# Duration of recovery from severe acute malnutrition and associated factors in children aged 6–59 months: a retrospective cohort study

## TL;DR

This study finds that children with severe acute malnutrition in Ethiopia typically recover in 12 days, with recovery time affected by vaccination status, infections, and medical complications.

## Contribution

The study identifies specific factors influencing recovery time from severe acute malnutrition in hospitalized children in Ethiopia.

## Key findings

- 81.1% of children with severe acute malnutrition recovered during hospitalization.
- Unvaccinated children and those with medical complications had significantly longer recovery times.
- Pneumonia and hospital-acquired infections were strong predictors of delayed recovery.

## Abstract

Malnutrition, particularly severe acute malnutrition (SAM) in children under five, is a global crisis affecting 25–35 million children, especially in Africa and Southeast Asia. In Ethiopia, 21% are underweight, 36% stunted, and 7% wasted. This study assesses recovery time from SAM in children admitted to public hospitals in Jimma Town. We conducted a retrospective study with 323 participants, collecting data from medical charts and analyzing it in Stata version 15. Used Kaplan-Meier for survival analysis and Cox regression for predictors of hospital stay, considering p-values < 0.05 as significant. A total of 81.1% of children with severe acute malnutrition recovered, with a recovery rate of 6.8 per 100 person-days and a median recovery time of 12 days. The predictors of nutritional recovery time were: unvaccinated (AHR = 1.630, 95% CI: 1.444, 1.894), having medical complications (AHR = 1.335, 95% CI: 1.195, 1.576), tuberculosis (AHR = 1.565, 95% CI: 1.395–2.809), pneumonia (AHR = 2.668, 95% CI: 2.405–2.769), being non-edematous (AHR = 1.880, 95% CI: 1.278, 2.765), marasmic kwashiorkor (AHR = 2.000, 95% CI: 1.254, 3.486), and hospital-acquired infections (AHR = 1.459, 95% CI: 1.315, 1.669). The study found optimal median recovery time influenced by vaccination status, comorbidities, and medical complications. Improved vaccination coverage, timely treatment, and infection control reduce hospital stays for severe acute malnutrition.

The online version contains supplementary material available at 10.1038/s41598-025-28931-5.