Treatment outcome and associated factors of severe acute malnutrition among 6–59 months old children in Debre Markos and Finote Selam hospitals, Northwest Ethiopia: a retrospective cohort study

BACKGROUND: In Ethiopia, the health sector has increased its efforts to enhance good nutritional practices through health education, treatment of extremely malnourished children and provision of micronutrients for mothers and children. But, the poor nutritional status of women and children continues to be still a major public health problem. METHODS: A retrospective cohort study was conducted to assess the treatment outcome and associated factors of severe acute malnutrition among a total of 253 children age 6–59 months old. Severe acute malnutrition registration logbook and patient charts were used as a source of data. Data were entered in to Epi-data version 3.1 and exported to SPSS version 20 for analysis. To identify associated factors, Cox proportional hazard analysis was computed and p-value <0.05 at 95% confidence interval was considered as statistically significant. RESULTS: The recovery rate was 77.9% and the overall median recovery time was 11 days. Those children age from 24 to 35 months had 34% lower probability of recovery from SAM compared to 6–11 months old children (AHR = 0.66, 95% CI: 0.35–0.89). Children whose ages from 36 to 59 months had 47% lower probability of recovery from SAM compared to 6–11 months old children (AHR = 0.53, 95% CI: 0.31–0.91). HIV negative children had 2.48 times higher probability of getting recovered from SAM compared to HIV positive children (AHR = 2.48, 95% CI: 1.23–5.01). Children who didn’t take folic acid supplement had 65% lower probability of recovery from SAM compared to children who took folic acid supplement (AHR = 0.35, 95% CI: 0.14–0.89). CONCLUSIONS: This study found that recovery rate of 6–59 months old children treated for severe acute malnutrition in therapeutics units was in acceptable range based on the WHO recommendation. Folic acid supplementation and screening for HIV status should be promoted at all levels of health facilities during early age.