RECOVERY RATE & ITS PREDICTORS AT OUTPATIENT TREATMENT PROGRAM OF SEVERE ACUTE MALNUTRITION IN HEALTH POSTS OF ARBAMINCH ZURIA WOREDA, GAMO ZONE, SOUTHERN ETHIOPIA; A RETROSPECTIVE COHORT STUDY.

Abstract

Background: Malnutrition is a major public health problem throughout the developing world, approximately one third of, nearly 8 million deaths in children who are under the age of five years worldwide. Although, numerous advances made in improving child health and the clinical management protocols for treating severe acute malnutrition, there is little published data on the recovery rate & its predictors in Ethiopia especially, after decentralizing of sever acute malnutrition management to the health post level. Objective: To determine recovery rate & its predictors in severe acute malnutrition treated at outpatient treatment program in health posts of Arbaminch zuria woreda, Gamo zone, Southern Ethiopia. Methods and Materials: Institutional based retrospective cohort study was conducted on 402 children who had been managed for sever acute malnutrition under outpatient therapeutic program, from January 1/2016 to December 30/ 2018, in health posts of Arbaminch zuria woreda. The children were selected using systematic random sampling method from 10 health posts. Recovery rate was determined and Kaplan Meier curve together with log rank test were fitted to compare recovery curves between different categories of predictors. Bivariable and multivariable cox proportional hazards model was used to identify predictors and association was summarized using AHR, statistical significance was declared at 95% CI and < 0.05 P- value. Result: The rate of recovery was 70.40% with the incidence rate of recovery 12 per100 child weeks and the median recovery time was 7 weeks (IQR 6–8). Sever acute malnurished children aged 24-59 months during admission (AHR=3.15, 95%CI = 1.85, 5.03), diagnosed with edema (AHR=1.75, 95%CI = 1.27, 2.43), with cough (AHR=0.22, 95% CI =0.13, 0.39), like wise those patients with anemia (AHR=0.64, 95%CI=0.42, 0.98) were independent significant predictors of recovery rate from sever acute malnutrition. Conclusion and Recommendations; Recovery rate was lower than the international SPHERE standard and time to recovery was acceptable according to Ethiopian guide line. Age category, type of sever acute malnutrition diagnosis, cough and anemia were significant predictors of recovery rate with P-value < 0.05. Therefore, Special attention should be given to young children, those with anemia, cough and Marasmic patients