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Outcome of moderate to severe malnutrition following persistent diarrhoea--a hospital-based retrospective study

W S Lee1, C S Gan, P F Chai

  • 1Department of Paediatrics, University of Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia. leews@um.edu.my

The Medical Journal of Malaysia
|March 3, 2009
PubMed

Insights

Nutritional intervention effectively treated moderate to severe malnutrition in children with persistent diarrhea (PD). Most children achieved diarrhea remission and improved weight-for-height z-scores, though some required home parenteral nutrition (PN).

Area of Science:

  • Pediatrics
  • Clinical Nutrition
  • Gastroenterology

Background:

  • Persistent diarrhea (PD) is a significant cause of malnutrition in children.
  • Moderate to severe malnutrition complicates PD, requiring specialized nutritional support.
  • Tertiary referral units manage complex pediatric malnutrition cases.

Purpose of the Study:

  • To evaluate the outcomes of nutritional interventions for children with moderate to severe malnutrition and persistent diarrhea.
  • To assess the effectiveness of dietary modifications and parenteral nutrition (PN) in managing these complex cases.
  • To determine the long-term nutritional status and diarrhea remission rates post-intervention.

Main Methods:

  • Retrospective analysis of 71 children with persistent diarrhea admitted to a Malaysian tertiary referral unit.
  • Assessment of nutritional status (weight-for-height z-score) upon admission and at 3 months post-discharge.
  • Documentation of interventions including dietary modifications and parenteral nutrition (PN) duration.
  • Tracking of diarrhea remission and need for home PN.

Main Results:

  • 44% of children presented with moderate to severe malnutrition.
  • 75% required dietary modifications, and 21% needed parenteral nutrition (PN) for a median of 96 days.
  • 91% achieved diarrhea remission.
  • Significant improvement in mean weight-for-height z-scores post-intervention (p < 0.001).
  • 22% still had moderate to severe malnutrition at 3 months post-discharge.

Conclusions:

  • Moderate to severe malnutrition is a frequent complication of persistent diarrhea in children.
  • Appropriate nutritional therapy, including dietary modification and PN, leads to remission in most cases.
  • A subset of patients requires ongoing home PN due to persistent diarrhea.

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