Rate, risk factors and estimated time to develop attrition after under-five children started moderate acute malnutrition treatment in Gubalafto, North East Ethiopia

Lost from follow-up, after starting moderate acute malnutrition (MAM) is an ongoing challenge of public health until the admitted children reached the standard weight of a reference child. Thus, the present study aimed to assess the rate and estimated time to attrition after under-five children started treatment for MAM in the Gubalafto district. A facility-based retrospective cohort study was employed among 487 participant children who had been managed targeted therapeutic feeding from 1 June 2018 to 1 May 2021. The overall mean (+/- sd) age of the participants' children was 22.1 (+/- 12.6) months. At the end of the study period, 55 (11.46 %) under-five children developed attrition from the treatment after starting ready use of therapeutic feeding. After checking all assumptions, a multivariable Cox regression model was used to claim independent predictors for time to attritions. The median time of attrition after starting treatment of MAM was 13 (IQR +/- 9) weeks, with the overall incidence of attrition rate reported at 6.75 children Per Week (95 % CI 5.56, 9.6). In the final model of multivariable Cox regression, the hazard of attrition was significantly higher for children from rural residence (AHR 1.61; 95 % CI 1.18, 2.18; P = 0.001), and caregivers with their dyads did not get nutritional counselling at baseline (AHR 2.78; 95 % CI 1.34, 5.78; P = 0.001). The findings of the present study showed that nearly one in every eleven under-five children was attrition (lost to follow-up) in a median time of 13 (IQR +/- 9) weeks. We strongly recommended for caregivers provisions of diversification of daily nutrition supplementation of their dyads.