title: Treatment outcomes of severe acute malnutrition in children treated within Outpatient Therapeutic Program (OTP) at Wolaita Zone, Southern Ethiopia: retrospective cross-sectional study.
abstract: Children in third world countries suffer from severe acute malnutrition (SAM) in an extent of public health important. SAM management protocol available this time brought the approach from facility-based to community-based by Outpatient Therapeutic Program (OTP). But, little was known about the treatment outcomes of the program in Ethiopia. Thus, this study was aimed to assess treatment outcomes of SAM and identify factors associated among children treated at OTP in Wolaita Zone.
  
  
  
  A retrospective facility-based cross-sectional study was conducted in OTP records of 794 children, treated at 24 health posts retrieved from January to December 2014. Population proportion to size (PPS) was used to allocate sample for each selected district and OTP sites within district. Individual cards of children were selected by systematic random sampling. Data were entered, thoroughly cleaned, and analyzed in SPSS version 20.
  
  
  
  The recovery rate was revealed as 64.9% at 95% CI (61, 68). Death rate, default rate, weight gain, and length of stay were 1.2%, 2.2%, 4.2 g/kg/day, and 6.8 weeks respectively. Children living in <25 min were with 1.53 times higher odds of recovery than children residing in ≥25 min (AOR = 1.53 at 95% CI (1.11, 2.12)). The likelihood of recovery was 2.6 times higher for children with kwashiorkor than for those with marasmus (AOR = 2.62 at 95% CI (1.77, 3.89)). Likewise, children provided with amoxicillin were 1.52 times more likely to recover compared to their counterparts (AOR = 1.52 at 95% CI (1.09, 2.11)).
  
  
  
  The recovery rate and weight gain were lower than sphere standard. Distance from OTP, provision of amoxicillin, and type of malnutrition were factors identified as significantly associated with treatment outcome of SAM. Building capacity of OTP service providers and regular monitoring of service provision based on the management protocol were recommended.
authors.affiliation: School of Public Health, Wolaita Sodo University, Southern Ethiopia, P.O.Box 126, Wolaita Sodo, Ethiopia. yohannismulugeta@yahoo.com.
authors.forename: Mulugeta Yohannis
authors.initials: MY
authors.lastname: Kabalo
authors.affiliation: School of Public Health, Wolaita Sodo University, Southern Ethiopia, P.O.Box 138, Wolaita Sodo, Ethiopia.
authors.forename: Canaan Negash
authors.initials: CN
authors.lastname: Seifu
mesh_terms: D000553:Ambulatory Care; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015362:Child Nutrition Disorders / Q000401:mortality / Q000628:therapy*; D002675:Child, Preschool; D003153:Community Health Services; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007732:Kwashiorkor / Q000628:therapy; D007902:Length of Stay; D008297:Male; D010045:Outpatients; D015397:Program Evaluation; D011502:Protein-Energy Malnutrition / Q000628:therapy; D012111:Residence Characteristics; D012189:Retrospective Studies; D000067011:Severe Acute Malnutrition / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome; D015430:Weight Gain
chemical_list: D000900:Anti-Bacterial Agents; D000658:Amoxicillin
keywords: Outpatient Therapeutic Program; Severe acute malnutrition; Treatment outcome