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Severe acute malnutrition in a tertiary hospital in north-central Nigeria, A review of hospitalized cases
Abstract
Background: Malnutrition is a major public-health problem throughout the developing world and is an underlying factor in over 50% of the 10-11 million children dying before 5 years of age The objective of this article was to document the outcome of treatment of Severe Acute Malnutrition using F75 and F100 milk based nutritional packs.
Methodology: All consecutively admitted patients with diagnosis of Severe Acute Malnutrition were recruited into the study. Data retrieved and reviewed were weight, height, presence or absence of oedema, clinical diagnosis, and admission outcomes, discharged or otherwise. All the subjects had received F75 and F100 milk based nutrition formula, amongst other treatment administered.
Results: Total of 135 (10.6%) patients were seen, females 56 (41.5%) and males 79 (58.5%). Mean age was 18.8±14months, females 20±16.7months and males 17.9+11.94months, (p=0.38); 36 (26.7%) had oedema. Mean admission weight was 5.87±1.8kg.Mean admission weight, non-oedema cases, 5.5+1.6kg and 6.76±2.1kg in oedematous patients, p=0.0006. Overall mean discharge weight 6.4±1.8kgp=0.0144; mean discharge weight non-oedematous patient 6.2±1.8kg, and 6.9±1.8kg oedematous patients, p=0.057. Septicemia was reported in 71.8%, Pulmonary Tb in 10.3% and severe anemia was found 12%. In all 21.5% were HIV cases. Diarrhea was a feature in 60% of the SAM cases, 6% had eye-signs suggestive of Vitamin A deficiency. Overall 62.6% were discharged, 16.8% absconded, 7.6% left against advice while 13% died (10.1% of unit deaths). Death was higher in HIV cases 17.2%, than in the others. Mean duration of hospital stay was 13±7days.
Conclusion: While significant improvement in weight and clinical condition occurred using the feeds, many absconded or left against advice. Further evaluation of impact is still needed. We encourage the use of F75 and F100 in management.
Methodology: All consecutively admitted patients with diagnosis of Severe Acute Malnutrition were recruited into the study. Data retrieved and reviewed were weight, height, presence or absence of oedema, clinical diagnosis, and admission outcomes, discharged or otherwise. All the subjects had received F75 and F100 milk based nutrition formula, amongst other treatment administered.
Results: Total of 135 (10.6%) patients were seen, females 56 (41.5%) and males 79 (58.5%). Mean age was 18.8±14months, females 20±16.7months and males 17.9+11.94months, (p=0.38); 36 (26.7%) had oedema. Mean admission weight was 5.87±1.8kg.Mean admission weight, non-oedema cases, 5.5+1.6kg and 6.76±2.1kg in oedematous patients, p=0.0006. Overall mean discharge weight 6.4±1.8kgp=0.0144; mean discharge weight non-oedematous patient 6.2±1.8kg, and 6.9±1.8kg oedematous patients, p=0.057. Septicemia was reported in 71.8%, Pulmonary Tb in 10.3% and severe anemia was found 12%. In all 21.5% were HIV cases. Diarrhea was a feature in 60% of the SAM cases, 6% had eye-signs suggestive of Vitamin A deficiency. Overall 62.6% were discharged, 16.8% absconded, 7.6% left against advice while 13% died (10.1% of unit deaths). Death was higher in HIV cases 17.2%, than in the others. Mean duration of hospital stay was 13±7days.
Conclusion: While significant improvement in weight and clinical condition occurred using the feeds, many absconded or left against advice. Further evaluation of impact is still needed. We encourage the use of F75 and F100 in management.
