Bune Girma Tenkolu, Mohammed Abuna, Hailu Samrawit, Ashenafi Eden
School of Public Heath, College of Medical and Health Sciences, Dilla University, Dilla, Ethiopia.
Department of Reproductive Health, College of Medical and Health Sciences, Dilla University, Dilla, Ethiopia.
PLoS One. 2025 Jan 3;20(1):e0313186. doi: 10.1371/journal.pone.0313186. eCollection 2025.
Severe acute malnutrition (SAM) is a severe condition causing bilateral pitting edema or signs of wasting in children, with a high mortality risk. An outpatient therapeutic program is recommended for managing SAM children without complications, but there is limited information on recovery time and its determinants.
This study aims to assess the time to recovery and its predictors among children aged 6-59 months with SAM admitted to the Outpatient therapeutic program in the Borena zone, Oromia region, Southern Ethiopia in 2023.
A prospective follow-up study was carried out from March 1-30, 2023, on 322 children aged 6-59 months in health facilities in the Borena zone. After being collected using a structured questionnaire, the data was imported into Epi Data Manager version 3.1 and exported to SPSS version 26 for analysis. Model fitness was assessed using the log rank test, and time-to-recovery from SAM was found to be predicted by Cox regression analysis. Lastly, the study used the Adjusted Hazard Ratio with a p-value < 0.05 and a 95% confidence interval to describe the connection.
The median duration for recovery was found to be 42 days with an interquartile range of 35 to 49. Children who received Amoxicillin had a four-times higher recovery rate (AHR = 4.09; 95% CI: 2.75, 6.07). The presence of diarrhea prolonged the recovery time by 53.0% (AHR = 0.47; 95% CI: 0.36, 0.62), while vomiting prolonged the recovery time by 58.0% (AHR = 0.42; 95% CI: 0.32, 0.55). Edema reduced the chances of recovery by 48% (AHR = 0.52; 95% CI: 0.36, 0.62).
The study found that recovery time for children with severe acute malnutrition is consistent with prior research. Key factors influencing recovery duration include the prompt administration of Amoxicillin upon admission and the presence of symptoms like diarrhea, vomiting, and edema. The findings emphasize the critical role of specific symptoms in predicting recovery times for children with SAM. By understanding these relationships, healthcare providers can enhance treatment strategies, improve resource management, and ultimately contribute to better health outcomes for affected children.
重度急性营养不良（SAM）是一种严重病症，可导致儿童出现双侧凹陷性水肿或消瘦体征，具有较高的死亡风险。对于无并发症的重度急性营养不良儿童，建议采用门诊治疗方案，但关于恢复时间及其决定因素的信息有限。
本研究旨在评估2023年在埃塞俄比亚南部奥罗米亚地区博雷纳区参加门诊治疗方案的6至59个月大的重度急性营养不良儿童的恢复时间及其预测因素。
2023年3月1日至30日，在博雷纳区的医疗机构对322名6至59个月大的儿童进行了一项前瞻性随访研究。使用结构化问卷收集数据后，将其导入Epi Data Manager 3.1版本，并导出到SPSS 26版本进行分析。使用对数秩检验评估模型拟合度，并通过Cox回归分析确定重度急性营养不良的恢复时间预测因素。最后，本研究使用调整后的风险比（p值<0.05，95%置信区间）来描述这种关联。
发现恢复的中位持续时间为42天，四分位间距为35至49天。接受阿莫西林治疗的儿童恢复率高出四倍（调整后风险比=4.09；95%置信区间：2.75，6.07）。腹泻的存在使恢复时间延长了53.0%（调整后风险比=0.47；95%置信区间：0.36，0.62），而呕吐使恢复时间延长了58.0%（调整后风险比=0.42；95%置信区间：0.32，0.55）。水肿使恢复机会降低了48%（调整后风险比=0.52；95%置信区间：0.36，0.62）。
该研究发现，重度急性营养不良儿童的恢复时间与先前研究一致。影响恢复持续时间的关键因素包括入院时及时给予阿莫西林以及腹泻、呕吐和水肿等症状的存在。这些发现强调了特定症状在预测重度急性营养不良儿童恢复时间方面的关键作用。通过了解这些关系，医疗保健提供者可以加强治疗策略，改善资源管理，并最终为受影响儿童带来更好的健康结果。
