The nutritional status of sick children seeking care at Kenyatta national hospital using the new who standards.
Abstract
Background: Despite malnutrition being the single most important potentiating
factor in childhood morbidities and mortalities, it remains poorly diagnosed and
managed. The diagnostic tool used in a facility is important because of differences in
sensitivity and specificity. The new World Health Organization (WHO) growth charts
rolled out in the year 2006 to be used for routine diagnosis of malnutrition are yet to be
adopted at Kenyatta National Hospital (KNH) amongst other hospitals.
Objectives:
Primary objective: To determine the prevalence of malnutrition in children seeking care
at KNH using the new WHO growth charts.
Secondary objectives:
1. To determine the prevalence of malnutrition in children presenting with acute
versus chronic illnesses.
2. To determine the socio-demographic, feeding and health factors associated with
malnutrition in this population.
Methods: A hospital based cross-sectional study done in the Pediatric Emergency Unit
(PEU) at KNH. All eligible patients were administered a standardized structured
questionnaire aimed at finding the socio-demographic, feeding and medical history.
Height and weight were taken and converted to z scores and nutritional status analyzed
in reference to the WHO standards.
Results: 585 children were recruited into the study, 570 children were analyzed. The
mean z scores for weight for age, weight for height and height for age were less than -1z
score even when stratified by age except for the first 6 months. One third of the patients
(33.3%) were malnourished (moderate 29.8%, severe 3.5%). None severe malnutrition
accounted for 89.5% of the cases of malnutrition. Moderate wasting was slightly higher
than underweight and stunting (27%, 20% and 20% respectively). A third of the children
who were acutely ill and a quarter of the chronically ill were moderately malnourished.
All the children with severe malnutrition were acutely ill.
The acutely ill children were more likely to be moderately wasted (p=0.001) and so were
the children who did not achieve the minimum dietary diversity (p=0.004). None of the
other feeding indicators and the socioeconomic factors were significantly associated
with malnutrition.
Conclusion: Malnutrition is a major co morbidity in sick children seeking care at
KNH PEU. Malnutrition starts within the first 6 months and is independent of age. For
every one child diagnosed as severely wasted, 8.05 are moderately wasted. These cases
need to be correctly diagnosed and managed.
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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