scholarly journals Profile of Children Admitted for Severe Acute Malnutrition in a Tertiary Hospital in Southwestern Nigeria

2019 ◽  
Vol 39 (1) ◽  
pp. 42-48
Author(s):  
Adefunke Olarinre Babatola ◽  
Oladele Simeon Olatunya ◽  
Temitope Olumuyiwa Ojo ◽  
Adekunle Bamidele Taiwo ◽  
Joseph Olusesan Fadare
Keyword(s):  
Severe Acute Malnutrition ◽  
Tertiary Hospital ◽  
Medical Advice ◽  
University Teaching ◽  
Acute Malnutrition ◽  
Southwestern Nigeria ◽  
Cross Sectional ◽  
Against Medical Advice ◽  
Presenting Symptoms ◽  
Morbid Conditions

Introduction: This study assessed the socio-demographic profile, outcomes of treatment and challenges encountered in the management of children admitted for Severe Acute Malnutrition at the Paediatric Unit of a State University Teaching Hospital, Ado-Ekiti, Nigeria.  Methods: A retrospective cross-sectional study was conducted. The records of twenty-five children with SAM admitted from March 2013-March 2018 were reviewed. SAM was defined according to the Wellcome Classification based on child’s weight and oedema status. Data on demographic characteristics, presenting symptoms, co-morbid conditions, duration of admission and outcome were extracted. Results: There were 13 (52.0%) males and 12 (48.0%) females. The median age of children with SAM was eight months. Eighteen children (72%) were marasmic, four (16%) had kwashiorkor while three (12%) had marasmic-kwashiorkor. Common presenting symptoms included poor weight gain (59.1%), fever (54.5%) and diarrhoea (36.4%). Majority (84.0%) of the patients had co-morbid conditions which included sepsis (66.7%), anaemia (37.5%), hypoglycaemia (16.7%) and hypothermia (16.7%). Twenty-one (84.0%) children were fully vaccinated for age, two (8.0%) had partial vaccination while two (8.0%) were never vaccinated. Only two (8.0%) had exclusive breastfeeding, 19 (76.0%) had mixed feeding from birth. Majority (60%) of the children had one or more social challenges such as teenage parents and financial constraints. Mean duration of admission was 4.56 days. Twelve (48.0%) left against medical advice, nine (36.0%) were discharged, one (4.0%) was referred to another tertiary facility and three (12.0%) deaths were recorded. Conclusions: Many of the children admitted for SAM in our study had social problems and almost half of them left the hospital against medical advice. Besides health problem, social factors may play more role in SAM.

scholarly journals Pediatric Discharges Against Medical Advice: A Review of Cases in Ado-Ekiti, Nigeria

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Adefunke Olarinre Babatola ◽  
Oladele Simeon Olatunya ◽  
Ezra Olatunde Ogundare ◽  
Ayotunde Emmanuel Ajibola ◽  
Temitope Olumuyiwa Ojo ◽  
...  
Keyword(s):  
Perinatal Asphyxia ◽  
Age Groups ◽  
Complete Information ◽  
Relevant Information ◽  
Medical Advice ◽  
University Teaching ◽  
State University ◽  
Cross Sectional ◽  
Against Medical Advice ◽  
Common Diagnosis

Background: Knowledge of the profile of pediatric discharge against medical advice (DAMA) may help design interventions to reduce its prevalence. Objectives: This study aimed to assess the profile of pediatric DAMA at Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Ekiti State, Nigeria. Methods: This retrospective cross-sectional descriptive study included all pediatric cases of DAMA from January 2012 to December 2018. Relevant information was extracted from the patients’ case notes. Data was analyzed using the statistical package for social sciences (SPSS) version 23. Results: The overall prevalence of pediatric DAMA was 3.8%. Of the 233 pediatric DAMA with complete information, 127 (54.5%) were males. Severe malaria (27.3%) was the most common diagnosis among DAMA cases at the children emergency ward (CEW), while severe perinatal asphyxia (25.0%) and neonatal sepsis (25.0%) were the most common at the special care baby unit (SCBU). Only 1 (0.4%) patient was enrolled in the National Health Insurance Scheme (NHIS). Moreover, 43 (18.5%) parents took DAMA due to financial constraints, and 55% of the patients had their DAMA form signed by their fathers. In addition, among the patients who referred for follow-up, 11 (4.7%) patients fully recovered, 2 (0.8%) recovered with disability, 1 (0.4%) was readmitted, and 1 (0.4%) died. The highest and lowest DAMA rates were in the months of May and December, respectively. Patients aged under five years old who took DAMA significantly had infectious diseases compared to older age groups (P

scholarly journals C-reactive protein as a marker of infection in children with severe acute malnutrition in Khartoum state, Sudan

2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Abdelmoneim E.M. Kheir ◽  
Balla G. Gebreel
Keyword(s):  
Severe Acute Malnutrition ◽  
Systemic Infection ◽  
Acute Phase Reactant ◽  
Study Data ◽  
Acute Malnutrition ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Presenting Symptoms ◽  
Severe Infections

Severe acute malnutrition and acute systemic infection are often synergistic in children and lead to considerable mortality. The main aim of this research was to determine whether children with severe acute malnutrition can mount an acute phase reactant response measured by C-reactive protein. This was a descriptive, cross-sectional, hospital-based study that was carried out in the five main children hospitals in Khartoum state, from November 1st, 2012 to March 1st, 2013. 132 children with severe acute malnutrition were included in the study. Data collection included history, examination and C-reactive protein measurement. The data were analyzed using Statistical Package for Social Sciences (SPSS) for descriptive and inferential statistics. The main results revealed that 93(70.5%) children between 12-23 months of age and most of them had marasmus. Diarrhoea was the commonest presenting symptoms in 86.4%, followed by fever and vomiting. Most of the children (82.6%) had positive C-reactive protein with variable levels. In conclusion malnourished children are able to synthesize C-reactive protein in response to an infectious process and the magnitude of this response is increased in those with severe infections.

scholarly journals Incidence Correction Factors for Moderate and Severe Acute Child Malnutrition From 2 Longitudinal Cohorts in Mali and Burkina Faso

2020 ◽  
Vol 189 (12) ◽  
pp. 1623-1627
Author(s):  
Francisco M Barba ◽  
Lieven Huybregts ◽  
Jef L Leroy
Keyword(s):  
Burkina Faso ◽  
Low Income ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Cross Sectional ◽  
Incidence Data ◽  
Moderate Acute Malnutrition ◽  
Cluster Randomized ◽  
Definition Of ◽  
Mid Upper Arm Circumference

Abstract Child acute malnutrition (AM) is an important cause of child mortality. Accurately estimating its burden requires cumulative incidence data from longitudinal studies, which are rarely available in low-income settings. In the absence of such data, the AM burden is approximated using prevalence estimates from cross-sectional surveys and the incidence correction factor $K$, obtained from the few available cohorts that measured AM. We estimated $K$ factors for severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) from AM incidence and prevalence using representative cross-sectional baseline and longitudinal data from 2 cluster-randomized controlled trials (Innovative Approaches for the Prevention of Childhood Malnutrition—PROMIS) conducted between 2014 and 2017 in Burkina Faso and Mali. We compared K estimates using complete (weight-for-length z score, mid-upper arm circumference (MUAC), and edema) and partial (MUAC, edema) definitions of SAM and MAM. $K$ estimates for SAM were 9.4 and 5.7 in Burkina Faso and in Mali, respectively; K estimates for MAM were 4.7 in Burkina Faso and 5.1 in Mali. The MUAC and edema–based definition of AM did not lead to different $K$ estimates. Our results suggest that $K$ can be reliably estimated when only MUAC and edema-based data are available. Additional studies, however, are required to confirm this finding in different settings.

scholarly journals Discharge against medical advice from the emergency department in a university hospital

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Feras H. Abuzeyad ◽  
Moonis Farooq ◽  
Salah Farhat Alam ◽  
Mudhaffar Ismael Ibrahim ◽  
Luma Bashmi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cross Sectional Study ◽  
Small Sample ◽  
Medical Advice ◽  
University Hospital ◽  
High Risk Population ◽  
Cross Sectional ◽  
Against Medical Advice ◽  
Level 3 ◽  
Collection Form

Abstract Background Patients discharged against medical advice (DAMA) act as a high-risk population for the Emergency Department (ED), regardless of their presentations, and can pose a serious burden for the hospital. This study examines the prevalence, demographic and clinical characteristics, reasons, and clinical outcomes of a small sample of DAMA patients in a teaching university hospital, including readmission, morbidity, and mortality. Methods A prospective, descriptive cross-sectional study was conducted in the ED of King Hamad University Hospital (KHUH) with 98,992 patient visits during a 1-year period from June 2018 to June 2019. Consenting DAMA patients were asked to complete a data collection form. Results Patients (n = 413) had a mean age of 44.1 years with a female majority (57.1%). The majority were categorized as triage level-3 (87.7%). The main reasons for DAMA included refusal of the procedure/operation (23.2%), long ED waiting time (22.2%), subjective improvement with treatment (17.7%), and children at home (14.8%), whereas the least selected reason was dissatisfaction with medical care (1.2%). Follow-up of DAMA patients revealed that 86 cases (20.8%) were readmitted to the ED within 72 h of which 41 (47.7%) cases were morbidity and 2 (2.3%) were mortality. Marital status was a predictor of DAMA patients who revisit the ED within 72 h. Conclusion The results act as a pilot study to examine a small sample of DAMA patients’ characteristics, diagnosis, and ED revisits. Hospitals should investigate further the DAMA population on a larger scale, reasons for refusing procedures, and utilize this knowledge to improve the healthcare process.

scholarly journals Clinico-epidemiological profile of acute respiratory infections and malnutrition in urban and rural population of central India

2016 ◽  
Vol 4 (1) ◽  
pp. 159
Author(s):  
Pranav G. Jawade ◽  
Neelam D. Sukhsohale ◽  
Gayatri G. Jawade ◽  
Binish Z. A. Khan ◽  
Pratik K. Kakani ◽  
...  
Keyword(s):  
Rural Population ◽  
Urban Population ◽  
Respiratory Infections ◽  
Severe Acute Malnutrition ◽  
Pediatric Population ◽  
Central India ◽  
Developing Nations ◽  
Acute Malnutrition ◽  
Acute Respiratory Infections ◽  
Cross Sectional

Background: Acute respiratory infections (ARI) and Malnutrition in children have tremendous burden on the health care sector of developing nations including India. The intensity with which these conditions are holding grip in the community is indeed a matter of concern and hence developing nations should develop an insight to assess the severity of it has become a necessity.Methods: A hospital based cross sectional study was carried out in children aged 0-14 years. Children were clinically assessed and diagnosis was made as URTI or LRTI Also anthropometry was performed and accordingly children were divided into categories of no malnutrition (NM), severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) in ‘under 5’ years age children according to WHO guidelines, whereas children aged ‘above 5’ years were categorized as per the IAP guidelines.Results: It was observed that most of the mothers of children were illiterate with inadequate or absent ventilation and use of biomass fuels (chulha) for cooking purpose in households of rural children. The proportion of malnutrition was found to be equal in Under 5 children. In ‘above 5 years’ age study subjects, 52.4% of urban study subjects were normal as compared to 16.7% of rural study subjects.Conclusions: Our study implies that ARI and Malnutrition definitely is more prevalent in the pediatric population. Prevalence of URTI was found to be on a higher side in the rural population and LRTI prevalence was found to be higher in the urban population. Similarly, the prevalence of malnutrition was almost similar in ‘Under 5’ aged children, whereas the prevalence of malnutrition in ‘Above 5’ aged children was higher in the rural population than urban population.

scholarly journals Coverage Assessment For Community-Based Management Of Acute Malnutrition In Rural And Urban Ghana: A Comparative Cross-Sectional Study. 

2021 ◽  
Author(s):  
Joana Apenkwa ◽  
Sam K Newton ◽  
Samuel Kofi Amponsah ◽  
Reuben Osei-Antwi ◽  
Emmanuel Nakua ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Qualitative Approach ◽  
Rural District ◽  
Urban Setting ◽  
Acute Malnutrition ◽  
Rural Setting ◽  
Community Based ◽  
Cross Sectional ◽  
Study District ◽  
Point Coverage

Abstract Background: Ghana for years has implemented the Community-based Management of Acute Malnutrition (CMAM) among children in order to reduce malnutrition prevalence. However, the prevalence of malnutrition remains high. This study aimed to determine CMAM coverage levels in the Ahafo Ano South (AAS), a rural district, and Kumasi Subin sub-metropolis (KSSM), an urban district. Methods: The study was a cross-sectional comparative study with a mixed-methods approach. In all, 497 mother/caregiver and child under-five pairs were surveyed using a quantitative approach while qualitative methods were used to study 25 service providers and 40 mother/ caregivers who did not participate in the quantitative survey. Four types of coverage indicators were assessed: point coverage (defined as the number of Severe Acute Malnutrition cases [SAM] in treatment divided by total number of Severe Acute Malnutrition cases in the study district), geographical coverage (defined as total number of health facilities delivering treatment for SAM divided by total number of healthcare facilities in the study district), and treatment coverage (defined as children with SAM receiving therapeutic care divided by total number of SAM children in the study district) and program coverage (defined as number of SAM cases in the CMAM programme ÷ Number of SAM cases that should be in the programme). The qualitative approach was used to support the assessment of the coverage indicators. Data were analyzed using STATA version 14, and Atlas.ti, version 7.5 for the quantitative and qualitative data respectivelyResults: Geographically, only 6% of the facilities in the urban communities were participating in the CMAM programme as against 29% of rural district facilities. The districts had point coverage of 41% and 10% for the urban and rural districts respectively. The urban setting recorded a SAM prevalence of 52% as against 36% in the rural setting. The proportion of SAM children enrolled in CMAM was higher in KSSM when compared with AAS; 41% and 33% respectively. In both districts, the most likely factors to attract mothers/caregivers to utilize the CMAM services were: ‘free services’ and ‘a cured child.’ The qualitative approach showed that coverage improvement in both districts is hampered by barriers such: distance, transportation cost, lack of trained personnel in the communities for community mobilization and home visits, and insufficient feeds. Conclusion: To improve CMAM coverage, there is the need to train health workers to embark on aggressive health education strategies to encourage mothers/caregivers of malnourished children to utilize CMAM while ensuring that services reach those who need them. Trial registration: This study is approved and registered with The Kwame Nkrumah University of Science and Technology Committee on Human Research, Ethics and Publications (CHRPE/AP/314/15)

scholarly journals Prevalence of hypoglycemia in diarrheal dehydration at hospitalization in severe acute malnutrition

2018 ◽  
Vol 5 (3) ◽  
pp. 1092 ◽  
Author(s):  
Rameshwar Ninama ◽  
Chakshu Chaudhry ◽  
Rameshwar Lal Suman ◽  
Suresh Goyal ◽  
Ramprakash Prakash Bairwa ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Acute Diarrhea ◽  
Severe Acute Malnutrition ◽  
Cross Sectional Study ◽  
Acute Malnutrition ◽  
Severe Dehydration ◽  
Cross Sectional ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Average Blood Glucose

Background: Diarrhea is the major cause of death in children below five years of age. Hypoglycemia has been a potential fatal complication of infectious diarrhea in both well-nourished and poorly nourished children. But prevalence of hypoglycemia in diarrheal dehydration is not exactly known. This study was done to evaluate the glycemic status in children having acute diarrhea with dehydration and specifically associated with severe acute malnutrition (SAM).Methods: This descriptive cross-sectional study was conducted during July 2017 to December 2017 at Bal Chikitsalaya Udaipur, Rajasthan, India. Blood glucose levels were assessed in 150 children of acute diarrhea with dehydration, comprising of 100 SAM and 50 Non SAM children.Results: Average blood glucose of SAM children was 89 mg/dl and of non-SAM, it was 120 mg/dl. Average blood glucose was low in SAM as compared to non-SAM in both some dehydration (116.08±21.26) and severe dehydration (66.69±19.80) as well as with or without ORS intake. Overall 18 (12%) of children had hypoglycemia and all were in severe dehydration and not taking ORS. Blood glucose levels were statistically low in severe dehydration and those who were not taking ORS at the time of hospitalization (p = 0.001). In severe dehydration 25% of children had hypoglycemia means every fourth child had low blood glucose <54 mg/dl.Conclusions: Overall prevalence of hypoglycemia is 12% in diarrheal dehydration and 20% in SAM with dehydration. Twenty five percent of severe dehydration children had hypoglycemia, and all have not started ORS. None of the child started ORS developed hypoglycaemia.

Malnutrition: Already exist and is being overlooked?

2021 ◽  
Vol 2 (5) ◽  
pp. 01-08
Author(s):  
Şule Gökçe ◽  
Aslı Aslan ◽  
Feyza Koç
Keyword(s):  
Nutritional Status ◽  
Pediatric Patients ◽  
Feeding Habits ◽  
Tertiary Hospital ◽  
The Body ◽  
Anthropometric Measurements ◽  
Acute Malnutrition ◽  
Cross Sectional ◽  
Negative Effect ◽  
Healthy Growth

Background: Malnutrition is defined as deficiency and or imbalance of nutrients and energy and may produce a negative effect on the growth, maintenance, and specific functions of the body. This study purposed to determine the nutritional situation, to define the presence of malnutrition, to detect the deficiencies of micronutrients of the children admitted to a pediatric tertiary hospital. Methods: A retrospective, cross‑sectional, single unit-based study in pediatric patients admitted to the pediatric wards for differential diagnosis or treatment was conducted between November 2017 and December 2019. The anthropometric measurements were figured out on hospital admission of all pediatric patients. The pediatric patients diagnosed with malnutrition were assessed to detect their nutritional status/feeding habits and to identify any associated factors. Results: A total of 1206 children were hospitalized with an acute illness diagnosis and/or treatment during the study period. One hundred fifteen patients were noted to have malnutrition; acute malnutrition (wasting) (weight for height z-score < - 2 SDS) (n=51/115, 44.3%) and chronic malnutrition (stunted) (height-for-age < −2 SDS) was detected in 64/115 (55.7%) patients; the prevalence of wasting, and stunting was 4.2% and 5.3%, respectively. Conclusions: Our study suggests that it should be performed an assessment of nutritional status/ history and anthropometric measurements every admission to the hospital in order to provide healthy growth development in childhood, particularly under 2 of age and interventions should be strengthened for general child health.

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