Abstract
BACKGROUND: Severe acute malnutrition (SAM) is a leading cause of mortality among under-five children in Ethiopia. Despite prior systematic reviews and meta-analyses in Ethiopia, the pooled recovery rate of SAM from 2019 to 2024 remains unknown, and the pooled effect of other contributing factors has not been investigated. Therefore, this study aimed to update the pooled estimate of the recovery rate of SAM and its associated factors among under-five children admitted to therapeutic feeding units (TFUs) in Ethiopia. METHODS: We searched PubMed, HINARI, Science Direct, Google Scholar, and African Journals Online from 1 May to 30 June 2024. The Joanna Briggs Institute checklist was used to critically appraise the selected studies. Heterogeneity was identified using I(2) statistics. Funnel plots and Egger's tests were used to determine publication bias. RESULTS: This analysis identified 1254 studies, of which 24 were included. The pooled recovery rate of SAM among under-five children admitted to TFUs was 71.4% (95% CI: 68.4 to 74.4). Anaemia (HR: 1.42, 95% CI: 1.28 to 1.58), being on a nasogastric tube (HR: 1.66, 95% CI: 1.44 to 1.91), pneumonia (HR: 1.51, 95% CI: 1.28 to 1.79), HIV (HR: 2.32, 95% CI: 1.69 to 3.19) and tuberculosis (HR: 1.9, 95% CI: 1.60 to 2.26) were associated with poor recovery, while vitamin A supplementation (HR: 1.40, 95% CI: 1.21 to 1.62) was associated with better recovery. CONCLUSIONS: The pooled recovery rate aligns with the minimum international standard. In addition to therapeutic feeding, prevention and early treatment of comorbidities should be emphasised. Vitamin A supplementation may also help improve the recovery rate. PROSPERO REGISTRATION NUMBER: CRD42024549424.