Clinico-biochemical profile of sick children with severe acute malnutrition

Abstract

Objective: Severe acute malnutrition (SAM) classified as edematous and marasmus, however, Kwashiorker represents the most severe phenotype of edematous malnutrition. The aim of this study was to describe the clinico-biochemical profile in sick children with severe acute malnutrition. Materials and Methods: This is a descriptive cross-sectional study, which included children aged 6 to 60 months, fulfilling the World Health Organization (WHO) criteria of severe acute malnutrition. We collected data on demography, anthropometry, history, and clinical examination. Investigations included arterial blood gas analysis, serum electrolytes, calcium, serum albumin, and blood sugar. P value < 0.05 was considered significant. Results: One hundred twenty-two children with SAM were recruited, out of which 65 (53.27%) had edematous malnutrition and 57 (46.7%) had nonedematous malnutrition. Out of total children, 90 (73.77%) were discharged from hospital, 18 (14.7%) died, and 14 (11.4%) were left against medical advice. Out of 122 children with SAM, edematous children were younger (25.7 vs. 34.5 months, P = 0.002). Children with edematous malnutrition were more likely to have pneumonia ( P = 0.04), acute gastroenteritis ( P < 0.001), hyponatremia ( P = 0.04), metabolic acidosis ( P = 0.005), and hypocalcemia ( P = 0.006) when compared with nonedematous children. Edematous malnutrition has 1.3 and 1.4 times more risk of death and leave against medical advice (LAMA) respectively as compared to nonedematous malnutrition. Mortality was higher in edematous malnutrition (12, 66.6%) than nonedematous malnutrition (6, 33.3%). Conclusion: Edematous malnutrition was commonly prevalent in 1 to 3 years of children and clinical and biochemical abnormalities frequently co-exist with edematous malnutrition.

Hyponatremia and its associated factors in children admitted to the pediatric intensive care unit in eastern Ethiopia: a cross-sectional study

“…In addition, malnourished children are three times more likely to develop hyponatremia than their counterparts. This finding is in line with studies conducted in India [ 33 ], Bangladesh [ 34 ], and Kenya [ 21 ]. This may be due to severely malnourished children; most children have excess total body sodium despite low serum sodium levels thus, masking sodium overload [ 35 ].…”

Study pattern of nutritional recovery in edematous and non-edematous malnourished children after a short hospital stay of nutrition rehabilitation

“…More importantly, in the present study, we revealed that at the time of admission, edematous children had significantly lower concentration levels of RBP, TTR, ALB, TRF, and Hg, than the non-edematous group, which has also been demonstrated in previous studies 27,28 . Furthermore, a recent study has revealed serious metabolic disturbance in the edematous child than those without edema 29 . In our study, at discharge, all nutrition-related proteins increased significantly to normal in both groups (Table 4) reflecting satisfactory nutritional recovery except for Hg which remained below normal in the non-edematous group.…”