Time to recovery and its predictors among under-five children with severe acute Malnutrition managed at Out-Patient therapeutic program in Fedis district, East Hararghe zone, Oromia regional state, Ethiopia: A facility-based prospective study

Abstract

The outpatient therapeutic feeding program (OTP) is one of the Community based management of acute malnutrition (CMAM) components where children aged 6-59 months and without medical complications advent of ready to use therapeutic food (RUTF) and routine medication in their homes. Despite numerous advances made in improving child health and the clinical management protocols for treating severe acute malnutrition at treatment centers, spreads of shreds of evidence concerning the time to recovery and predictors associated are scarce in the study setting. Objective: To determine a time to recovery and its predicator among children aged 6-59 months with Severe Acute Malnutrition (SAM) at OTP in Fedis district Methodology: Facility-based prospective study was conducted on 250 children with SAM. A Structured questionnaire and checklist were prepared and used to collect relevant data related to the child’s socio-demographic, nutritional, and maternal-related variables. The anthropometric measure was also made at each OTP follow-up visit. Data was entered using Epi-data and analyzed using SPSS. Kaplan Meir was used to estimating time to recovery. Cox proportional hazard model was fitted to identify predictors of time to recovery. Adjusted hazard ratio (AHR) was used to indicate the magnitude of the association at the significance level of p-value less than 0.05. Result: The median time to recovery was 5 weeks with IQR (4.61, 5.39). Out of 249 study participants, 208 (83.5%) were cured before 16 weak maximum standard time of follow at OTP. Mother attending school [AHR=2.73; CI: 1.34-5.53], engagement of mother in mothers support group [AHR=2.87; CI: 1.97- 4.16], completing immunization [AHR=1.84; CI: 1.22-2.77], deworm[AHR=1.69 ;CI: 1.15- 2.63], distance from the facility[AHR=0.98 ;CI: 0.97- 0.99], and low dietary diversity[AHR=1.68;CI: 1.18- 2.39] were significantly associated delay in time to recovery from SAM. Conclusion: The time to recovery from SAM children on OTP was relatively good. Maternal, child, and environmental factors positively affected with child’s time to recovery from SAM during the OTP program. Health care providers need to emphasize the promotion of mother-to-mother support groups (MtMSG) to improve childcare.