{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T22:53:07Z","timestamp":1789685587170,"version":"4.0.1"},"reference-count":57,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T00:00:00Z","timestamp":1653955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019917","name":"Action Against Hunger","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100019917","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100013212","name":"EU Civil Protection Mechanism","doi-asserted-by":"publisher","award":["ECHO\/- WF\/BUD\/2015\/91065"],"award-info":[{"award-number":["ECHO\/- WF\/BUD\/2015\/91065"]}],"id":[{"id":"10.13039\/501100013212","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010409","name":"Children's Investment Fund Foundation","doi-asserted-by":"publisher","award":["grant: \"CIFF03: Reinventing community based management of malnutrition\""],"award-info":[{"award-number":["grant: \"CIFF03: Reinventing community based management of malnutrition\""]}],"id":[{"id":"10.13039\/100010409","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013212","name":"EU Civil Protection Mechanism","doi-asserted-by":"publisher","award":["ECHO\/ERC\/BUD\/2016\/91006"],"award-info":[{"award-number":["ECHO\/ERC\/BUD\/2016\/91006"]}],"id":[{"id":"10.13039\/501100013212","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012056","name":"Enhancing Learning and Research for Humanitarian Assistance","doi-asserted-by":"publisher","award":["HIF"],"award-info":[{"award-number":["HIF"]}],"id":[{"id":"10.13039\/100012056","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Every year, over 4 million children are treated for severe acute malnutrition with varying program performance. This study sought to explore the predictors of time to recovery from and non-response to outpatient treatment of SAM.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Children with weight-for-height z-score (WHZ) &lt;-3 and\/or mid-upper arm circumference (MUAC) &lt;115 mm, without medical complications were enrolled in a trial (called MANGO) from outpatient clinics in Burkina Faso. Treatment included a weekly ration of ready-to-use therapeutic foods. Recovery was declared with WHZ \u2265-2 and\/or MUAC \u2265125 mm, for two weeks without illness. Children not recovered by 16 weeks were considered as non-response to treatment. Predictors studied included admission characteristics, morbidity and compliance during treatment and household characteristics. Cox proportional hazard models were fitted and restricted mean time to recovery calculated. Logistic regression was used to analyse non-response to treatment.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Fifty-five percent of children recovered and mean time to recovery was eight weeks while 13% ended as non-response to treatment. Independent predictors of longer time to recovery or non-response included low age, being admitted with WHZ &lt;-3, no illness nor anaemia at admission, illness episodes during treatment, skipped or missed visits, low maternal age and not practising open defecation. Eighty-four percent of children had at least one and 59% at least two illness episodes during treatment. This increased treatment duration by 1 to 4 weeks. Thirty-five percent of children missed at least one treatment visit. One missed visit predicted 3 weeks longer and two or more missed visits 5 weeks longer treatment duration.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Both longer time to recovery and higher non-response to treatment seem most strongly associated with illness episodes and missed visits during treatment. This indicates that prevention of illnesses would be key to shortening the treatment duration and that there is a need to seek ways to facilitate adherence.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0267538","type":"journal-article","created":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T13:32:42Z","timestamp":1654003962000},"page":"e0267538","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Predictors of time to recovery and non-response during outpatient treatment of severe acute malnutrition"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1477-7649","authenticated-orcid":true,"given":"Suvi T.","family":"Kangas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Salp\u00e9teur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Niki\u00e8ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Ritz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Friis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Briend","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2769-4666","authenticated-orcid":true,"given":"Pernille","family":"Kaestel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,5,31]]},"reference":[{"key":"pone.0267538.ref001","doi-asserted-by":"crossref","first-page":"17067","DOI":"10.1038\/nrdp.2017.67","article-title":"Severe childhood malnutrition","volume":"3","author":"ZA Bhutta","year":"2017","journal-title":"Nat Rev Dis Primer"},{"key":"pone.0267538.ref002","article-title":"WHO child growth standards and the identification of severe acute malnutrition in infants and children: a joint statement by the World Health Organization and the United Nations Children\u2019s Fund. 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