Abstract:
Background: One of the challenges in treating children with severe acute malnutrition is the 
recurrence of the condition. After receiving treatment for severe acute malnutrition, the 
percentage of children who relapsed ranged widely, from 0% to 37%, depending on how long 
it had been after discharge. There is little data on the consequences of severe acute 
malnutrition after discharge including relapse. 
Objective: To assess magnitude of relapse and associated factors of sever acute malnutrition 
children aged 6-59 months in Karamara General Hospital, Jigjiga Town, Ethiopia from 
March 1- 30, 2023
Method: Institution-based cross-sectional study was conducted among 419 children aged 6-
59 months discharged from therapeutic feeding programs for severe acute malnutrition in
Karamara General Hospital in Jigjiga town, eastern Ethiopia. Data was collected from 
mothers after cases were identified from health management information system report and 
registration. Bivariable and multivariable logistic regression analyses were used to identify 
factors significantly associated with undernutrition. Adjusted Odds ratios (AOR) with (95% 
CI) was used to report association and significance declared at p-value <0.05.
Results: A total of 415 children aged 6-59 mo. with mothers/caregivers were included in the 
study. The magnitude of relapse of severe acute malnutrition after 15 days after discharge 
was 15.7% (95% CI: 12.1, 18.8). Several associated factors were identified for relapse of 
severe acute malnutrition. Maternal age(15-30yrs) (AOR = 3.23; 95% CI: (1.55, 6.74)), 
maternal educational level (AOR = 0.07; 95% CI: (0.38,0.14)), antibiotic medication after 
discharge (AOR = 4.48; 95% CI: (1.46, 6.40)), food security status of HHs(AOR = 3.40, 95% 
CI: 1.40,8.09), type of admission(AOR= 2.02; 95%CI: (1.01, 4.05)) and household food 
security status (AOR = 0.81; 95% CI: (0.34,0.91)) were significantly associated with relapse 
of severe acute malnutrition.
Conclusions: This study revealed that magnitude of relapse of SAM in children aged 6-59 
months was high in the study area. Maternal age, maternal educational level, admission type, 
antibiotic medication and food security status of the HHs were factors significant predictors 
of relapse of severe acute malnutrition. Therefore, strengthening maternal education, due 
emphasis for readmitted children and adhering to medication guideline in SAM were 
recommended to reduce SAM relapse.