scholarly journals Invasive Fungal Infections in Under-Five Diarrheal Children: Experience from an Urban Diarrheal Disease Hospital

Life ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 94
Author(s):  
Nusrat Jahan Shaly ◽  
Mohammed Moshtaq Pervez ◽  
Sayeeda Huq ◽  
Dilruba Ahmed ◽  
Chowdhury Rafiqul Ahsan ◽  
...  
Keyword(s):  
Septic Shock ◽  
Early Diagnosis ◽  
Late Onset ◽  
Fungal Infections ◽  
Severe Acute Malnutrition ◽  
Fatal Outcome ◽  
Invasive Fungal Infections ◽  
Acute Malnutrition ◽  
Study Group ◽  
Co Morbidity

Invasive fungal infections (IFIs) are opportunistic, especially in immunocompromised and hospitalized patients. Children with IFIs are more vulnerable to a fatal outcome. For early diagnosis and treatment, knowledge of the spectrum and frequency of IFIs among children is prerequisite. In this prospective observational study, we enrolled 168 children of 2–59 months old of either sex from March 2018 to December 2019 admitted to the Dhaka hospital, icddr,b. Study participants with suspected IFIs were with or without severe acute malnutrition (SAM) along with sepsis/pneumonia and fulfilled any of the following criteria: (i) failure to respond to injectable antibiotics, (ii) development of a late-onset hospital-acquired infection, (iii) needed ICU care for >7 days, (iv) took steroids/antibiotics for >2 weeks before hospitalization, and (v) developed thrush after taking injectable antibiotics. The comparison group included non-SAM (weight-for-length Z score ≥ −2) children with diarrhea and fever <3 days in the absence of co-morbidity. We performed real-time PCR, ELISA, and blood culture for the detection of fungal pathogen. Study group children with SAM, positive ELISA and PCR considered to have a IFIs. In the study group, 15/138 (10.87%) children had IFIs. Among IFIs, invasive candidiasis, aspergillosis, histoplasmosis detected in 6 (4.53%), 11 (7.97%), and 1 (0.72%) children, respectively, and (3/15 [2.17%]) children had both candidiasis and aspergillosis. Children with IFIs more often encountered septic shock (26.7% vs. 4.9%; p = 0.013) and had a higher death rate (46.7% vs. 8.9%; p < 0.001) than those without IFIs. IFIs were independently associated with female sex (OR = 3.48; 95% CI = 1.05, 11.55; p = 0.042) after adjusting for potential confounders. Our findings thus implicate that, malnourished children with septic shock require targeted screening for the early diagnosis and prompt management of IFIs that may help to reduce IFIs related deaths.

scholarly journals Study of Anaemia in Children with Severe Acute Malnutrition

2018 ◽  
Vol 37 (3) ◽  
pp. 250-253 ◽  
Author(s):  
Deepak Dwivedi ◽  
Veerendra Singh ◽  
Jyoti Singh ◽  
Sangita Sharma
Keyword(s):  
Severe Acute Malnutrition ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Acute Malnutrition ◽  
Folic Acid Deficiency ◽  
Care Hospital ◽  
Macrocytic Anaemia ◽  
Normal Children ◽  
Co Morbidity ◽  
Morphologic Type

Introduction: Severe anaemia is a leading cause of paediatric morbidity, hospitalization, and mortality and it is very important co morbidity in children with severe acute malnutrition. Severe Acute Malnutrition (SAM) with anaemia has been shown to have 2.62 times higher mortality as compared to SAM with no anaemia. So this study was done to evaluate this co-morbidity further. The aim of present study was to determine the prevalence and type of anaemia and to evaluate the possible aetiologies of anaemia in severe acute malnourished (SAM) children.Material and Methods: In tertiary care hospital a cross sectional study was conducted over a period of 8 month with 100 cases of SAM children and 101 cases of normal children. In both cases disorders of primary haematological problem were excluded. Auto analysers were used to measure blood counts. Blood smear was analysed by pathology consultant of institute and recorded for all patients with anaemia. Grade of anaemia and morphologic type of anaemia was analysed. Data were entered in Excel spreadsheets and analysed using SPSS 20.0.Results: Patient with SAM 42% had moderate anaemia and 19% had severe anaemia in contrast 41.6% and 16.8% in NON SAM child respectively. Predominant morphologic type in SAM patient was macrocytic anaemia (33%), while in controls microcytic anaemia (40.6%) was more prevalent.Conclusion: There was a high prevalence of anaemia in SAM children. Major morphologic type in SAM children was macrocytic anaemia which may indirectly show vitamin B12 or folic acid deficiency in these children.  

scholarly journals Clinical Spectrum and Comorbidity Pattern of Severe Acute Malnutrition in Hospitalised Children Age between 6 Months to 59 Months

2021 ◽  
Author(s):  
Ashutosh Kumar Sharma ◽  
Ghanshyam Das ◽  
Durgesh Shukla
Keyword(s):  
Nutrition Education ◽  
Work Performance ◽  
Severe Acute Malnutrition ◽  
Public Health Problem ◽  
Sub Saharan Africa ◽  
Acute Malnutrition ◽  
Categorical Variables ◽  
Comprehensive Treatment ◽  
Treatment Unit ◽  
Co Morbidity

Abstract BACKGROUND The prevalence of underweight children in India is the highest in the world, and is nearly double that of Sub-Saharan Africa. Poor nutrition in the first 1000 days of a child’s life leads to stunted growth, impaired cognitive ability, reduced school and work performance. The mortality rate and duration of stay in hospital with oedematous SAM has remained unacceptably high. Such high mortality in inpatients has been attributed to co-morbidities.METHOD Descriptive hospital based study was done in the Department of Paediatrics, Kamla Raja Hospital, Gwalior from October 2018 to October 2020. Children 6-59 months of age with severe acute malnutrition admitted in severe acute malnutrition treatment unit were enrolled. WHO criteria were used to define severe acute malnutrition. The quantitative variables were described as mean ± standard deviation and categorical variables were in terms of proportion.RESULT Out of 29036 children, 1020 have severe acute malnutrition, constitute prevalence of 3.51%. A total of 400 cases met eligibility criteria and exploited. Sex ratio male and female 52.5%:47.5%. The peak prevalence was found in age group between 6-12 months (55%). Anaemia (68.25%) was found to be the commonest co morbidity, and then pneumonia (17.75%) dehydration (16.5%) followed by sepsis (13.5%). Most common chief complaint was fever (69%), followed by cough (38%) and watery loose motion (38%).CONCLUSION Severe acute malnutrition remains severe public health problem and mainly affects children under 24 months. Commonest causes are poor feeding practices, improper care of sick child at home, low maternal BMI. Maternal nutrition, education, media awareness, domestic decision, adequate nutrition of the girl child, early identification of anaemia, diarrhoea, pneumonia, sepsis and comprehensive treatment can reduces the morbidity and mortality.

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