Time to nutritional recovery and its determinants among children aged 6 to 59 months with severe acute malnutrition admitted to stabilization centers of WagHimra Zone, Northeast Ethiopia

ABSTRACT

Severe acute malnutrition is a life-threatening condition that contributes to over half of under five deaths in developing countries. Urgent and specialized treatment to improve the time to recovery and recovery rate is very important. However, data regarding time to nutritional recovery is limited in Ethiopia. Hence, this study aimed to determine the average time to recovery and its determinants among children aged 6 to 59 months admitted with SAM to the stabilization centers of Wag Himra zone, northeast Ethiopia. A retrospective cohort study was conducted on 501 patients charts of children with severe acute malnutrition (SAM) admitted to stabilization centers (SCs) from September 2014 to August 2017. The charts were selected using the systematic random sampling technique. Data were extracted from the charts of each child using a pretested standard checklist and entered using Epi data version 3.1 and analyzed by STATA 14. A Cox proportional–hazard regression analysis was carried out to identify determinants of time to recovery. Any statistical test was considered significant at P-values < 0.05. In this study, the overall recovery rate from SAM was 80.4% (95% Confidence Interval [CI]: 76, 84) with the median nutritional recovery time of 11 (Inter Quartile Range [IQR]: 8–18) days. Patients aged 6–23 months (Adjusted Hazard Ratio [AHR] = 0.74, 95%CI: 0.60, 0.92), and had pneumonia (AHR = 0.44; 95% CI: 0.32, 0.59), anemia (AHR = 0.65; 95% CI: 0.52, 0.81) and vomiting (AHR = 0.63, 95% CI: 0.49, 0.82) at admission were less likely to recover quickly compared to those who did not have these conditions or were in other age categories, whereas edematous malnourished children (AHR = 2.85; 95% CI: 2.28, 3.56) were positively and significantly associated with early recovery. The median nutritional recovery time fell within the recommended international standards. However, the length of stay was significantly longer among children with severe wasting, aged 6-23 months, and had vomiting, pneumonia, and anemia at admission than their counterparts. Therefore, interventions should focus on young children with severe wasting, pneumonia, vomiting, and anemia to prevent prolonged stay in the SCs without recovery. Retrospectively registered

KEYWORDS:

• Severe acute malnutrition
• stabilization centers
• Wag Himra Zone

Abbreviations

AHR: Adjusted Hazard Ratio, CI: Confidence Interval: HF, Health Facility: IQR, Interquartile Range: MUAC, Middle Upper Arm Circumference: SC, Stabilization Center: SAM, Severe Acute Malnutrition: WHO, World Health Organization

Acknowledgments

We would like to thank the University of Gondar College of Medicine and Health Science Research and Ethical Review Committee for the approval of the ethical clearance. We would also thank Wag Himra Zonal Health Department for giving us a letter of permission to conduct the research. We would like to extend our thanks to data collectors and supervisors for their commitment to collect data in a well-organized manner.

Availability of data and material

The minimal data underlying all the findings in the manuscript will be available upon request.

Competing interests

The authors declare that they have no competing interests.

Declarations

Ethics approval and consent to participate

Ethical clearance was obtained from the Ethical Review Committee of the University of Gondar, College of Medicine and Health Science, Institute of Public Health. Letter of the permission was obtained from Wag Himra zonal Health department to review patient records and use the data. To keep the confidentiality of the patients, patient identification numbers were used during data collection instead of names. Additionally, all the collected data were kept safe throughout.

Additional information

Funding

University of Gondar funds this research for collecting the data.