Time to recovery and its predictors among children aged 6 to 59 months with uncomplicated severe acute malnutrition treated in outpatient therapeutic programs in Adet Woreda, Central Zone of Tigray, Northern Ethiopia: A retrospective cohort study

Background Severe acute malnutrition remains a major public health problem and a leading cause of under-five morbidity and mortality in low and middle income countries. Although outpatient therapeutic feeding programs are widely used to treat uncomplicated cases, recovery time often remains below SPHERE standards. Evidence on time to recovery and its predictors is limited in Tigray, particularly in post-conflict settings where health services have been disrupted. Objective To determine the time to recovery and identify its predictors among children aged 6–59 months with uncomplicated severe acute malnutrition treated in outpatient therapeutic programs in Adet woreda. Methods A retrospective cohort study was conducted among children aged 6–59 months with uncomplicated severe acute malnutrition treated in outpatient therapeutic programs from March 2023 to February 2024. A total of 479 children were selected by systematic random sampling. Bivariable Cox proportional hazards regression was performed to identify candidate variables, and variables with a p ≤ 0.25 were entered into the multivariable model. Statistical significance was declared at p < 0.05. Results The overall recovery rate was 90.8%, with a median recovery time of 49 days. Independent predictors of recovery time were sex (AHR = 1.27, 95% CI:1.04, 1.54), travel time to health facility (AHR = 0.57, 95% CI: 0.44,0.74), residence (AHR = 0.52, 95% CI: 0.42, 0.64), vomiting at admission (AHR = 2.48, 95% CI: 1.27, 4.83), pneumonia at admission (AHR = 3.06, 95% CI: 1.83, 5.11), admission status (AHR = 0.52, 95% CI: 0.39, 0.71), and admission diagnosis (AHR = 0.54,95% CI:0.36,0.81). Conclusions The recovery rate of children with severe acute malnutrition treated in outpatient therapeutic feeding programs exceed the minimum standard. Early identification and management of medical illnesses, improved access to health facilities, and strengthened collaboration between governmental and nongovernmental organizations are essential reduce recovery time among children receiving outpatient therapeutic programs services.