Predictors of recovery in children aged 6 to 59 months with uncomplicated Severe Acute Malnutrition: a multi-center study.

Objective To identify predictors of recovery in children with uncomplicated severe acute malnutrition (SAM). Design This is a secondary data analysis from an individual randomised controlled trial, where children with uncomplicated SAM were randomised to three feeding regimens, namely RUTF-C, RUTF-L, or A-HPF, under two age strata (6-17 months and 18-59 months) for 16 weeks or until recovery. Three sets of predictors that could influence recovery, viz. child, family, and nutritional predictors, were analysed. Setting Rural and urban slum areas of three states of India, viz. Rajasthan, Delhi, and Tamil Nadu. Subjects In total, 906 children (age: 6-59 months) were analysed to estimate the adjusted hazard ratio (AHR) using the Cox proportional hazard ratio model to identify various predictors. Results Being a female child [AHR: 1.269 (1.016-1.584)], better employment status of the child's father [AHR: 1.53 (1.197-1.95)], and residence in a rental house [AHR: 1.485 (1.137-1.94)] increased the chances of recovery. No hospitalisation [AHR: 1.778 (1.055-2.997)], no fever, [AHR: 2.748 (2.161-3.494)], and ≤2 episodes of diarrhoea [AHR: 1.579 (1.035-2.412)] during the treatment phase; availability of community-based peer support to mothers for feeding [AHR: 1.61 (1.237-2.097)]; and a better weight-for-height Z-score (WHZ) at enrolment [AHR: 1.811 (1.297-2.529)] predicted higher chances of recovery from SAM. Conclusion The probability of recovery increases in children with better WHZ, and with the initiation of treatment for acute illnesses to avoid hospitalisation, availability of peer support, and better employment status of the father.