for high morbidity and mortality among children under 5 years of age in the world. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. Even though enormous problems determine time to recovery from severe acute malnutrition, no study was done in the study area with agro pastoralist community which indicates the need for further study to assess the time to recovery from SAM and its predictors among under five children admitted to stabilization centers. Objective: To estimate the time to recovery from SAM and predictors of time to recovery for severely malnourished under-five children admitted to the stabilization centers of Mieso Woreda Public health facilities, Eastern Ethiopia from January 01/ 2019 to December 31/2022. Methods: Facility-based retrospective cohort study was conducted among 535 severely acute malnourished children. Simple random sampling method was used to select medical records of the study participants. Data was extracted from severe acute malnutrition management registration book adopted from the Ethiopian protocol for the management of SAM, using pretested standard checklist. Data was entered using Epidata version 4.6 and was exported to STATA version 17 for analysis. Log logistic survival regression was fitted to identify the predictors of time-to-recovery, thereby estimating the crude and adjusted time ratios with 95% confidence intervals. Statistical significance was considered at p<0.05. Results: After a maximum of 38 days treatments 65.98% (95CI: 61.9%- 69.9%) of the children recovered from SAM with median recovery time of 12days with Inter quartile ranges (IQR) of 11 to 13days. The overall incidence rate of recovery was 58 per 1000 person-day observation with total person - time observation of 6,091 days. The independent predictors of delay in recovery time from SAM were presences of pneumonia (ATR: 0.80, 95%CI:0.75-0.85), malaria (ATR:0.79, 95%CI:0.65-0.90), severe anemia(ATR:0.71,95%CI:0.59-0.84),dehydration (ATR:0.82,95%CI: 0.74-0.91) and Nasogastric tube feeding (ATR:0.80,95%CI: 0.69-0.93). Conclusions: While the average length of stay and the median time- to- recovery from SAM were within the acceptable ranges of SPHERE standard, the cure rate was below the standard. Presence of pneumonia, malaria, severe anemia, dehydration and Nasogastric tube feeding were the xv significant predictors of delay in recovery time from SAM. Strong emphasis should be given to early diagnosis and management of Pneumonia, Malaria, Severe anemia, dehydration and NG tube feeding.