ABSTRACT

Background: Complicated Severe Acute Malnutrition(SAM) is a major public health challenge in the Central Ethiopia Region(CER) and major killer of children under five years of age. In CER SAM management is facility-based treatment at the Stabilization Centers (SC). However, there is limited evidence regarding time to recovery and its predictors among children affected by SAM in the study area.

Objectives: To assess time to recovery from severe acute malnutrition and predictors among children 6-59 months managed at the inpatient therapeutic program(TFP) in CER, Ethiopia

Methods: A hospital based prospective cohort study was conducted among 482 6- 59 months old children at 13 selected public hospitals in CER from Sept/2024 to Jan 20/2025. A. Structure and pretested questionnaires were used to collect data by KoBoToolbox. The data was analyzed using SPSS version 20. A Kaplan-Meier survival curve, log-rank test and Cox-regression were run. To identify the associations between dependent and independent variables a bivariate analysis was used. Variables with P-value < 0.25 at bivariate analysis were included in adjusted cox regression model to identify determinants of time to recovery. Association yielding p- value < 0.05 in multiple cox regression was considered independent predictors. Hazard ratio with 95% CI was interpreted in the result.

Result: The nutritional recovery rate was, 246 (76.4%) recovered with recovery incidence density of 8.1 per 100 person days and a median recovery time of 10 days with Inter Quartile Range (IQR) of 13(9, 35). Overall, a total of 482 the participants contributed a total of 4542 person-days of follow-up. Controlling for other factors; having dermatosis [AHR= 1.4, 95% CI: (1.03; 2.0)] and had severely wasted at admission (MUAC <11.5 cm or WFH<70% or -3 z score [AHR= 1.5, 95% CI: (1.05,2.0)] were significant predictors of time to recovery

Conclusion and Recommendation: Over all the recovery rate and the nutritional recovery time of children with SAM in the study area were within the recommended sphere of national standards. It is advisable to give emphasis to SAM patients having dermatosis at admission and any pitting bilateral edematous with MUAC <11.5 cm or WFH<70% or -3 z score.

Key Words = Complicated severe acute malnutrition; time to recovery; inpatient,

 Temesgen Kelaye (BSC, MPH)