Evidence map›Paper›PMID 41717987›Full record

ArticleJournal of global health2026

Levels and determinants of child wasting relapse: a prospective cohort study from Somalia.

Kemish Kenneth Alier, Shelley Walton, Samantha Grounds, Sydney Garretson, Said Aden Mohamoud, Mohamud Ali Nur, Sadiq Mohamed Abdiqadir, Mohamed Billow Mahat, Michael Ocircan P'Rajom, Meftuh Omer Ismail and 10 more

Registry-linked trialAbstract read
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In one paragraph

Article in Journal of global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06642012 (Comparing Effectiveness and Cost-effectiveness of Cash Plus Interventions in Preventing Acute Malnutrition in Somalia), which is not on this map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06642012 nacompletednot on this map

Comparing Effectiveness and Cost-effectiveness of Cash Plus Interventions in Preventing Acute Malnutrition in Somalia

TypeinterventionalSponsorJohns Hopkins Bloomberg School of Public HealthRan2023 to 2024Enrolled3,384ConditionsMalnutrition, Child, Wasting Disease, Stunting, MalnutritionArmsCash only, Cash + Social Behavior Change Communication, Cash + top-up cash
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

20 authors.

Kemish Kenneth AlierJohns Hopkins University, Department of International Health, Baltimore, USA.
Shelley WaltonJohns Hopkins University, Department of International Health, Baltimore, USA.
Samantha GroundsJohns Hopkins University, Department of International Health, Baltimore, USA.
Sydney GarretsonJohns Hopkins University, Department of International Health, Baltimore, USA.
Said Aden MohamoudSave the Children, Somalia Country Office, Mogadishu, Somalia.
Mohamud Ali NurSave the Children, Somalia Country Office, Mogadishu, Somalia.
Sadiq Mohamed AbdiqadirSave the Children, Somalia Country Office, Mogadishu, Somalia.
Mohamed Billow MahatSave the Children, Somalia Country Office, Mogadishu, Somalia.
Michael Ocircan P'RajomSave the Children, Somalia Country Office, Mogadishu, Somalia.
Meftuh Omer IsmailSave the Children, Somalia Country Office, Mogadishu, Somalia.
Abdullahi Abdulle FarahSave the Children, Somalia Country Office, Mogadishu, Somalia.
Qundeel KhattakSave the Children, Save the Children International, London, UK.
Lilly SchofieldSave the Children, Save the Children International, London, UK.
Marina TripaldiSave the Children, Save the Children International, London, UK.
Fabrizio LoddoSave the Children, Save the Children International, London, UK.
Pierluigi SinibaldiSave the Children, Save the Children International, London, UK.
Farhan MohamedFederal Government of Somalia, Ministry of Health & Human Service, Mogadishu, Somalia.
Abdifatah Ahmed MohamedFederal Government of Somalia, Ministry of Health & Human Service, Mogadishu, Somalia.
Adam Abdulkadir MohamedSave the Children, Somalia Country Office, Mogadishu, Somalia.
Nadia AkseerJohns Hopkins University, Department of International Health, Baltimore, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Understanding the rates and determinants of severe acute malnutrition (SAM) relapse is crucial for stakeholders in Somalia, where evidence is limited. This study aimed to assess SAM relapse rates and associated risk factors among children discharged from outpatient therapeutic programmes (OTP) in the Bay and Hiran regions of Somalia. Methods: We conducted a prospective cohort study of 160 children aged 7-53 months discharged as recovered from OTP SAM treatment between August-September 2023. Children were followed monthly for six time points post-discharge. Anthropometric measurements, morbidity data, and household information were collected. Survival analysis was used to calculate cumulative incidence of SAM relapse, defined by weight-for-height z-score (WHZ)<-3 standard deviation (SD) or mid-upper arm circumference (MUAC)<11.5 cm or oedema. Cox proportional hazard models identified factors associated with relapse. Results: Cumulative incidence of SAM relapse at Time 1 (T1) = 5.2% (95% confidence interval (CI) = 2.5, 10.6%), T2 = 14.3% (95% CI = 9.4, 21.5%) and T6 = 26.0% (95% CI = 19.3, 34.5%) by WHZ and 13.2% (95% CI = 8.8, 19.5%) by MUAC. The relapse rate for combined SAM and moderate acute malnutrition by WHZ at T1 = 26.9% (95% CI = 19.5, 36.3%), T2 = 36.2% (95% CI = 28.0, 46.1%) and T6 = 50.1% (95% CI = 41.0, 60.0%). Weight-for-height z-score (WHZ)-based relapse was higher in rural areas (31.4% vs. 22.7% urban, P = 0.285) and among children with WHZ<-3 SD at admission (37.4% vs. 21.2%, P = 0.029). Mid-upper arm circumference (MUAC)-based relapse was higher in urban areas (20.8% vs. 4.1% rural, P = 0.002), among younger children (19.7% vs. 5.5% > 2 years, P = 0.009), and internally displaced persons (21.8% vs. 5.8% non-internally displaced persons, P = 0.003). Factors significantly associated with increased relapse risk included WHZ<-3 SD at admission (adjusted hazard ratio (HR) = 2.22; 95% CI = 1.04, 4.72) and longer OTP stay (adjusted HR = 1.02 per day; 95% CI = 1.00, 1.04). Participation in a cash assistance programme was protective (adjusted HR = 0.44; 95% CI = 0.22, 0.90). Conclusions: Severe acute malnutrition (SAM) relapse rates in Somalia are considerable, with varying patterns by anthropometric indicator, region, and demographic factors. Cash assistance programme offers a promising complementary intervention. These findings can inform targeted interventions and policy changes to reduce relapse and improve long-term outcomes for children recovering from SAM in Somalia and similar contexts. Registration: The cluster-RCT associated with this cohort study is registered at ClinicalTrials.gov, ID: NCT06642012.

Indexed as

Severe Acute MalnutritionWasting SyndromeChild, PreschoolFemaleHumansInfantMaleProspective StudiesRecurrenceRisk FactorsSomalia

Identifiers

PMID41717987
PMCPMC12922464

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.