Time to Cure and Predictors of Recovery Among Children Aged 6-59 Months with Severe Acute Malnutrition Admitted in Jimma University Medical Center, Southwest Ethiopia: A Retrospective Cohort Study

• Published in: Clinical epidemiology Vol. 12; pp. 1149 - 1159
• Main Authors: Hussen Kabthymer, Robel, Gizaw, Getu, Belachew, Tefera
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2020; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Age; Amoxicillin; Analysis; Care and treatment; Children & youth; Clinical medicine; Cohort analysis; Data collection; Edema; Epidemiology; Ethiopia; Exports; Fatalities; Health aspects; jimma; Malnutrition; Medical centers; Medical records; Mortality; Nurses; Original Research; Pneumonia; predictors; Rankings; recovery; retrospective cohort; severe acute malnutrition; Software; Sub-Saharan Africa; Survival analysis; Sub-Saharan Africa; Ethiopia; Asia; Africa; predictors; recovery; severe acute malnutrition; retrospective cohort; Jimma
• ISSN: 1179-1349; 1179-1349
• DOI: 10.2147/CLEP.S265107

Treatment at a stabilization center is an important intervention to avert the huge burden of mortality for children with complicated severe acute malnutrition (SAM). Despite the improvement in hospital coverage and the development of standardized WHO treatment guidelines, recent reviews indicated a wide range in recovery rate (34-88%) due to several context-specific factors. This study aimed to estimate time to recovery and to determine predictors of time to recovery among children aged 6-59 months with severe acute malnutrition. An institution-based retrospective cohort study design was used among 375 children aged 6-59 months admitted to Jimma University Medical Center, Jimma, Ethiopia from September 2015 to September 2017. All eligible children were enrolled and assessed using a pretested questionnaire. Kaplan-Meir estimates and survival curves were used to compare the time to recovery using log rank test among different characteristics. Cox proportional hazard model was used to identify significant predictors of time to recovery. A -value less than 0.05 was declared statistically significant. The rate of recovery was 4.06 per 100 person days. Median time of recovery for our cohort of SAM children's was 19 days (95% CI: 17.95-20.05). Independent predictors of time to recovery were play stimulation (AHR=1.93, 95% CI: 1.23-3.03), vaccination status (AHR=2.26, 95% CI: 1.12-4.57), tuberculosis (AHR= 0.48, 95% CI: 0.27-0.87), malaria (AHR=0.34,95% CI:0.13-0.88), use of amoxicillin (AHR=1.54, 95% CI: 0.008-2.34), deworming (AHR=1.8, 95% CI: 1.18-2.73), and shock (AHR=0.18, 95% CI: 0.05-0.59). The findings of this study showed that the average length of stay on treatment and median time for recovery are within the sphere standard. Psychosocial stimulation, appropriate provision of routine medication and management of medical co-morbidity are needed to promote fast recovery.