Severe acute malnutrition in a population of hospitalized under-five nigerian children

This study was to determine the prevalence and socio- clinical factors associated with severe acute malnutrition (SAM) among hospitalized under-five children.

A cross-sectional survey of children aged less than 59 months was carried out at the Children's Ward of the Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria using the 2006 WHO criteria for SAM.

A total of 208 children were studied. Overall, 64.9% had normal nutrition while 18.3% had SAM. Of the 38 children with SAM, 68.4% were hospitalised primarily for severe protein-energy malnutrition using the Wellcome classification. Low maternal education (84.2% vs 65.2%; p = 0.025), non-exclusive breastfeeding (84.2% vs 61.5%; p = 0.009), untimely commencement of weaning (77.8% vs 47.1%; p = 0.006), cessation of breastfeeding before the age of 12 months (45.5% vs 0.0%; p < 0.0001) and presence of infections (84.2% vs 58.5%; p = 0.004) were associated with SAM. Multivariate analysis identified presence of infections (OR = 4.9; p = 0.002), non- exclusive breastfeeding (OR = 1.1; p = 0.048) and low maternal education (OR = 2.1; p = 0.02) as strong determinants of SAM.

The prevalence of SAM among hospitalized Under-Fives was high. This justifies the routine use of the WHO diagnostic criteria at the community level for early detection of at-risk children.