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Background <p>Severe Acute Malnutrition (SAM) is a significant contributor to child mortality and morbidity, particularly prevalent in low-resource settings such as Afghanistan. Studies have found various factors that influence the recovery from uncomplicated SAM. However, such associations are yet to be studied in the Afghan context, which has been affected by decades of conflicts and instabilities. This study aims to identify the predictors of recovery from uncomplicated SAM in children aged 6–59 months admitted to an outpatient therapeutic feeding program.</p> Methods <p>A multicentre prospective cohort study enrolled 713 children with uncomplicated SAM between October 2023 and March 2024. Baseline, follow-up, and end data were collected through structured questionnaires and anthropometric measurements, guided by the national guidelines. Recovery from uncomplicated SAM was defined as achieving a mid-upper arm circumference ≥ 125&#xa0;mm or weight-for-height Z-score ≥ − 2SD, together with the absence of bilateral pitting oedema for two consecutive visits, within three months of treatment. Multivariable logistic regression analyses were conducted to identify predictors of recovery from uncomplicated SAM. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported. Statistical significance was set at <i>p</i> &lt; 0.05.</p> Results <p>A total of (567, 79.5%) children recovered from uncomplicated SAM. Children with literate mothers (AOR 6.03, 95%CI 1.76–20.57, <i>p</i> = 0.004), those from small family size (AOR 4.05, 95%CI 2.56–6.41, <i>p</i> &lt; 0.001), those with access to an improved water source (AOR 4.24, 95%CI 2.63–6.82, <i>p</i> &lt; 0.001), good adherence to routine antibiotics (AOR 4.28, 95%CI 2.49–7.34, <i>p</i> &lt; 0.001) and caregivers who received nutrition counselling (AOR 2.80, 95%CI 1.72–4.58, <i>p</i> &lt; 0.001) were significantly more likely to recover from uncomplicated SAM.</p> Conclusions <p>In this study, 79.5% of children recovered from uncomplicated SAM. Factors such as maternal literacy, adherence to routine antibiotics, caregiver nutrition counselling, small family size, and access to improved water sources were linked to better recovery from uncomplicated SAM. These findings highlight the potential importance of educational, behavioural, household, and environmental factors in recovery from uncomplicated SAM and may help inform future research and program planning.</p>

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Predictors of recovery from uncomplicated severe acute malnutrition among children aged 6–59 months in Kandahar, Afghanistan: a multicentre prospective cohort study

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  • 发表日期：

    2026年7月20日

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  • Ahmad Haroon Baray,
  • Anita Mesic,
  • Nazifullah Mohmand,
  • Giulia Scarpa

摘要

Background

Severe Acute Malnutrition (SAM) is a significant contributor to child mortality and morbidity, particularly prevalent in low-resource settings such as Afghanistan. Studies have found various factors that influence the recovery from uncomplicated SAM. However, such associations are yet to be studied in the Afghan context, which has been affected by decades of conflicts and instabilities. This study aims to identify the predictors of recovery from uncomplicated SAM in children aged 6–59 months admitted to an outpatient therapeutic feeding program.

Methods

A multicentre prospective cohort study enrolled 713 children with uncomplicated SAM between October 2023 and March 2024. Baseline, follow-up, and end data were collected through structured questionnaires and anthropometric measurements, guided by the national guidelines. Recovery from uncomplicated SAM was defined as achieving a mid-upper arm circumference ≥ 125 mm or weight-for-height Z-score ≥ − 2SD, together with the absence of bilateral pitting oedema for two consecutive visits, within three months of treatment. Multivariable logistic regression analyses were conducted to identify predictors of recovery from uncomplicated SAM. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported. Statistical significance was set at p < 0.05.

Results

A total of (567, 79.5%) children recovered from uncomplicated SAM. Children with literate mothers (AOR 6.03, 95%CI 1.76–20.57, p = 0.004), those from small family size (AOR 4.05, 95%CI 2.56–6.41, p < 0.001), those with access to an improved water source (AOR 4.24, 95%CI 2.63–6.82, p < 0.001), good adherence to routine antibiotics (AOR 4.28, 95%CI 2.49–7.34, p < 0.001) and caregivers who received nutrition counselling (AOR 2.80, 95%CI 1.72–4.58, p < 0.001) were significantly more likely to recover from uncomplicated SAM.

Conclusions

In this study, 79.5% of children recovered from uncomplicated SAM. Factors such as maternal literacy, adherence to routine antibiotics, caregiver nutrition counselling, small family size, and access to improved water sources were linked to better recovery from uncomplicated SAM. These findings highlight the potential importance of educational, behavioural, household, and environmental factors in recovery from uncomplicated SAM and may help inform future research and program planning.