Time to recovery from severe acute malnutrition and associated factors among under-5 children in public Health Centers in Jarso District, East Ethiopia: Retrospective Cohort Study

Background About 20 million children under the age of five worldwide suffer from severe acute malnutrition, which is the leading cause of death for children under the age of five. In Africa, 4.1 million of the 14.0 million wasted children under five are seriously wasted. Ethiopia has the highest mortality rate for children under the age of five, with malnutrition being responsible for 28% of all child fatalities. Recovery time from severe acute malnutrition is commonly disregarded despite its therapeutic significance. Objective To determine the median time to recovery from severe acute malnutrition and associated factors among children admitted to health centers in Jarso District, East Hararghe, Ethiopia, 2022. Method A retrospective cohort study was conducted in Jarso District from March 01 to April 30, 2022. The total sample size was 440 and a quantitative pretested data abstraction format was used. Kaplan Meier analysis was used to estimate the time to nutritional recovery and the Log-rank test was used to test the observed difference of the recovery time between different groups of predictor variables is significant or not, and Cox proportional-hazard regression analysis was performed to determine the independent predictors. Result The nutritional recovery rate was 82.7% and the median recovery time was 28 days (95% CI: 24.98–31.02). Older age (AHR = 0.75, 95% CI: 0.59–0.93), daily weight gain ≤ 8g/kg/day (AHR = 0.22, 95% CI: 0.15–0.35), not vaccinated children (AHR = 0.12, 95% CI: 0.03–0.21), presence of pneumonia (AHR = 0.44, 95% CI: 0.27–0.63), presence of stunting (AHR = 0.44, 95% CI: 0.36–0.55), presence of shock (AHR = 0.64, 95% CI: 0.46–0.90), and children received vitamin A (AHR = 2.95, 95% CI: 1.73–5.06) were significant predictors of nutritional recovery time. Conclusion T he nutritional recovery rate and median recovery time was 82.7% and 28 days respectively. Daily weight gain of ≥ 8g/Kg, vaccination status, and Vitamin A supplementation was proven to reduce nutritional recovery time. Conversely, older age, the presence of pneumonia, the presence of stunting, and the presence of shock as comorbidities were proven to increase nutritional recovery time. Therefore, the district health office should work on child nutritional service delivery in collaboration with health extension workers to prevent co-morbidities and strengthen screening and referral of malnutrition cases at a community level.