ArticleBMC public health2025
Time to stabilization among under-five children with severe acute malnutrition in Ethiopia: a retrospective cohort study.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDue to their fragile physiologic functions, Over 65% of deaths from complicated severe acute malnutrition occur in the first week of treatment, primarily due to medical complications. To reduce this, early stabilization is crucial, and there is limited evidence regarding stabilization time in Ethiopia.
objectiveTo assess predictors of time to stabilization among under-five children admitted with severe acute malnutrition to stabilization centers in Ethiopia.
methodA retrospective follow up study was conducted from January 20 to February 29, 2025 on 543 sampled children selected by a simple random sampling from severely malnourished children admitted to selected hospitals in Western Oromia between January 2020 and December 2024. After collecting data using kobotoolbox, it was exported to STATA version 17 for analysis. Kaplan Meier curve and log-rank test were used to estimate the stabilization rate and presence of statistically significant difference in survival and hazard rate between categories of explanatory variables. Proportional hazard assumption was checked using schoenfeld residual test and log-log survival curve. After performing model comparison, the Weibull model was selected and variables with p < 0.25 on bi-variable regression was selected for multivariable weibull regression. Estimating adjusted hazard ratio with their respective 95% confidence interval, P-value of less than 0.05 was used to declare statistically significant association with stabilizing time.
resultOver 5600 child-days of observation, the median time to stabilize from severe acute malnutrition was 11 days, with 86.39% rate of stabilization and 86.6/1000 incidence of stabilization (95% CI: (74.45-89.44)). Immunization status (AHR: 0.66, 95% CI (0.54-0.8)), pneumonia (AHR: 2.17, 95% CI (1.74-2.70)), hospital acquired infections (AHR: 1.34 95% CI (1.09-1.65)) and vitamin A supplementation (AHR: 0.61, 95%CI (0.49-0.77)) were predictors of stabilization time.
conclusionThis study found prolonged time to stabilization of 11 days compared to the recommendation of Ethiopian national management protocol of severe acute malnutrition. To achieve quicker stabilization, health professionals, hospital managers, and all stakeholders must collaboratively address and reduce the burdens stemming from identified predictors.
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