Al Amad Mohammed Abdullah, Raja'a Yahia Ahmed, Algendari Khaled
Community Medicine, Sana'a University Faculty of Medicine and Health Sciences, Sana'a, Capital Municipality, Yemen
Community Medicine, Sana'a University Faculty of Medicine and Health Sciences, Sana'a, Capital Municipality, Yemen.
BMJ Open. 2025 Jul 16;15(7):e101454. doi: 10.1136/bmjopen-2025-101454.
To determine the time to full recovery and its predictors among children with severe acute malnutrition (SAM) admitted to therapeutic feeding centres (TFCs) in Sana'a, Yemen.
A prospective cohort study conducted from August 2023 to November 2024.
Two public hospitals in Sana'a City (Al-Sabeen and Al-Zubairi hospital) that provide therapeutic feeding services for children with SAM.
Children aged 6-59 months who were admitted to TFCs based on WHO SAM criteria and successfully transferred to outpatient therapeutic programmes (OTPs).
The primary outcome was time to full recovery from SAM, defined as the normalisation of both weight-for-height z-score (WHZ) and mid-upper arm circumference (MUAC). Secondary outcomes included identification of predictors associated with recovery time.
Among 267 children, 51% were aged 6 to <12 months and 56% were female. The median time to full recovery was 14 weeks (IQR: 12-18 weeks). Children admitted with concurrent deficiency in both WHZ <-3 and MUAC<11.5 cm had a 50% lower likelihood of full recovery (adjusted HR (aHR): 0.5; 95% CI: 0.3 to 0.9; p=0.015). Antibiotic use during OTP care nearly doubled the likelihood of recovery (aHR: 2.1; 95% CI: 1.2 to 3.4; p=0.002), while the presence of diarrhoea lowered the likelihood of full recovery by 50% (aHR: 0.5; 95% CI: 0.3 to 0.9; p=0.011).
Three months and a half were the median time to full recovery from complicated SAM. Concurrent WHZ and MUAC deficits, antibiotic use and the absence of diarrhoea were the significant predictors. Standardising the use of combined WHZ and MUAC recovery is recommended to improve comparability across programmes and better reflect nutritional outcomes.
确定也门萨那治疗性喂养中心收治的重度急性营养不良（SAM）儿童完全康复的时间及其预测因素。
2023年8月至2024年11月进行的一项前瞻性队列研究。
萨那市的两家公立医院（萨宾医院和祖贝里医院），为患有SAM的儿童提供治疗性喂养服务。
根据世界卫生组织SAM标准入住治疗性喂养中心并成功转入门诊治疗项目（OTP）的6至59个月大儿童。
主要结局是从SAM完全康复的时间，定义为身高别体重Z评分（WHZ）和上臂中部周长（MUAC）均恢复正常。次要结局包括确定与康复时间相关的预测因素。
在267名儿童中，51%的年龄为6至<12个月，56%为女性。完全康复的中位时间为14周（四分位间距：12 - 18周）。同时存在WHZ<-3和MUAC<11.5 cm缺陷的入院儿童完全康复的可能性降低50%（调整后风险比（aHR）：0.5；95%置信区间：0.3至0.9；p = 0.015）。在OTP护理期间使用抗生素使康复可能性几乎增加一倍（aHR：2.1；95%置信区间：1.2至3.4；p = 0.002），而腹泻的存在使完全康复的可能性降低50%（aHR：0.5；95%置信区间：0.3至0.9；p = 0.011）。
三个半月是复杂SAM完全康复的中位时间。同时存在的WHZ和MUAC缺陷、抗生素使用以及无腹泻是重要预测因素。建议标准化WHZ和MUAC联合恢复的使用，以提高各项目之间的可比性并更好地反映营养结局。
