Time to Recovery and Determinants of Uncomplicated Severe Acute Malnutrition Among 6–59 Months Children From the Outpatient Therapeutic Feeding Program in North Shewa Zone of Oromia Region, Ethiopia. A Prospective Follow-Up Study.

Abstract

Introduction: Community-based management of acute malnutrition is implementing in Ethiopia. But there is scarce information in our study set up regarding the time to recovery and its predictors of SAM among 6-59 months children, so this study aimed to assess the time to recovery and its predictors of uncomplicated SAM among 6-59children managed at the OTP in north Shewa zone, Ethiopia.Methods: A health post-based prospective follow-up study had conducted on 6-59months children from November 20/2020 – February 20/2021. A total of 423 children had included in the study. A structured interviewer-administered questionnaire had used. The median time to recovery had calculated using the Kaplan Meier (KM) curve. The predictors of time to recovery were determined using both bi-variable and multi-variable Cox regression models with a 95% confidence interval (CI). Finally, the variable that had a p-value < 0.05 in the multi-variable analysis was declared as the predictors of time to recovery. Proportional hazard assumption was checked graphically and using Schoenfeld residual test.Result: From the total 423 Children, 327 (77.3%) recovered. The median time to recovery was 42 + IQR of 14 days. Children from food secure households; AHR= 9.6 with 95% CI (8.1-18.5), mild food insecure; AHR= 6.5 with 95% CI (3.1, 13.8), moderate food insecure; AHR= 2.5 with 95% CI (1.2-5.3). Mothers who traveled less than 2 hours walking distance to the health post; AHR=2.6 with 95% CI (1.8-18.7). Children who received the correct dose of the RUTF AHR=1.6 with 95% CI (1.1-2.3), children who measured their weight weekly AHR= 1.5 with 95% CI (1.1-2.0), and children treated by health extension worker who took the Nutrition-related training AHR= 2.1 with 95% CI (1.0-4.5) were predictors of time to recovery. Conclusion and recommendation: The median time to recovery was within the acceptable range of the Ethiopian protocol for the management of uncomplicated SAM in the Outpatient setup. Household food security status, the distance between home and health posts, the correct dose of RUTF, weekly weight measurement per protocol, and HEWs nutrition-related training status were the significant predictors of time to recovery. It is advisable to improve the household food security status, and the Health extension worker's (HEWs) nutrition-related training.