Risk factors for wasting among hospitalised children in Nepal
Aiko Inoue1, Bhim Gopal Dhoubhadel2,3, Dhruba Shrestha4
1Department of Global Health, School of Tropical Medicine and Global Health (TMGH), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
Insights
Systematic anthropometric measurements significantly improve the identification of malnutrition in hospitalized children. Risk factors include ethnic minority status, diarrheal diseases, respiratory infections, and earthquake-related housing damage.
Area of Science:
- Pediatric Nutrition
- Public Health
- Epidemiology
Background:
- Malnutrition poses significant adverse effects on children's health.
- Hospitalized children are a vulnerable population requiring nutritional assessment.
- Identifying malnutrition risk factors is crucial for effective intervention.
Purpose of the Study:
- To determine risk factors for malnutrition in hospitalized children.
- To analyze changes in nutritional status from admission to discharge.
- To evaluate the effectiveness of systematic anthropometric measurements in identifying malnutrition.
Main Methods:
- A cohort of 426 children (6 months to 15 years) was studied.
- Anthropometric measurements were taken at admission and discharge.
- Multivariable logistic regression models identified risk factors.
Main Results:
- Wasting prevalence was 9.2% at admission and 8.5% at discharge.
- Risk factors for wasting included ethnic minority, diarrheal diseases, respiratory diseases, and earthquake damage to housing.
- Systematic anthropometry identified substantially more malnourished children than clinical observation.
Conclusions:
- Ethnic minority, diarrheal diseases, respiratory infections, and housing damage are key risk factors for childhood wasting.
- Systematic anthropometric examination is a superior method for detecting malnutrition compared to clinical observation alone.
Background:
Malnutrition has various adverse effects in children. This study aimed to determine risk factors for malnutrition among hospitalised children, changes in nutritional status at admission and discharge and effects of use of systematic anthropometric measurement in identification of malnutrition.
Methods:
We enrolled 426 children, aged between 6 months and 15 years, admitted to Siddhi Memorial Hospital, Bhaktapur, Nepal, from November 2016 to June 2017. Anthropometric measurements were performed at the time of admission and discharge. Risk factors were assessed by multivariable logistic regression models.
Results:
Median age of children was 26 months (IQR: 13-49), and males were 58.7%. The prevalence of wasting was 9.2% (39/426) at admission and 8.5% (36/426) at discharge. Risk factors associated with wasting at admission were ethnic minority (aOR: 3.6, 95% CI 1.2-10.8), diarrhoeal diseases (aOR = 4.0; 95% CI 1.3-11.8), respiratory diseases (aOR: 3.4, 95% CI 1.4-8.1) and earthquake damage to house (aOR = 2.6; 95% CI 1.1-6.3). Clinical observation by care providers identified only 2 out of 112 malnutrition cases at admission and 4 out of 119 cases at discharge that were detected by the systematic anthropometric measurement.
Conclusions:
Ethnic minority, diarrhoeal diseases, respiratory infections and house damage due to the earthquake were risk factors associated with wasting. Systematic anthropometric examination can identify significantly more malnourished children than simple observation of care providers.
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