| dc.description.abstract | Nutritional status and .food intake are critical factors III disease process. Therefore
nutrition care and support are key factors in patients' management during active phase of
acute infection, disease and convalescence. A cross sectional study was carried 0 ut in
three health facilities to assess the nutritional status of inpatients. This study investigated
nutritional status of patients on admission, and identified factors that influence
acceptability of hospital diets. A pilot study on multiple micronutrient supplementations
was carried out in Mbagathi district hospital which had a relatively higher proportion of
malnourishe~atients and longer .average length of hospital stay.
Subjects were enrolled from among inpatients being admitted for treatment of pulmonary
tuberculosis, pneumonia, malaria, control gastroenteritis/diarrhea, dehydration disorders,
undernutrition and anemia. Patients willing to participate and who satisfied the inclusion
criteria; adults aged 18-50 years, admitted for control of pulmonary TB, gastro enteritis
were included in the study.
Data from the trial facility was pooled by treatment group and analyzed for changes in
the end points. The effect of food supplements were based on serum albumin
~ I
\
,/ .
concentrations, total lymphocyte counts, hemoglobin and hematocrit changes at the
primary level. Other variables included dietary intake, changes in erythrocyte
sedimentation rates (ESR), and signs and symptoms in clinical presentation. Analysis
consisting of summary descriptive statistics, analysis of variance (ANOV A) paired and
. independent t test for intra and inter group comparisons were undertaken.
xiv
The finding indicate that the chronically ill patients were on average undernourished with
a mean body mass index 17.8 ± 3.2kg/m2 at the time of admission. History of frequent
hospitalization (43.7%), and poor nutritional status admission are likely, were likely to be
the main reasons these patients had a longer mean average length of stay (ALOS) 10.8 ±
6.9 days, low serum albumin, 34.3 ± 8.5 g/dl, low mean hemoglobin 8.9 ± 1.8 and high
infection level as indicated by high mean erythrocyte sedimentation rate (ESR) 98.9 ±
46.2 mm/hr.
The study showed that appearance, smell, and taste of hospital diets and food
supplements are key factors that contribute to food intake and adheherence to
supplementation for hospitalized patients. The mean calorie, protein and fat intake of
1080 ± 457.7 kcals, 28 ± 15.6 gms, and 17.6 ± 1.9 gms respectively were below
recommended dietary allowance (RDA) for healthy individuals.
In conclusion, the study identified that intake of hospital food could not adequately meet
the nutrient needs of most of the study subjects. It was however not conclusive on
multiple micronutrient supplementation in relation to recovery due to early discharge and
failure for patients to return for post discharge evaluation. In order to meet the nutrient
needs of patients, improvement on nutrient density, palatability and presentation are
required. Supplementation with multiple micronutrients may also be required to shorten
the recovery period to the deficient patient. Follow up controlled studies based on these
are required to enable estimation of efficacy of such interventions in inpatients. | en |
