Treatment Outcome and Associated Factors Among Under Five Children with Severe Acute Malnutrition Treated in Ethiopia: A Multi- Center Retrospective Cohort Study

Introduction : Severe acute malnutrition (SAM) remains a major obstacle to achieving millennium development goals and is a leading cause of child mortality. However, there is limited information on the factors influencing treatment outcomes for children admitted with SAM. Objective : : This study aimed to assess treatment outcomes and their associated factors among children under five years of age with severe acute malnutrition admitted to public hospitals in Addis Ababa, Ethiopia. Methods: A retrospective cohort study was conducted using secondary data from medical records of patients enrolled in the therapeutic feeding centre from March 2024 to august 2024. The total sample size was 423. Samples were collected at 3 public hospitals in Addis Ababa, which was selected by simple random sampling. A structured questionnaire was used to collect data from the available individual folders and registers. The data analysis was performed using bivariable and multivariable analysis. In bivariable analysis those predictors whose p value less than 0.25 was entered into multivariable analysis and those whose p value less than 0.05 was considered as statistically significant. The odds ratio with 95% CI was used to identify predictor variables. Results: A total of 418 records of children with a diagnosis of severe acute malnutrition were reviewed. Of these cases of malnutrition, the recovery rate was 53.8%. The deathrate, default rate, and medical transfer were 4.3%, 26.1%, and 15.8% respectively. In multivariable analysis, those participants who experienced oedema were about 4 times have poor treatment outcome (AOR=3.884: CI= 2.160-8.898) as compared to their counter parts. Those participants who has vomiting were about 3.5 times have poor outcome as compared to those who don’t have vomiting (AOR= 3.500: CI=1.265-9.682). Those participants who had fever were about 3 lower treatment outcome as compared to their counterpart (AOR=3.029: CI=2.406-9.133). Those who were vaccinated for their age about 7 times had good treatment outcome as compared to their counter parts (AOR= 6.85CI=3.68–12.76) Conclusion and recommendation : The assessment of severe acute malnutrition (SAM) treatment outcomes in children under five in Addis Ababa identified significant challenges, including a low cure rate, elevated mortality, and a high default rate. Healthcare providers should prioritize SAM cases with complications like vomiting and fever. Emphasis should be given to edematous patients. Addis Ababa Regional Health Bureau should provide community-based health education and counseling for mothers on EPI services.