Published in PLOS One on 2026-09-29, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Ashebr Abrha, Solomon Hintsa, Ebud Ayele Dagnazgi, Freweyni Fisshatsion, Goitom Girmay
Source: PLOS One • DOI 10.1371/journal.pone.0359619
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Severe acute malnutrition remains a major public health problem and a leading cause of under-five morbidity and mortality in low and middle income countries. Although outpatient therapeutic feeding programs are widely used to treat uncomplicated cases, recovery time often remains below SPHERE standards. Evidence on time to recovery and its predictors is limited in Tigray, particularly in post-conflict settings where health services have been disrupted.
To determine the time to recovery and identify its predictors among children aged 6–59 months with uncomplicated severe acute malnutrition treated in outpatient therapeutic programs in Adet woreda.
A retrospective cohort study was conducted among children aged 6–59 months with uncomplicated severe acute malnutrition treated in outpatient therapeutic programs from March 2023 to February 2024. A total of 479 children were selected by systematic random sampling. Bivariable Cox proportional hazards regression was performed to identify candidate variables, and variables with a p ≤ 0.25 were entered into the multivariable model. Statistical significance was declared at p < 0.05.
The overall recovery rate was 90.8%, with a median recovery time of 49 days. Independent predictors of recovery time were sex (AHR = 1.27, 95% CI:1.04, 1.54), travel time to health facility (AHR = 0.57, 95% CI: 0.44,0.74), residence (AHR = 0.52, 95% CI: 0.42, 0.64), vomiting at admission (AHR = 2.48, 95% CI: 1.27, 4.83), pneumonia at admission (AHR = 3.06, 95% CI: 1.83, 5.11), admission status (AHR = 0.52, 95% CI: 0.39, 0.71), and admission diagnosis (AHR = 0.54,95% CI:0.36,0.81).
The recovery rate of children with severe acute malnutrition treated in outpatient therapeutic feeding programs exceed the minimum standard. Early identification and management of medical illnesses, improved access to health facilities, and strengthened collaboration between governmental and nongovernmental organizations are essential reduce recovery time among children receiving outpatient therapeutic programs services.
Introduction
Severe acute malnutrition (SAM) is defined as presence of bilateral pitting edema, a mid upper arm circumference of less than 115 mm, or a weight for height below Z score below −3 according to the World Health Organization (WHO) child growth standards. These criteria are widely used for the identification and management of SAM in both community and clinical settings. SAM remains a major global public health problem, particularly in low and middle income countries, and is strongly associated with increased morbidity, mortality, impaired growth, and poor cognitive development among children under five years of age [1,2].
Globally, an estimated 13 million children are affected by SAM every year [3]. The burden is high in Africa, where approximately 12.7 million children are affected by moderate and severe wasting, including about 3.5 million with severe wasting. SAM remains a major contributor to under-five mortality, accounting for 11% of deaths among affected children [4]. In sub-Saharan Africa, about 11.8 million children experience moderate and severe wasting, including 3 million with SAM, and the recovery rate among children treated for SAM is about 71.2%, which is below the minimum SPHERE standard [5,6].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Ashebr Abrha, Solomon Hintsa, Ebud Ayele Dagnazgi, Freweyni Fisshatsion, Goitom Girmay. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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- Evidence brief: Time to recovery and its predictors among pediatric patients with severe community-acquired pneumonia admitted to public general hospitals in Tigray, Ethiopia, 2025: A prospective follow-up study
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