Clinical outcomes of children aged 6 to 59 months with severe acute malnutrition admitted to Mbagathi District Hospital
BACKGROUND: The W.H.O estimates that moderate and severe acute malnutrition contribute to about 3.5 million and 1.5 million preventable childhood deaths every year, respectively. Systematic use of the W.H.O case management guidelines for severe malnutrition has been reported to improve nutritional outcomes, reduce days of hospitalization and reduce case fatality rates to acceptable levels in resource limited environments. OBJECTIVES: The primary objective was to determine the proportion of children aged 6 to 59 months with severe acute malnutrition achieving a weight for height Z score equal to or greater than -1SD within 21 days of therapeutic feeding or at discharge whichever was earlier. The secondary objectives were to determine the mean weight gain, the case fatality rate, the socio-demographic factors and co-morbid conditions (pneumonia and diarrhea) associated with adverse outcomes. METHODOLOGY: This study was part of a larger maternal and child malnutrition study that was conducted at the Mbagathi District Hospital. It was a short prospective study involving infants and children aged 6 to 59 months with W.H.O defined severe acute malnutrition admitted at the hospital. Eligible infants and children were consecutively enrolled. Socio-demographic, clinical and anthropometric data as well as nutritional and other medical diagnoses were entered in specially designed forms. Each participant was subsequently weighed on alternate days till discharge, day 21 or death whichever came earlier. Therapeutic feeds intake was monitored using the 24 hour dietary recall method and the emergence of new symptoms, specifically, vomiting, diarrhoea and breathing difficulties was noted at the time of weighing.