Missed diagnosis of malnutrition in children aged 6-59 months attending health care at the Mbagathi District Hospital
Abstract
ABSTRACT
Background
Malnutrition remains a challenge worldwide and more so in the developing countries.
Malnutrition is associated with more than 60% of childhood mortality in these countries¹.
Studies have shown that clinicians miss the diagnosis of malnutrition in children, more so
mild and moderate forms of malnutrition in which the clinical presentation may not be
obvious.
Objectives
Primary objective: To find out the prevalence of missed diagnosis of malnutrition in
children aged 6-59 months attending health care at Mbagathi District Hospital.
Secondary objective: To determine the reasons why health workers missed the diagnosis
of malnutrition.
Methodology
It was a cross sectional study carried out at the pediatric emergency outpatient clinic. The
children’s nutritional assessment was carried out consecutively after they concluded their
consultation with the attending clinician. The records were then reviewed to find out if
malnutrition, should it be present in the child was missed.
For the secondary objective, different cadres of health workers attending to the paediatric
patients were interviewed.
Results
A total of two hundred and fifty five children were recruited into the study. Malnutrition
was missed in 88(38.3%) of these children. The investigators identified malnutrition in
230 (90.2%) of 255 children who were seen, severe malnutrition was detected in
111(43.5%), moderate malnutrition in 46(18%) and at risk of malnutrition in 73 (28.6%)
of the children.
The reasons health workers gave for lack the missed diagnosis of malnutrition included:
lack of anthropometric measurements being taken, lack of knowledge on how to make a
diagnosis, a focus on the presenting complaints, poor clinical assessment of patients, not
recording the nutritional status of the patients, understaffing, lack of equipment for taking
anthropometric measurements, and lack of knowledge of the mother on the nutritional
status of their children.
Citation
A dissertation presented in part fulfillment of the degree of masters of medicine in Paediatrics and Child Health at the University of Nairobi.Publisher
Paediatrics and Child Health, University of Nairobi