Determinants of Hospital Length of Stay in Children Under 59 Months with Acute Severe Malnutrition: Insights from Eastern Democratic Republic of Congo

Introduction Acute severe malnutrition (ASM) is a pressing global health issue, particularly in low- and middle-income countries, where it significantly impacts children under five years of age. In 2023, approximately 19 million children globally were affected, leading to roughly 400,000 deaths annually, with the highest prevalence found in sub-Saharan Africa. The Democratic Republic of the Congo (DRC) faces an exacerbated situation due to ongoing conflict, food insecurity, and limited healthcare access, contributing to heightened morbidity and mortality among malnourished children. Methods This prospective cohort study was conducted in two general hospitals—Katwa and Musienene—and the University Clinics of the Graben in Eastern DRC from July 1, 2024, to May 31, 2025. The study focused on children under 59 months diagnosed with ASM. Data on sociodemographic and clinical characteristics were collected exhaustively from all eligible patients admitted during the study period. Results During a study involving 2,684 hospitalized children in Katwa, Musienene, and University Clinics of the Graben, 238 (8.86%) were diagnosed with acute severe malnutrition (ASM). Out of these, 170 (71.43%) were cured. The Katwa health zone reported the highest cases at 79 (46.5%). Key findings showed that males had longer hospital stays, younger children had increased risks, and significant factors affecting recovery included the type of malnutrition, oedema presence, appetite, and comorbidities like tuberculosis. The type of medication influenced recovery time, with Ready-to-Use Therapeutic Food showing the most significant benefits. Conclusion Identifying determinants of hospitalization duration is essential for healthcare providers and policymakers in formulating effective intervention strategies to manage ASM in vulnerable populations. By addressing the challenges posed by malnutrition in early childhood, we can enhance health outcomes and develop targeted public health initiatives aimed at reducing the incidence and impact of ASM in Eastern DRC. Further analysis of the collected data will contribute to a comprehensive understanding of malnutrition's clinical implications and drive improvements in pediatric healthcare practices.