A retrospective cohort study of survival status and mortality predictors among children with severe acute malnutrition in public health facilities, Hawassa City, Southern Ethiopia

Abstract

• The survival rate for children with severe acute malnutrition admitted to public health facilities in Hawassa was low. • Co-morbidities and the lack of Albendazole/Mebendazole deworming is identified as significant predictors of mortality. • It is recommended to strengthen and expand immunization and deworming programs, integrating them with nutrition interventions. • Primary health care facilities should enhance health education for mothers and caregivers, emphasizing deworming, seeking medical care for sick children, and ensuring children are vaccinated. Despite improvements in child health and nutrition in Ethiopia, undernutrition remains a critical issue, causing half of child deaths. Many severely malnourished children seek treatment at therapeutic feeding centers, but a significant number still die in stabilization centers. This study aimed to estimate survival rates and identify predictors of mortality among children with severe acute malnutrition admitted to public health facilities in Hawassa City, Southern Ethiopia. A facility-based retrospective cohort study was employed to estimate survival status and predictors among under-five children with severe acute malnutrition admitted to selected health facilities. A total of 476 randomly selected under-five children with SAM from January 2018 to December 31, 2021, participated in the study. Data were analyzed by SPSS IBM version 26. Bivariable and multivariable Cox regression models assessed risk factors. Kaplan- Maier Curve and Long rank test were used to estimate cumulative survival probability and to compare survival status probability across different groups. Over the 3-year observation period, the overall survival status was, (84.7 %), [95 % CI; 81.2, 87.8]. The incidence density of death was 3.8/100 person-day. The overall median survival time was 34 [95 % CI 32.2––37.5] days. After controlling for other factors a child who had co-morbidities [AHR = 3.305, 95 %; CI:(1.1, 10.9)], and deworming using Albendazole [AHR = 5.3, 95 %; CI:(1.3, 21.7)] were identified as the independent predictors of the time to death.