Missed Opportunities for Diagnosis of Acute Malnutrition in Children Aged 1-23 Months at Paediatric Emergency Unit at Kenyatta National Hospital

Abstract

Background: In children under the age of five years acute malnutrition has remained a major health concern, with poor progress made towards achieving the desired reduction in prevalence. Currently 17 million children globally are severely malnourished. (3) The current prevalence of wasting in Kenya is at 4% among children under five with severe wasting at 1% (4). The lack of recognition and emphasis on diagnosis (especially the moderate form) and failure to recognize the mortality risks associated with wasting may be an indicator that policy makers are not aware that wasting is a priority health problem in children. Study Justification/Utility: The aim of this study was to better understand the gap with regard to timely diagnosis of acute malnutrition and linkage to appropriate care in a hospital based setting Primary Objective To determine the prevalence of missed opportunities for diagnosis of acute malnutrition in children aged 1-23 months at Pediatric Emergency Unit (PEU) at Kenyatta National Hospital (KNH). Methodology A cross sectional study carried out to determine the prevalence of missed opportunities for diagnosis of acute malnutrition among children aged 1-23 months presenting to the Pediatric emergency unit (PEU) of Kenyatta National Hospital. x

Results Forty-two children were found by the researcher to have acute malnutrition giving a proportion of 10.4% (95% CI 7.6 to 14%). Of the 42 malnourished children, only 1 was correctly identified by the registrar on duty while 97.6% (41/42) (95 CI 87 to 99%) were missed. Twenty-four percent (86/358) of the participants had correctly filled growth charts. The MOH register 204A is not being utilized at PEU, in place a KNH coded register is being used which does not record routine anthropometry for all patients. Conclusion Missed opportunities for diagnosis of malnutrition is 97.6% with only one case correctly identified. Twenty four percent of the participants had correctly filled growth charts. MOH Form 204A outpatient register is not utilized by the PEU ........