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Time to stabilization among under-five children with severe acute malnutrition in Ethiopia: a retrospective cohort

Diriba Bekele Geleta1, Dawit Tesfaye Daka2, Tesfaye Abera Gudeta3

  • 1Department of Pediatrics and Neonatal Nursing, School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia. diribabekele120@gmail.com.

BMC Public Health
|November 22, 2025
PubMed

Insights

Severe acute malnutrition stabilization in Ethiopian children took a median of 11 days, longer than recommended. Key predictors include immunization status, pneumonia, hospital infections, and vitamin A supplementation, highlighting areas for intervention to improve outcomes.

Area of Science:

  • Pediatrics
  • Public Health
  • Infectious Diseases

Background:

  • Over 65% of deaths from complicated severe acute malnutrition (SAM) occur within the first week of treatment due to medical complications.
  • Early stabilization is critical for reducing mortality in SAM cases, but evidence on optimal stabilization time in Ethiopia is limited.

Purpose of the Study:

  • To assess predictors of time to stabilization among under-five children admitted with severe acute malnutrition (SAM) to stabilization centers in Ethiopia.

Main Methods:

  • A retrospective follow-up study analyzed data from 543 children admitted to hospitals in Western Oromia between January 2020 and December 2024.
  • Statistical analysis involved Kaplan-Meier curves, log-rank tests, and multivariable Weibull regression to identify predictors of stabilization time.
  • Data were collected using kobotoolbox and analyzed using STATA version 17.

Main Results:

  • The median time to stabilization from severe acute malnutrition (SAM) was 11 days, with an 86.39% stabilization rate.
  • Predictors of stabilization time included immunization status (protective), pneumonia (increased time), hospital-acquired infections (increased time), and vitamin A supplementation (protective).

Conclusions:

  • The study identified a median stabilization time of 11 days for severe acute malnutrition (SAM), which is longer than the Ethiopian national protocol recommends.
  • Addressing predictors such as immunization status, pneumonia, hospital-acquired infections, and vitamin A supplementation is crucial for health professionals and stakeholders to achieve quicker stabilization.
Abstract

Keywords:
EthiopiaPredictorsSevere acute malnutritionStabilizationUnder-five

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