Abstract
Malnutrition is a major disease burden in developing countries, particularly in recurrently drought-affected areas. Despite the Ethiopian government's initiatives to set up stabilization centers in different hospitals to tackle severe acute malnutrition, there is limited data on the time to recover from severe acute malnutrition and its determinants among under-five children in northeast Ethiopia. The objective of the study is to determine time to recovery of under-five children from severe acute malnutrition to normal nutritional status and its predictors in northeast Ethiopia. A facility-based retrospective record review was carried out from March 1-20, 2023. The tools for the data extraction format were adapted from the national guidelines for the management protocol for severe acute malnutrition. The Kaplan-Meier survival curve was used to compare different categorical variables. The time-varying covariate Cox-proportional hazards regression model was fitted due to the violation of the Cox proportional hazard assumption (p = 0.007). A p-value < 0.05 was a cutoff point to declare statistical significance. In the final analysis, a total of 372 children aged 6-59 months with severe acute malnutrition were included, 58.1% of whom were recovered. The incidence rate of recovery from severe acute malnutrition was 4.43 per 100 child days. Children living in rural areas (AHR = 0.7, 95% CI: 0.5-0.94) and those without F-100 supplement (AHR = 0.85, 95% CI: 0.79-0.91) had a lower recovery rate from severe acute malnutrition. Children lacking IV antibiotics (AHR = 1.4, 95% CI: 1.03-2.0) and those HIV-free (AHR = 1.76, 95% CI: 1.1-3.3) were more likely to recover from severe acute malnutrition. The percentage of recovery in the study area was found to be lower than the sphere standard. F-100 supplements should be mandatory to improve and speed up the recovery rate. Special attention should be given to children from rural areas, those receiving IV antibiotics, and those living with HIV/AIDS.