Recovery rate of sever acute malnutrition and its predictors among children admitted to therapeutic feeding unit in Northcentral Ethiopia

Severe acute malnutrition (SAM) is the leading cause of hospital admissions and continues to be the leading cause of death in pediatric wards for children under five (25-30% of deaths), particularly in developing nations. Even if Ethiopia implements SAM treatment guidelines and protocols, the study area needs to have up-to-date data on the recovery rate. This study aimed to assess the recovery rate of severe acute malnutrition and its determinants among under-five children admitted to a therapeutic feeding unit. An institution-based retrospective follow-up study was conducted admitted severely malnourished children from January 1, 2021 to December 30, 2022 in Debre Tabor Comprehensive Specialized Hospital. Data from all 209 study participants were collected using SAM registration logbooks and medical record charts with structured questionnaires. Data were entered into Epi Info version 7 and exported into SPSS version 25 for further analysis. The Kaplan-Meier curve and life table were used to describe the variable. To identify predictors, a Cox proportional hazard analysis was computed. The hazard ratio with a 95% CI was calculated, and a P-value of ≤ 0.05 was considered to declare statistical significance. A review of 209 records of children diagnosed with severe acute malnutrition (SAM) was included in this study. Among these 75.1% recovered from SAM and the median survival time of recovery for children admitted in DTCSH was 15.42 days. Appetite status at admission and HIV status were significantly influenced recovery rates, with children showing poor appetite [Adjusted hazard ratio [AHR] 2.32, 95% CI 1.1-4.95] and HIV-positive status [AHR 2.55, 95% CI 1.001-6.5] at higher risk of delayed recovery rate. In this study, the overall nutritional recovery time was within an acceptable level of the Sphere standards. The main determinants of time to recovery in severely malnourished children were appetite status and HIV status during admission. Therefore, prompt checking of the appetite status of children and screening and intervention accordingly for their HIV status during admission are highly recommended for good nutritional recovery.