INTRODUCTION About 20 million children suffer from severe acute malnutrition each year. The World Health Organization recommends the outpatient therapeutic program as a standard treatment protocol for the management of uncomplicated severe acute malnutrition and for children who are transferred from inpatient cares after recovery. This study aimed to assess the treatment outcome of severe acute malnutrition and determinants of survival in children admitted to outpatient therapeutic program at public health institutions, Afar Regional State. METHODS Institution-based prospective cohort study was conducted on 286 children aged 6-59 months admitted to the outpatient therapeutic program, from April to September 2017, at selected public health institutions in Afar Regional State. For the comparison of time to recovery among the different groups of children on the outpatient therapeutic program, Kaplan-Meir curve was used and significance test for these differences was assessed by the log-rank test. Then, a proportional hazard in the Cox model was used to identify independent predictors of survival. p value < 0.05 was considered significant. RESULTS Of 286 children, 238 (83.2%; 95% CI (79, 88)), 18 (6.3%), 14 (4.9%), 8 (2.8%), and 8 (2.8%) cases were cured, defaulters, non-responder, died, and transfer to inpatient care, respectively. The overall mean rate of weight gain was 10.5(± 3.45) g/kg/day, and mean length of stay was 44.15(± 8.77) days. The recovery rate of children whose mothers travel less than 2 h to the health institution was about three times (AHR, 2.91; 95% CI (2.18, 3.88)) higher than children whose mothers travel 2 h and above. Compared with children who received vitamin A supplementation, children who lack supplementation were less likely (AHR, 0.39; 95% CI (0.25, 0.59)) to be cured. Moreover, the rate of recovery from outpatient therapeutic program among children who received antibiotics was about 1.4 times (AHR, 1.38; 95% CI (1.01, 1.89)) higher compared with children who did not receive of antibiotics. CONCLUSION This study showed that nearly eight children in every ten had recovered from severe acute malnutrition. Therefore, considering the distance of health facility from children's residence, improving vitamin A supplementation and antibiotics are vital in improving the rate of recovery. Further research is also required to identify and address barriers to the provision of antibiotics and vitamin A supplementation.

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埃塞俄比亚阿法尔地区州公共卫生机构接受门诊治疗计划的儿童中与儿童生存相关的因素：一项前瞻性队列研究。

引言每年约有2000万儿童患有严重的急性营养不良。世界卫生组织建议将门诊治疗方案作为标准的治疗方案，以管理简单的严重急性营养不良以及康复后从住院治疗中转移出来的儿童。这项研究旨在评估在阿法尔州州公共卫生机构接受门诊治疗计划的儿童的严重急性营养不良的治疗结果和生存率的决定因素。方法于2017年4月至9月，在Afar地区州的选定公共卫生机构对入院门诊治疗计划的286名6-59个月的儿童进行了基于机构的前瞻性队列研究。为了比较门诊治疗方案中不同组儿童的恢复时间，使用Kaplan-Meir曲线，并通过对数秩检验评估这些差异的显着性检验。然后，在Cox模型中使用比例风险来确定生存的独立预测因子。p值<0.05被认为是显着的。结果在286名儿童中，治愈238名（83.2％； 95％CI（79，88）），18名（6.3％），14名（4.9％），8名（2.8％）和8名（2.8％），,愈，无反应者，死亡和转移到住院护理。总体平均体重增加率为10.5（±3.45）g / kg /天，平均住院时间为44.15（±8.77）天。母亲前往医疗机构的时间少于2小时的儿童的康复率约为三倍（AHR，2.91; 95％CI（2.18，3。88））高于母亲旅行2小时及以上的孩子。与接受维生素A补充剂的儿童相比，缺乏补充剂的儿童治愈的可能性较小（AHR，0.39； 95％CI（0.25，0.59））。此外，与未接受抗生素治疗的儿童相比，接受抗生素治疗的儿童从门诊治疗方案中恢复的速度大约高1.4倍（AHR，1.38； 95％CI（1.01，1.89））。结论这项研究表明，十分之八的儿童已经从严重的急性营养不良中康复。因此，考虑到卫生设施离儿童居住地的距离，改善维生素A补充剂和抗生素对提高康复率至关重要。