Effect of Nutritional Rehabilitation on Neurocognitive Development in Children with Severe Acute Malnutrition in Sokoto State, North West Nigeria

Severe acute malnutrition (SAM) in early childhood is associated with lasting neurocognitive deficits that impair school readiness, academic performance, and adult productivity. Evidence on the reversibility of these deficits following nutritional rehabilitation in sub-Saharan Africa remains limited. This prospective cohort study examines the effect of structured nutritional rehabilitation on neurocognitive development in children aged 6 to 36 months recovering from SAM at the paediatric nutrition unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto State, North West Nigeria. A total of 148 SAM children completing the acute phase of rehabilitation were enrolled and followed for six months. Neurocognitive assessments using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III), were administered at enrolment and at three and six months post-rehabilitation. Developmental domains assessed included cognitive, language, and motor composites. At enrolment, 91.2% of children had composite scores below the normative mean. After six months of rehabilitation with nutritional supplementation and psychosocial stimulation, significant improvements were observed in all three domains (p less than 0.001). Children who received concomitant psychosocial stimulation achieved greater cognitive gains (mean improvement 12.4 points) compared to nutrition-only rehabilitation (mean improvement 7.8 points). Maternal education and socioeconomic status were significant moderators of recovery. The study supports integrated SAM rehabilitation combining nutrition with early stimulation. Keywords: severe acute malnutrition, neurocognitive development, rehabilitation, Sokoto State, North West Nigeria.