Treatment outcomes and their associated factors among a cohort of children with wasting and severe wasting enrolled in the Integrated Child Development Services (ICDS) program in Sivakasi, Tamil Nadu, 2023-24

Abstract

Background

This study aimed to estimate the incidence of recovery and relapse over a four-month follow-up period among children aged 6–59 months diagnosed with wasting or severe wasting in the Srivilliputhur block of the Sivakasi Health Unit District, Tamil Nadu, during 2023–2024.

Methods

We conducted a prospective cohort study among children aged 6–59 months diagnosed with wasting or severe wasting in December 2023. We collected the data using structured questionnaires. Baseline assessments were conducted in December 2023 (T0), with monthly follow-ups until April 2024 (T4). To identify factors associated with recovery and relapse, we first conducted a univariate analysis, followed by a multivariable Poisson regression analysis. Pathways of recovery and relapse were visualized using a Sankey diagram, while Kaplan-Meier survival curves were plotted to illustrate recovery and relapse rates over time.

Results

A total of 78 children were enrolled, with a median age of 23 months. The incidence of recovery was 9.02 per 1000 person-days, while relapse incidence was 3.96 per 1000 person-days. The mean time to recovery was 77.5 days, whereas the mean time to relapse was 84.5 days. Factors influencing recovery included age, dietary preference, and caregiver occupation, with therapeutic diets playing a major role in improving outcomes.

Conclusions

This study highlights the critical need for targeted nutritional interventions and comprehensive care strategies to manage childhood wasting effectively. The findings underscore the importance of continuous monitoring and tailored approaches to enhance recovery rates and minimize relapse, ultimately contributing to improved child health and socio-economic development.