Hospital malnutrition and causative factors among paediatric in-patients aged 6-59 months

Abstract

Malnutrition is prevalent among hospitalized patients and is associated with higher complication of the disease and mortality. The risk for malnutrition and the causative factors have not yet been very clearly elucidated. This study was designed to study the prevalence and factors associated with In-hospital malnutrition amongst hospitalized paediatric patients aged 6-59 months in Kenyatta National Hospital. A prospective / descriptive study was undertaken with 172 children aged 6-59 months hospitalized for at least a day with their mothers/caregivers as respondents. Nutritional status was assessed by Weight-for-age, weight-for-height and height-for-age Z-scores and In-hospital malnutrition was classified as weight loss (less than or equal to) >/= 0.5 kg. Semi-structured questionnaires were used to collect socio-demography and socio-economic information, nutritional status at admission and discharge, morbidity progression, length of hospitalisation and referral to the Nutrition Department. Data was analyzed using univariate and multivariate logistic regression methods. Results showed that malnutrition is a serious problem among hospitalised paediatric patients. Nutritional status at admission was diagnosed as wasting 43.9%, stunting 29.2 %, and underweight at 45.4%. At discharge wasting was determined as 43.2%, stunting at 33.6% and underweight at 45.9 %. 38.4% Patients were classified with in-hospital malnutrition. The inhospital malnutrition prevalence was significantly higher in patients aged 6-17 months at 73.1% than other age groups. Patients with diarrhoea were significantly more likely to be malnourished compared to those without diarrhoea (Odds ratio [OR] = 21.4, P<0.001). The risk factors for inhospital malnutrition were wasting (OR = 5.02, P< 0.05), diarrhoea (OR = 23.4, P<0.001), nutrition education (OR = 0.123, P< 0.05), Appetite (OR = 0.079, P<0.001) and length of hospitalisation (OR = 2.75, P< 0.00). The study concludes that paediatric patients who are wasted at admission, have diarrheal infection, reduced appetite, are hospitalized for long duration, have reduced appetite and whose caregivers have not received nutrition education are at high risk of developing hospital malnutrition. Diarrhea infection is the greatest risk factor for hospital malnutrition.