Time to Achieve Target MUAC and Its Predictors Among Children with Severe Acute Malnutrition Under Outpatient Therapeutic Programs, Hossana, Ethiopia

Abstract

Severe acute malnutrition (SAM) is the most severe and visible form of undernutrition and remains a major cause of morbidity and mortality in developing countries, particularly in Sub-Saharan Africa. Despite its public health significance, limited studies especially multicenter studies have been conducted in Ethiopia, including the present study area. Therefore, this study aimed to assess the time to achieve target mid-upper arm circumference (MUAC) and its predictors among children with severe acute malnutrition treated in the outpatient therapeutic feeding program (OTP) in Hossana Town, Central Ethiopia. A retrospective follow-up study was conducted among 631 children with SAM enrolled in OTP using systematic random sampling. Kaplan–Meier survival analysis was used to estimate the time to achieve target MUAC, and Cox proportional hazards regression analysis was employed to identify independent predictors. Variables with a p-value <0.25 in the bivariable analysis were included in the multivariable Cox regression model, and statistical significance was declared at p-value <0.05. A total of 631 children were included in the study. The incidence rate of achieving target MUAC was 17.7 per 1000 child-days of observation. Overall, 94.9% of children achieved the target MUAC, while 5.31% were censored (2.16% lost to follow-up and 3.15% referred). The median time to achieve target MUAC was 60 days (IQR: 54–65). Factors significantly associated with time to achieve target MUAC included the presence of cough (AHR = 0.39; 95% CI: 0.30–0.51), inappropriate consumption of ready-to-use therapeutic food (RUTF) (AHR = 0.21; 95% CI: 0.17–0.26), and HIV/AIDS infection (AHR = 0.42; 95% CI: 0.22–0.77). In conclusion, the time to achieve target MUAC was significantly influenced by cough, HIV/AIDS infection, and inappropriate RUTF consumption. Therefore, providing special attention and appropriate management for children with these conditions is essential to improve recovery outcomes and reduce the duration of treatment in OTP programs.