Risk factors for wasting among hospitalised children in Nepal

Abstract

Background Malnutrition has various adverse effects in children. This study aimed to determine risk factors for malnutrition among hospitalised children, changes in nutritional status at admission and discharge and effects of use of systematic anthropometric measurement in identification of malnutrition. Methods We enrolled 426 children, aged between 6 months and 15 years, admitted to Siddhi Memorial Hospital, Bhaktapur, Nepal, from November 2016 to June 2017. Anthropometric measurements were performed at the time of admission and discharge. Risk factors were assessed by multivariable logistic regression models. Results Median age of children was 26 months (IQR: 13–49), and males were 58.7%. The prevalence of wasting was 9.2% (39/426) at admission and 8.5% (36/426) at discharge. Risk factors associated with wasting at admission were ethnic minority (aOR: 3.6, 95% CI 1.2–10.8), diarrhoeal diseases (aOR = 4.0; 95% CI 1.3–11.8), respiratory diseases (aOR: 3.4, 95% CI 1.4–8.1) and earthquake damage to house (aOR = 2.6; 95% CI 1.1–6.3). Clinical observation by care providers identified only 2 out of 112 malnutrition cases at admission and 4 out of 119 cases at discharge that were detected by the systematic anthropometric measurement. Conclusions Ethnic minority, diarrhoeal diseases, respiratory infections and house damage due to the earthquake were risk factors associated with wasting. Systematic anthropometric examination can identify significantly more malnourished children than simple observation of care providers.

A cross-sectional study evaluating the prevalence and predictors of malnutrition among children and adolescents visiting an urban academic hospital in Nepal

“…Stunting was higher among younger children compared with older children. Our data are higher than regional data (22 %) (6) and another cross-sectional, hospital-based study (19 %) (25) . This may be reflective economic effects of COVID-19 particularly related to the rising cost of food and supply chain restrictions, but may also be reflective of the socio-demographic characteristics of the children served by this hospital.…”

“…Compared with national data and other hospital-based surveys, we found a higher prevalence of wasting among our sample (8 % and 9·2 % (on admission) v . 17·3 %, respectively) (6,25) . Several factors may account for this discrepancy.…”

Head Circumference Measurements Based on Nutritional Status of Hospitalized Children

“…Our study shows that 34.4 of the admitted children were severely stunted which is higher than the result of a hospital based studies done in Egypt and Western Kenya which revealed that stunted among under 60 month old children were ly [23,24]. More than thirty percent of severely stunted children belonged to the age group 06-24 months which is much higher than the frequency of stunting among 06-24 month old children in a study included hospitalized children in Nepal (4.7%) and a community based study done in Vellore, India (14.1%) [25,26]. Stunting by the age of 2 years is largely irreversible, as the child cannot recover height in the same way that they can regain weight [9,10].…”