Treatment Outcome of Severe Acute Malnutrition Among Children (6-59 Months) in Outpatient Therapeutic Feeding Program in Gursum District, Somali Region, Ethiopia

Abstract

Severe Acute Malnutrition (SAM) is one of public health problems in developing countries which mainly affect under five children. Ethiopia is one of the countries with uppermost under-five child mortality rate, in which malnutrition contributes to 57% of all children's death. This study provides an insight based on management of SAM and help to improve the management of severe acute malnutrition in outpatient therapeutic program (OTP). This study aimed to assess treatment outcomes of severe acute malnutrition and associated factors among children treated at outpatient program in Gursum woreda, Eastern Ethiopia. Facility-based retrospective cross-sectional study was conducted in outpatient program records of 350 children, treated at twelve health facilities obtained from January 1, 2016 to December 31, 2018. Proportional allocation was conducted to get sample size for each selected health facility and outpatient program sites within woreda. Individual cards of children were selected by systematic random sampling. Data were entered using Epi data software version 3.1 and exported to SPSS version 22 for cleaning and further analysis. Crude and Adjusted odd ratio along with the 95% confidence interval were estimated by using bivariate and multivariate logistic regressions to identify factors associated with treatment outcome. Level of significance was declared at P-value less or equal to 0.25 and 0.05 respectively. The recovery rate of sever acute malnutrition was 81.7%. Death rate, defaulter rate, weight gain, and length of stay were 0%, 12.6%, 3.8g/kg/day and 6.7 weeks respectively. The odd of recovery was 2.5 times higher for children with kwashiorkor than children with marasmus (AOR: 2.877, 95% CI: 1.141, 7.255, P=0.025), and those children with self-referral were 57.4% more likely to recover than their counterpart. The average weight gain and length of stay were not in acceptable range of international SPHERE Standard. Also Type of malnutrition and self-referral were factors identified as significant associated with treatment outcome of severe acute malnutrition. Capacity building of OTP service providers, regular monitoring of service provision based on the severe acute management protocol and awareness creation of community were recommended.