Time to recovery and its predictors among under five children in outpatient therapeutic feeding programme in Borena zone, Southern Ethiopia: a retrospective cohort study

• Published in: BMJ open Vol. 13; no. 9; p. e077062
• Main Authors: Kitesa, Gutu Yonas, Berhe, Trhas Tadesse, Tedla, Getachew Weldeyohannes, Sahile, Addisu Tadesse, Abegaz, Kedir Hussein, Shama, Adisu Tafari
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 14.09.2023; BMJ Publishing Group
• Series: Original research
• Subjects: Age; Cachexia; Child; Children & youth; Cohort analysis; Comorbidity; COVID-19 vaccines; Data collection; Edema; Environment; Ethiopia - epidemiology; Food security; Health facilities; Humans; Immunization; Malnutrition; Outpatients; Population; Public Health; Recovery (Medical); Retrospective Studies; Sample size; Sampling techniques; Variables; Ethiopia; retrospective studies; primary health care; nutrition & dietetics; public health; community child health
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-077062

This study aimed to assess the time to recovery and its predictors among 6-59 months aged children treated at an outpatient therapeutic feeding programme in Borena zone. A retrospective cohort study. Facility based; 23 treatment sites included in this study. Among the cohorts of 601 children aged 6-59 months enrolled from July 2019 to June 2021, records of 590 children were selected using systematic random sampling. Transfers and incomplete records were excluded. Time to recovery was a main outcome while its predictors were secondary outcomes. The median recovery time was 49 days (95% CI=49 to 52) with a recovery rate of 79.8% (95% CI=76.4 to 83.0). Absence of comorbidity (adjusted HR, AHR=1.72, 95% CI=1.08 to 2.73), referral way by trained mothers on screening (AHR=1.91, 95% CI=1.25 to 2.91), new admission (AHR=1.59, 95% CI=1.05 to 2.41) and adequate Plumpy'Nut provision (AHR=2.10, 95% CI=1.72 to 2.56) were significantly associated with time to recovery. It is also found that being from a distance ≥30 min to treatment site lowers a chance of recovery by 27% (AHR=0.73, 95% CI=0.60 to 0.89). The findings showed that a time to recovery was within an acceptable range. Incidence of recovery is enhanced with early case detection, proper management, nearby service, new admissions, provision of adequate Plumpy'Nut and enabling mothers to screen their own children for acute malnutrition. However, we did not observe a statistically significant association among breastfeeding status, type of health facility, wasting type, vaccination and routine medications. Service providers should improve adherence to treatment protocols, defaulter tracing, community outreach and timely case identification.