The Outcomes of Hospital Acquired Infections, Time-to-Recovery and Predictors Among Severely Malnourished Children During Stabilization Center in Ethiopia
Authors: Elema Teshome Bekele , Desalegn Tewodros , Edae Gemechu , Roba Kedir Teji , Jara Dube , Habtamu Ashenafi , Gebretsadik Solomon , Baye Kaleab 
Published: February 2025

Background: Hospital -acquired infections (HAIs) can increase healthcare costs due to prolonged stay, and also contribute to increased microbial resistance due to the widespread occurrence of multidrug resistant pathogens in health facilities. The share of hospital-acquired infection in hospital stay time to the population of severe acute malnourished receiving treatment remains uncertain. Objective: This study investigates the outcomes, time to recovery and predictors of hospital -acquired infections (HAIs) among severe acute malnourished (SAM) children admitted to the Asella Referral and Teaching Hospital in Ethiopia's Oromia Region.Methods: A retrospective cohort study design was implemented, assessing factors influencing recovery time and identifying key predictors of HAIs among 493 infection-acquired children in the Hospital from registry data of 2020 to 2022. Data was extracted for one month by three nurses working on the pediatric ward. A descriptive survival analysis and a log-rank test was performed to make a comparison of survival characters among the categories of covariates. A Cox proportional hazard regression model was fitted to identify predictors that affect the outcome variable (time to recovery). Statistical significance of a variable was declared at a p-value less than 0.05.Results: The findings revealed a median time to recovery is 18+ 1.2 days, with HAIs observed in 38.5% of cases for 1957 days in the hospital. Children who acquired hospital infections (HAIs) during treatment experienced a high percentage of 40% delay in recovery (AHR = 0.60, 95% CI: 0.445 &ndash; 0.829, P = 0.002), and the statistical report indicated that the result is significant. The survival of the SAM associated HAIs children was significant statistically among male (

= 3.5, p= 0.06, fully immunized(

= 0.53, P= 0.467), and received antibiotics medication (

= 4.34, p= 0.037) during the treatment, and, (

= 4.34, p = 0.0373 respectively). The incidence rate recovery/survival was 0.03678 per-person day and IR of death is 0.04 per-person day among NIs. According to the WHZ Z score, children under the age of 0 to 5 and a half months fell between the range of -0.5 &lt;z-score&lt; -0.10. Conclusion and recommendations: The recovery rate of the children in the current study was 37.9% for SAM associated NIs and 57.75% for non-NIs, which is below the minimum standard of the SPHERE project and other studies in Ethiopia. Children who obtained antibiotic during care recovered far better than those who did not (Adjusted Hazard Ratio [AHR]: 0.607, 95% CI: 0.445&ndash;0.82, P = 0.002). This emphasizes how crucial the right antibiotic treatment is to be enhancing these children's likelihood of recovery. Anemia, tuberculosis, HAI, and bottle feeding are the most common co-morbidities seen and the main contributor to the delay of recovery, which is consistent with the reports of different scholars in Africa. Determining the most common type of HAIs in a hospital setting also requires defining the various types of HAIs. We suggested looking into more research on the impact of HAIs (NIs) on the recovery of malnutrition, particularly in edematous SAM.