Wasting and associated factors among critically ill children admitted to pediatric intensive care unit in Ethiopia

Abstract

Background Nutritional problems are increasingly associated with acute infections. It is also related to further complications of illnesses and poor treatment outcomes of medical conditions. This study aimed to assess wasting and associated factors among critically ill children admitted to intensive care units at the time of admission. Methods An institution-based prospective observational study was employed among children admitted to pediatric intensive care of the University of Gondar Comprehensive Specialized Hospital from February 1, 2018, to July 30, 2019. Data about socio-demographic, clinical, and anthropometric measurements were taken from children at the time of admission and length of hospital stay and treatment-related data were collected by chart review at discharge. Summary measures were computed and presented in the form of text, tables, and graphs. A p-value of less than 0.2 was used to select candidate variables for multivariable analysis. A binary logistic regression model was fitted to identify factors associated with wasting. Adjusted odds ratio with 95% confidence interval (CI) was calculated and variables with a p-value less than 0.05 in the multi-variable analysis were considered to declare factors associated with wasting. Results The median age at admission was 48 (IQR: 12 to 122) months. Of the total admitted children to ICU, 47.97% were undernourished, of which 32% (95%CI: (26.8% to 37.4%) were severely wasted. Caregivers who had no formal education (AOR=4.43, 95%CI 1.62 12.10), transferred from wards (AOR=2.98, 95%CI: 1.02 8.69), duration of illness ≥6 days before health facility visit (AOR=2.14, 95%CI: 1.22 3.72) and comorbidity (AOR=6.85, 95%CI: 2.93 16.05) were statistically significant factors associated with wasting. Conclusion Wasting was high among children admitted to the intensive care unit. No formal education, transferred from wards and operation rooms, longer duration of illness before health facility visits, and comorbidity were factors associated with wasting. Wasted patients had higher mortality as compared to patients with no wasting. A multicenter study with larger sample size is recommended for a more generalizable result.

Six in ten children with epilepsy visiting the University of Gondar comprehensive specialized hospital were undernourished: a cross-sectional study

“…This is supported by a population-based case-control study done in Bangladesh (AOR = 1.5 95%CI:1.0,2.1) [15]. This could be because caregiver knowledge and awareness of nutritional practices affect the nutritional status of a child [17]. Fathers are usually the backbones and breadwinners of the family in Ethiopia.…”

The magnitude of pediatric mortality and determinant factors in intensive care units in a low-resource country, Ethiopia: a systematic review and meta-analysis

“…One article was conducted with a cohort study design, while the other was conducted with a crossectional study design. In our review, the analysis method used for the three articles was chi-square analysis ( 14 , 17 , 20 ), while the analysis method for the five articles was logistic regression, and one article used the survival model ( 11 , 15 , 16 , 18 , 19 , 21 ); it helps to minimize confounding factors, and this study includes the determinate factors for pediatric mortality in PICU ( Table 1 ).…”