[Management of Acute Malnutrition in Children in a Sahelian Secondary Hospital]

Malnutrition among children under five is a major public health problem in low-income countries, and contributes significantly to mortality in this age group. The purpose of this work was to evaluate the epidemiological and clinical profile of malnourished children at the Nara hospital in north of Mali.

It was a retrospective and descriptive study, from 01/01/2016 to 31/12/2016. Children aged 6 months to 59 months admitted for acute malnutrition were included.

Four hundred and sixty-one children had malnutrition, representing 15% of consultations and 50% of hospitalizations. The median age was 26 months (2 months-93 months). The sex ratio was 0.92 (M = 222, F = 239). Nineteen percent of the patients had progressive weaning (n = 90), and it was brutal in 371 patients (80%). The distribution of patients according to the Z-score was as follows: Z-score <-1 (n = 15, 3%), Z-score <-2 (n = 46, 10%), Z-score <-3 (n = 400, 87%). Mean MUAC was 105 mm (99mm-124mm). Hypoglycemia was noted in 45% (n = 204). The marasmus cases accounted for 80% (n = 367) kwashiorkor 10% (n = 48). The mixed form of malnutrition accounted for 10% (n = 46). The disease associated with malnutrition were pneumonia (n = 219, 47%), malaria (n = 115, 25%) and gastroenteritis (n = 68, 15%). The F75 milk was administered predominantly for 3 months in 93% of cases. For phase 2 of treatment, Plumpy Nut and F100 milk were respectively administered in 88% and 12%. The nutritional recovery rate was 95% (n = 435). Five percent of the patients died (n = 26). Pneumonia was the cause of death in 85% of cases. The cure rate for marasmus and kwashiorkor cases was respectively 94% and 93%.

Acute malnutrition remains frequent in the Sahelian environment. Better knowledge of mothers about weaning and dietary diversification will improve the nutritional status of children.