Severe malnutrition among children under the age of 5 years admitted to a rural district hospital in southern Mozambique

Bibliographic Data

ID15091173
AuthorsTacilta Nhampossa (0000-0002-4616-8752, Instituto Nacional de Saúde, corresponding author), Betuel Sigaúque (0000-0001-6012-7052, Manhiça Health Research Centre), Sónia Machevo (Eduardo Mondlane University), Eusébio Macete (0000-0002-8071-4761, Manhiça Health Research Centre), Pedro L Alonso (0000-0003-3292-3443, Manhiça Health Research Centre), Pedro Alonso, Quique Bassat (0000-0003-0875-7596, Manhiça Health Research Centre), Clara Menéndez (0000-0002-2641-6907, Manhiça Health Research Centre), Victoria Fumado (0000-0002-3287-252X, Universitat de Barcelona)
Year2013
Volume16
Issue9
Pages1565-1574
Publication date2013-09-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePublic Health Nutrition (JOURNAL)
Journal identifiersISSN: 1368-9800 • E-ISSN: 1475-2727
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s1368980013001080
PMID23635423
OpenAlexW2094128040
LanguageEN
Citations received6
References cited28

Objective To describe the burden, clinical characteristics and prognostic factors of severe malnutrition in children under the age of 5 years. Design Retrospective study of hospital-based data systematically collected from January 2001 to December 2010. Setting Rural Mozambican district hospital. Subjects All children aged Results During the 10-year long study surveillance, 274 813 children belonging to Manhiça's Demographic Surveillance System were seen at out-patient clinics, almost half of whom (47 %) presented with some indication of malnutrition and 6 % (17 188/274 813) with severe malnutrition. Of these, only 15 % (2522/17 188) were eventually admitted. Case fatality rate of severe malnutrition was 7 % (162/2274). Bacteraemia, hypoglycaemia, oral candidiasis, prostration, oedema, pallor and acute diarrhoea were independently associated with an increased risk of in-hospital mortality, while malaria parasitaemia and breast-feeding were independently associated with a lower risk of a poor outcome. Overall minimum community-based incidence rate was 15 cases per 1000 child-years at risk and children aged 12–23 months had the highest incidence. Conclusions Severe malnutrition among admitted children in this Mozambican setting was common but frequently went undetected, despite being associated with a high risk of death. Measures to improve its recognition by clinicians responsible for the first evaluation of patients at the out-patient level are urgently needed so as to improve their likelihood of survival. Together with this, the rapid management of complications such as hypoglycaemia and concomitant co-infections such as bacteraemia, acute diarrhoea, oral candidiasis and HIV/AIDS may contribute to reverse the intolerable toll that malnutrition poses in the health of children in rural African settings

District hospital · Malnutrition · Malnutrition in children · Severe Acute Malnutrition · Under-five · Child Nutrition and Water Access · Global Maternal and Child Health · Medicine · Poverty, Education, and Child Welfare · Emergency Medicine · Internal Medicine · Pediatrics

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