title: Predictors of nutritional recovery time and survival status among children with severe acute malnutrition who have been managed in therapeutic feeding centers, Southern Ethiopia: retrospective cohort study.
abstract: BACKGROUND
  Malnutrition remains to be one of the most common causes of morbidity and mortality among children in developing countries. The prevalence of wasting in Ethiopia remained about 10 % for the past ten years. Mortality rate of children with severe acute malnutrition treated in inpatient set ups has remained unacceptably high.
  
  
  METHODS
  A retrospective cohort study was conducted in Southern Ethiopia. The study population were children with severe acute malnutrition aged from 6 to 59 months who have been managed at Karat and Fasha stabilization centers between September 30, 2013, and Sep. 29, 2014. The total sample size was 420 and pretested questionnaire was used. Kaplan Meier analysis was used to estimate time to nutritional recovery and Cox proportional-hazard regression analysis was carried out to determine independent predictors.
  
  
  RESULTS
  Nutritional recovery rate was 3.61 per 100 person day observations. Median nutritional recovery time was 22 and 29 days for edematous malnourished and severely wasted children respectively. The independent predictors of nutritional recovery rate were: stabilization center (AHR = 1.4, 95 % CI: 1.1-1.7), malnutrition status (AHR = 1.8, 95 % CI: 1.3-2.4), weight (AHR = 1.5, 95 % CI: 1.2-1.9), mid- upper arm circumference (AHR = 1.4, 95 % CI: 1.1-1.9), inpatient complications (AHR = 2.2, 95 % CI: 1.4-3.5) and did not lose edema within four days of inpatient treatment (AHR = 2.3, 95 % CI: 1.1-4.8).
  
  
  CONCLUSIONS
  The findings of this study confirm the probability of surviving gets slimmer with inpatient complications and staying longer in stabilization centers. So, to prevent complications and enhance recovery rate due emphasis should be given in improving early detection and treatment of severely malnourished children in Ethiopia.
authors.affiliation: Department of Public Health, Ambo University, College of Medicine and Health Sciences, P.O. Box 19, Ambo, Ethiopia. delelegnyilma@gmail.com.
authors.forename: Delelegn Yilma
authors.initials: DY
authors.lastname: Gebremichael
mesh_terms: D001837:Body Weights and Measures; D015362:Child Nutrition Disorders / Q000401:mortality* / Q000628:therapy*; D002675:Child, Preschool; D003906:Developing Countries; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D015995:Prevalence; D012189:Retrospective Studies; D000067011:Severe Acute Malnutrition / Q000401:mortality* / Q000628:therapy*; D012720:Severity of Illness Index; D013997:Time Factors