Hospital-acquired malnutrition in children at a tertiary care hospital

  • Sean Del-Rossi Quadros Aga Khan University Hospital
  • Rose Kamenwa Aga Khan University Hospital
  • Samuel Aketch Aga Khan University Hospital
  • William Macharia Aga Khan University Hospital
Keywords: anthropometric measurements, Body Mass Index z-scores, hospital-acquired malnutrition, weight-for-height z-scores

Abstract

Objectives: This study sought to investigate the incidence and factors associated with hospital-acquired malnutrition in children. Design: A hospital-based longitudinal survey carried out between December 2013 and February 2014. Setting: Aga Khan University Hospital, Nairobi, Kenya, a tertiary care hospital. Subjects: One hundred and seventy children who met the inclusion criteria were included in the study. Outcome measures: Anthropometry was done at admission and discharge. Incidence of hospital-acquired malnutrition was estimated from the total number of children showing a decrease in weight-for-height/length (WFH) or Body Mass Index (BMI) z-scores from the time of admission to discharge. Logistic regression analysis was performed to determine associations between selected variables and weight loss during hospitalisation. Results: Albeit a borderline level of significance, a decrease in calculated z-scores occurred in 60.6% (Confidence Interval (CI) 53.1–67.6%) of children during hospitalisation with a mean weight decrease of 0.5 kg (Standard Deviation (SD) ± 3.37, p = 0.055). Children ≤ 60 months of age demonstrated a mean decrease in weight-for-height/length z-score of 0.145 (SD ± 0.73, p = 0.042); and those > 60 months, a mean decrease in BMI z-score of 0.152 (SD ± 0.39, p = 0.004). The majority with weight loss had been admitted with a diagnosis of gastroenteritis (81.2%), gastritis (64.3%) and pneumonia (55.6%). Weight loss was associated with duration of admission: 3 - 5 days (Odds Ratio (OR) 2.43, CI 1.46–4.03), 5 - 7 days (OR 4.67, CI 1.34–16.24), and > 7 days (OR 2.75, CI 0.88–8.64); score test for trend of odds is OR 1.37 (95% CI 1.11–1.69, p = 0.003). Conclusion: This study found a high incidence of hospital-acquired malnutrition in children. The most affected were those with gastroenteritis, gastritis and pneumonia. Hospital-acquired malnutrition was associated with an increased duration of hospitalisation. (Full text available online at www.medpharm.tandfonline.com/ojcn) South Afr J Clin Nutr 2018; DOI: 10.1080/16070658.2017.1322825

Author Biographies

Sean Del-Rossi Quadros, Aga Khan University Hospital
Consultant Pediatrician Department of Paediatrics and Child Health Aga Khan University Hospital Nairobi
Rose Kamenwa, Aga Khan University Hospital
Assistant Professor: Pediatric Gastroenterologist Department of Pediatrics and Child Health Aga Khan University Hospital Nairobi
Samuel Aketch, Aga Khan University Hospital
Consultant Pediatrician Department of Paediatrics and Child Health Aga Khan University Hospital Nairobi
William Macharia, Aga Khan University Hospital
Professor and Clinical Epidemiologist Department of Paediatrics and Child Health Aga Khan University Hospital Nairobi
Published
2018-04-06
Section
Original Research