Survival status and predictors of mortality among children with severe acute malnutrition admitted to public health facilities at Hawassa City, Southern Ethiopia: a retrospective cohort study.

Background: 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.

Objective: The main aim of this study was to estimate survival status and predictors of mortality among children with severe acute malnutrition admitted to public health facilities at Hawassa City, Southern Ethiopia.

Method: 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.

Results: 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 Albendazole [AHR = 5.3, 95%; CI: (1.3, 21.7)] were identified as the independent predictors of the time to death.

Conclusion: The findings of this study confirm the mortality rate was higher than in most national studies. A significantly low recovery rate was identified for the children with co-morbidities and those who had not been dewormed. Expanding the immunization programs and deworming programs regularly which link nutrition interventions was recommended to raise the recovery rate.