Time to recovery and its predictors among underfive children with severe acute malnutrition in Metekele Zone, Northwest Ethiopia: A retrospective follow-up study
DOI:
https://doi.org/10.20372/mhsr.v2i2.1938Keywords:
Time to recovery , Under-five children , Predictors , Severe acute malnutrition , Northwest EthiopiaAbstract
Background: Severe acute malnutrition is characterized by a weight-for-height measurement below -3 standard deviations of the World Health Organization (WHO) growth standards or a mid-upper arm circumference of less than 115 mm in children older than six months, and/or the presence of bilateral edema. Despite therapeutic programs, recovery time from severe acute malnutrition remains concerning in Ethiopia. This study assessed recovery time from severe acute malnutrition and its predictors among children under five admitted to stabilization centers in Metekele Zone, Northwest Ethiopia, 2022.
Methods: From May 29 to June 21, 2022, a retrospective follow-up study was conducted involving 512 participants selected through a simple random sampling technique among children admitted with severe acute malnutrition. A structured checklist was employed to extract necessary data from medical logbooks and record folders. After enteredinto Epi-data and data was subsequently exported to Stata version 15.0 for analysis. Survival time was estimated using the Kaplan-Meier curve, while a Cox proportional hazards regression model identified predictors of time to recovery.
Results: A total of 350 children (68.36%) recovered, with an incidence rate of 6.4 per 100 child-days (95% CI: 5.75-7.09). The median time to recovery was 13 days. Predictors of time to recovery included the absence of tuberculosis (AHR=1.98, 95% CI: 1.23-3.19), HIV-negative status (AHR=2.62, 95% CI: 1.45-4.73), and intake of F-100 milk (AHR=2.41, 95% CI: 1.07-5.43).
Conclusion: Although the median recovery time was within acceptable limits, the overall rate did not meet Sphere standards. Clinical efforts should prioritize children with tuberculosis, HIV-positive status, or those lacking F-100 formula milk to facilitate early recovery.
Downloads
References
REFERENCES
Lippincott Williams & Wilkins. In: Ross. C, Caballero. B, Cousin. R, Tucker. K, Ziegler. T. Modern Nutrition in Health and Disease Eleven edition . Protein-energy malnutrition. 2014, 894-905.
Egata G, Berhane Y, Worku A. Predictors of acute undernutrition among children aged 6 to 36 months in east rural Ethiopia : a community based nested case - control study. 2014;
Philippines D of H, World Food Programme. National Guidelines on the Management of Moderate Acute Malnutrition for Children under Five Years. 2020;(May).
WHO. Guideline: Updates on the management of severe acute malnutrition in infants and children. Geneva: World Health Organization; 2013.
United Nations-World Health Organization-The World Bank Group. UNICEF-WHO-The World Bank: Joint child malnutrition estimates - Levels and trends. Report. 2019;p.1-15.
UNICEF, WHO WBG. Joint Child Malnutrition Estimates. 2021;24(2):51–78.
Brien KSO, Amza A, Kadri B, Nassirou B, Cotter SY, Stoller NE, et al. Short Communication Comparison of anthropometric indicators to predict mortality in a population-based prospective study of children under 5 years in Niger. 2019;23(3):538–43.
Olofin I, Mcdonald CM, Ezzati M, Flaxman S, Black RE. Associations of Suboptimal Growth with All-Cause and Cause-Specific Mortality in Children under Five Years : A Pooled Analysis of Ten Prospective Studies. 2013;8(5).
UNICEF, WHO, World Bank UPD. Estimates Developed by the UN Inter-agency Group for Child Mortality estimation. 2012;1–32.
UNICEF. The state of the worla’s children, 2019. Children food and nutrition., 2019. Children , food and nutrition. 2019.
UNICEF, WHO and World Bank. Levels and trends in child malnutrition: UNICEF/ WHO/World Bank Group joint child malnutrition estimates, 2017.
Hobbs B and Bush A 10 point plan for tackling acute malnutrition in under fives. Acute malnutrition:An everydays emergency, Generation Nutrition Campaign Report, Available at: https://www.popline.org/node/579688 .Date accessed: November 28, 2018.
Ethiopia_Fact-Sheet_Nutrition_Oct-2020. FACT SHEET. 2020.
Girum T. Incidence and Predictors of Mortality among Severe Acute Malnourished Under Five Children Admitted to Dilla University Referal Hospital : A Incidence and Predictors of Mortality among Severe Acute Malnourished Under Five Children Admitted to Dilla Univers. 2017;(January 2016).
Wagnew F, Tesgera D, Mekonnen M, Abajobir AA. Predictors of mortality among under-five children with severe acute malnutrition , Northwest Ethiopia : an institution based retrospective cohort study. 2018;1–10.
WHO. 2019. “ETHI.” Ethiopia Sets New Standards for the Management of Acute Malnutrition.
Gordon DM, Frenning S, Draper HR, Kokeb M. Prevalence and burden of diseases presenting to a general pediatrics ward in gondar, ethiopia. J Trop Pediatr. 2013;59(5):350–7.
Sphere Association. The Sphere Handbook: Humanitarian Charter and Minimum Standards in Humanitarian Response, fourth edition, Geneva, Switzerland, 2018. www.spherestandards.org/handbook The.
Adem F, Edessa D, Bayissa B, Mohammed Hassen M, A Mohammed M. Treatment Outcomes and Associated Factors in Hospitalised Children with Severe Acute Malnutrition: A Prospective Cohort Study. Pediatr Heal Med Ther. 2020;Volume 11:235–43.
Gebremichael DY. Predictors of nutritional recovery time and survival status among children with severe acute malnutrition who have been managed in therapeutic feeding centers , Southern Ethiopia : retrospective cohort study. BMC Public Health. 2015;1–11.
Atnafe B, Teji K, Id R, Dingeta T. Time of recovery and associated factors of children with severe acute malnutrition treated at outpatient therapeutic feeding program in Dire Dawa , Eastern Ethiopia. 2019;569:1–16.
Tefera TK, Abebe SM, Hunegnaw MT, Mekasha FG. Time to Recovery and Its Predictors among Children 6 – 59 Months Admitted with Severe Acute Malnutrition to East Amhara Hospitals , Northeast Ethiopia : A Multicenter Prospective Cohort Study. 2020;2020.
Desyibelew HD, Bayih MT, Baraki AG, Dadi AF. The recovery rate from severe acute malnutrition among under-five years of children remains low in sub-Saharan Africa. A systematic review and meta-analysis of observational studies. PLoS One. 2020;15(3):1–18.
Baraki AG, Akalu TY, Wolde HF, Takele WW, Mamo WN, Derseh B, et al. Time to recovery from severe acute malnutrition and its predictors: A multicentre retrospective follow-up study in Amhara region, north-west Ethiopia. BMJ Open. 2020;10(2):8–13.
Tegegne AS, Belay DB. Predictors for time to recovery from sever acute malnutrition among under-five children admitted to therapeutic feeding unit at Dubti referral hospital, Afar region, Ethiopia. BMC Pediatr. 2021;21(1):1–13.
Kabthymer RH, Gizaw G, Belachew T. 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. Clin Epidemiol. 2020;12:1149–59.
Hassen SL, Astatkie A, Mekonnen TC, Bogale GG. Survival Status and Its Determinants among Under-Five Children with Severe Acute Malnutrition Admitted to Inpatient Therapeutic Feeding Centers in South Wollo Zone, Amhara Region, Ethiopia. J Nutr Metab. 2019;2019.
Desyibelew HD, Fekadu A, Woldie H. Recovery rate and associated factors of children age 6 to 59 months admitted with severe acute malnutrition at inpatient unit of Bahir Dar Felege Hiwot Referral hospital therapeutic feeding unite, northwest Ethiopia. PLoS One. 2017;12(2):1–12.
Tesfay W, Abay M, Hintsa S, Zafu T. Length of stay to recover from severe acute malnutrition and associated factors among under-five years children admitted to public hospitals in Aksum, Ethiopia. PLoS One. 2020;15(9 September):1–13.
Derseh B, Mruts K, Demie T, Gebremariam T. Co-morbidity , treatment outcomes and factors affecting the recovery rate of under -five children with severe acute malnutrition admitted in selected hospitals from Ethiopia : retrospective follow up study. 2018;1–8.
Federal Ministry of Health [Ethiopia]. Evaluation of Community Management of Acute Malnutrition in Ethiopia. Addis Ababa may. 2013.
Anonymous: ‘Ethiopia commits to ending under-nutrition by 2030 with the Seqota Declaration.’ Scale Up of Nutrition RetrievedScale 24/05, 2016. 2015. 2016.
Kebede F, Eticha N, Negese B, Giza M, Tolossa T, Wakuma B. Predictors for a Cure Rate of Severe Acute Malnutrition 6-59 Month Children in Stabilizing Center at Pawe General Hospital , Northwest Ethiopia : Retrospective Cohort Study. 2021;1–10.
Asres DT, Prasad RPCJ, Ayele TA. Recovery time and associated factors of severe acute malnutrition among children in Bahir Dar city, Northwest Ethiopia: An institution based retrospective cohort study. BMC Nutr. 2018;4(1):1–8.
Tadesse Z, Teshome DF, Lakew AM, Debalkie G, Gonete KA. 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. Ecol Food Nutr. 2021;60(6):751–64.
Wagnew F, Dejenu G, Eshetie S, Alebel A, Worku W, Abajobir AA. Treatment cure rate and its predictors among children with severe acute malnutrition in northwest Ethiopia: A retrospective record review. PLoS One. 2019;14(2):1–13.
Mena MB, Dedefo MG. Treatment Outcome of Severe Acute Malnutrition and Its Determinants among Pediatric Patients in West Ethiopia. 2018;2018.
Id BW. Time to recovery from severe acute malnutrition and its predictors among children aged 6 – 59 months at Asosa general hospital , Northwest Ethiopia . A retrospective follow up study. 2022;1–14.
Mekuria G, Derese T, Hailu G. Treatment outcome and associated factors of severe acute malnutrition among 6 – 59 months old children in Debre Markos and Finote Selam hospitals , Northwest Ethiopia : a retrospective cohort study. 2017;1–8.
Sadler K, Kerac M, Collins S, Khengere H, Nesbitt A. Improving the Management of severe acute malnutrition in an area of high HIV prevalence. J Trop Pediatr. 2018;54(6):364–369.
Workneh Z, Id B, Alebel A, Worku T, Alemu A. Recovery rate and its predictors among children with severe acute malnutrition in Addis Ababa , Ethiopia : A retrospective cohort study. 2020;1–16.
Tirore MG, Atey TM, Mezgebe HB. Survival status and factors associated with treatment outcome of severely malnourished children admitted to Ayder referral hospital: A cross-sectional study. BMC Nutr. 2017;3(1):1–9.
S. O. H. Kanan and M. O. Swar, “Prevalence and outcome of severe malnutrition in children less than five-year-old in Omdurman Paediatric Hospital, Sudan,” Sudanese Journal of Paediatrics, vol. 16, no. 1, pp. 23–30, 2016.
Banbeta A, Seyoum D, Belachew T, et al. Modeling time-to- cure from severe acute malnutrition: application of various parametric frailty models. Arch Public Health 2015;73:6.
L. G. Savadogo, P. Donnen, E. Kafando, P. Hennart, and M. Dramaix, “Impact of HIV/AIDS on mortality and nutritional recovery among hospitalized severely malnourished children before starting antiretroviral treatment,” Open Journal of Pediatrics, vol. 3, n.
Fikrie A, Alemayehu A, Gebremedhin S. Treatment outcomes and factors affecting time-to-recovery from severe acute malnutrition in 6 – 59 months old children admitted to a stabilization center in Southern Ethiopia : A retrospective cohort study. 2019;1–9.
Bhutta ZA, Berkley JA, Bandsma RHJ, Kerac M. Europe PMC Funders Group Severe childhood malnutrition. 2020.
Downloads
Published
How to Cite
License
Copyright (c) 2025 Medical and Health Sciences Research Journal
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Medical and Health Sciences Research Journal,
MHSR © 2023 Copyright; All rights reserved
Accepted 2026-02-17
Published 2025-12-27
