Prédicteurs de mortalité précoce en cours d'hospitalisation des enfants malnutris aigus sévères de 0-59 mois au CHU Sourou Sanou, Bobo-Dioulasso / Predictors of early mortality during hospitalization of severe acute malnourished children aged 0-59 months at CHU Sourô Sanou, Bobo-Dioulasso

Objectifs : étudier les facteurs de risque de mortalité des enfants malnutris aigus sévères (MAS) dans les 72 premières heures d'hospitalisation. Méthode : Nous avons mené une étude rétrospective sur des données d'enfants MAS de 0-59 mois, hospitalisés du 1er juin 2016 au 31 mai 2019 au CHUSourô Sanou (CHUSS) de Bobo-Dioulasso. Une régression logistiquea été réalisée pour déterminer les facteurs de risque de décès. Les variables avec un odds ratio (OR) >1, et p 3s [OR :3.55, 95%IC: 1.50-8.27], le sepsis [OR : 3.39, 95%IC: 1.33-8.50], étaient les facteurs de risque prédictifs de mortalité. Conclusion : Une formation et supervision continue du personnel soignant sur la prise en charge des urgences pédiatriques, l'utilisation du protocole OMS de prise en charge de la MAS, la disponibilité de kits d'urgence pourraient améliorer la prise en charge des MAS. Mots clés : Mortalité, précoce, MAS, BoboDioulasso

Objectives: to study risk factors for mortality in SAM children within the first 72 hours of hospitalization. Methods: We conducted a retrospective study on data from 0-59-month-old SAM children hospitalized from June 1th, 2016, to May 31th, 2019, at CHUSourô Sanou of Bobo-Dioulasso. A logistic regression was performed to determine risk factors for death. Variables with odds ratio (OR) > 1, and p 3seconds [OR :3.55, 95%IC: 1.50-8.27], sepsis[OR :3.39, 95%IC: 1.33-8.50]were the risk factors predictive of mortality. Conclusion: Training and ongoing supervision of healthcare staff in the management of paediatric emergencies, the use of the WHO SAM management protocol and the availability of emergency kits could improve SAM management

Mobile phone application in the management of maternal and young child malnutrition: a review

Background: Malnutrition is one of the leading causes of maternal and young child mortality in underdeveloped countries, particularly during pregnancy and delivery. The effects of malnutrition in pregnant women include low birth weight, preterm birth, intrauterine growth restriction, nutrient deficiencies and reduced breast milk production. Mobile phone applications are widely used with features such as portability, ease of communication, storage at relatively low cost that makes such technology attractive to nutritionists. Objective: To assess if mobile phone applications can be beneficial in maternal and young child malnutrition intervention. Methods: Zotero reference management software was used to ensure the rigor and reproducibility of the review process. Based on defined key words, a search was conducted on Google Scholar, ScienceDirect, PubMed and Springer databases to retrieve all publications on mobile phone applications in maternal and young child malnutrition interventions. The study used ten articles from unique studies that met the study criteria and are reported in terms of authors, year, sample size, study design and outcome measure. Results: The articles revealed that mobile phone applications were highly useful in maternal and young child malnutrition intervention, prompting nutrition information seeking and facilitating communication with healthcare providers. Conclusion: Mobile phone applications are widely acknowledged, and beneficial in maternal and neonatal malnutrition management, they have the potential to improve maternal and young child nutritional status through self-monitoring. Given the low uptake of current mobile phone application, it should be given a significant consideration as a potential strategy for managing maternal and young child malnutrition.

Aetiology of pancytopenia: Experience of a South African tertiary academic centre

Background: Pancytopenia is a manifestation of numerous disease entities. The causes of pancytopenia differ with geographic region, socio-economic factors and HIV prevalence. Awareness of the common causes of pancytopenia may aid timely diagnosis. Objective: This study aimed to determine the aetiology of pancytopenia in a South African population.Methods: A retrospective observational study of adult patients presenting with pancytopenia at Tygerberg Academic Hospital, South Africa, from January 2016 to December 2017 was performed. Data on pancytopenia cases were obtained from the laboratory information system and utilised to determine the causes of pancytopenia. Results: A total of 673 cases of pancytopenia were identified. The most common causes of pancytopenia were chemoradiation therapy (25%), sepsis (18%), haematological malignancy (9%), advanced HIV (7%), and megaloblastic anaemia (6%). The diagnostic yield of bone marrow examinations (BME) was 57% (n = 52/91). The aetiology of pancytopenia differed according to age, with malignancy being a more common cause of pancytopenia among the elderly. Conclusion: Several easily recognisable and treatable conditions can manifest as pancytopenia. Prompt management of such conditions, notably sepsis and megaloblastic anaemia, can result in the resolution of the cytopenias and negate the need for a BME. However, haematological malignancy and unexplained pancytopenia strongly rely on a BME to establish a diagnosis. Pancytopenia investigations, when guided by appropriate clinic-laboratory findings, can promptly identify the underlying aetiology, while also identifying cases where an expedited BME is required. This is valuable in resource-conscious medicine

Patients in public hospitals received insufficient food to meet daily protein and energy requirements: Cape Town Metropole, South Africa

Objectives: This study aimed to determine the energy and protein content of meals served and consumed by hospitalised patients compared with their needs, to assess patients' food satisfaction and investigate associations with energy and protein intake. Design: This was an exploratory quantitative cross-sectional study. Setting: Three public hospitals within the Cape Town metropole were recruited; a central hospital (945 beds), large district hospital (372 beds) and a medium district hospital (172 beds). Subjects: Adult inpatients 18+ years admitted to medical or surgical wards, on a non-therapeutic/normal hospital diet were recruited by purposive sampling method between 2018 and 2019.Outcomes measures: Each participant's weight and height were measured to calculate body mass index (BMI) and to determine energy/protein requirements. The Acute Care Hospital Foodservice Patient Satisfaction Questionnaire was administered. Meals were weighed before and after consumption to calculate energy and protein intake per patient/day. Results: A total of 128 patients (males = 71) participated. Total protein served did not meet patient requirements in any of the hospitals. Consumed energy and protein were significantly below requirements in all hospitals (p < 0.002). Perceived food quality (r = 0.38, p = 0.039) and staff/service issues (r = 0.39; p = 0.035) were significantly positively correlated with protein intake, while appetite correlated positively (r = 0.42, p = 0.006; r = 0.41, p = 0.008) and length of stay (LOS) correlated negatively (r = −0.46, p = 0.002; r = −0.42, p = 0.008) with energy and protein intake, respectively. Conclusion: Energy and protein served was significantly lower than participants' requirements in all three hospitals and none achieved the official ration scale amounts. Nearly 40% reported having a normal appetite and did not receive additional food from family or friends, which may lead to hospital-acquired malnutrition and increased hospital length of stay (LOS). Improved hospital food quality, quantity, mealtimes and staff training should be a focus to improve patient energy and protein intake

Les indicateurs de l'alimentation du nourrisson et du jeune enfant prédicteurs de la malnutrition chez les enfants 6-23 mois dans la zone de santé de Kapolowe, Haut-Katanga, R D Congo / NA

Introduction. L'étude visait évaluer les indicateurs de l'alimentation du nourrisson et du jeune enfant liés à l'état nutritionnel dans la zone de santé de Kapolowe, province du Haut Katanga avant les essais cliniques. Matériel et méthodes. Nous avons conduit une étude descriptive transversale dans la communauté auprès des 568 couples mère-enfant 6-23 mois évalués sur les indicateurs nutritionnels associés à la malnutrition. Résultats. L'allaitement maternel optimal était observé chez 10,7% des couples mère-enfant et l'alimentation complémentaire adéquate bénéficiée par 5,5% des enfants. Presque 25,6% des ménages utilisaient des toilettes améliorées, 98,8% des ménages buvaient l'eau des sources protégées et 12,1% des mères pratiquaient un minimum de lavage de mains. Le premier aliment complémentaire donné à la moitié des enfants (46%) était importé, mais 60,3 % des mères utilisaient le mélange farine de maïs + huile + sucre comme aliment de complément. La prévalence de la malnutrition aiguë, de la malnutrition chronique et de l'insuffisance pondérale était respectivement de 11,9%, 37% et 26,8%. La malnutrition aiguë était associée à l'occupation de la mère, au niveau socio-économique du ménage, à la Religion de la mère, à la consultation prénatale suivie par la mère, au Minimum de Diversité Alimentaire, à l'allaitement maternel non optimal, aux infections récurrentes et au faible poids de naissance. L'insuffisance pondérale était associée au sexe, à l'occupation de la mère, au niveau socio-économique, à la religion de la mère, au minimum de diversité alimentaire, à l'allaitement maternel non optimal, aux infections récurrentes et au faible poids de naissance. La malnutrition chronique était associée au sexe, au niveau socio-économique,

Introduction. The aim of the study was to assess infant and young child feeding indicators related to nutritional status in the Kapolowe health zone, Haut Katanga province prior to the clinical trials. Material and methods. We conducted a descriptive cross-sectional study in the community among568 mother-child pairs 6-23 months of age assessed on nutritional indicators associated with malnutrition. Results. Optimal breastfeeding was observed in 10.7% of the mother-child pairs and adequate complementary feeding in 5.5%. Almost 25.6% of households used improved toilets, 98.8% of households drank water from protected springs and 12.1% of mothers practiced minimal hand washing,12.1% of mothers practiced minimal handwashing. The first supplementary food given to half of the children (46%) was imported food, but 60.3% of mothers used maize flour + oil + sugar as a complementary food. The prevalence of acute malnutrition, chronic malnutrition and under weight were 11.9%, 37% and26.8% respectively. Acute malnutrition was associated with the mother's occupation, household socio-economic level, mother's religion, prenatal consultation attended by the mother, minimum dietary diversity, non-optimal breastfeeding, recurrent infections, and low birth weigh. Underweight was associated with gender, maternal occupation, socio-economic level, maternal religion, minimum dietary diversity, non-optimal breastfeeding, recurrent infections and low birth weight. Chronic malnutrition was associated with gender, socio-economic level, minimum meal frequency, type of toilet used, non-optimal breastfeeding, recurrent infections, and low birth weight. Conclusion. The prevalence of malnutrition, in all its forms, is still very high and worrying among children aged 6-23 months. The feeding practices are predictors of it.

Les métaux lourds plus polluant dans la malnutrition chez l'enfant de moins de 5 ans à Lubumbashi / NA

Introduction : Lubumbashi, première ville du Katanga et deuxième grande ville de la République Démocratique du Congo, est une zone minière et le poumon économique du pays. De ce fait, elle constitue le siège d'une effervescence d'activités minières artisanales et industrielles. Ce travail vise à évaluer la bioaccumulation ou l'intoxication des métaux lourds dans la population des enfants malnutris. Matériel et méthodes : Le cobalt, le chrome, l'antimoine et le Plomb ont été dosés dans le sérum chez les enfants de moins de 5ans (n = 311). L'ICP OES ou le spectrophotomètre d'absorption atomique couplé à un spectrophotomètre à émission optique ont été utilisés pour le dosage. Trois cent onze enfants ont été colligés au cours de la période allant du 1 Juillet 2013 au 31 décembre 2014. Les analyses statistiques ont été réalisées au moyen du logiciel Epi Info 7.1.1.0. Résultats : Parmi les métaux lourds, l'antimoine s'est révélé moins toxique que les autres, tandis que les prévalences et risques de pollution significatifs suivants ont été observés chez les enfants malnutris : 76 % (OR [IC 95 %] : 1,5[1,04-2,25]) pour le chrome, 58 % (OR [IC 95 %] : 1,7[1,18-2,59]) pour le cobalt et 58 % pour le Plomb (OR [IC 95 %] : 1,7[1,15-2,65]). Conclusion : L'intoxication aux métaux lourds reste un problème de santé à Lubumbashi dans la population en général, particulièrement chez les malnutris. Plus l'enfant est jeune, de sexe féminin plus, il était exposé à l'intoxication aux métaux lourds plus polluants dans la majorité des cas. Pour la plupart les zscores PPA et TPA étaient au-delà de 2 avec une différence statistique hautement significative.

Socio-demographic and nutritional assessment of under five children in Benue State North Central Nigeria

Background: Globally, malnutrition is a major public health concern. Under nutrition in Nigeria is a long standing problem since independence and the magnitude is on the increase. This is so because food consumption both in quantity and quality has decreased considerably due to unemployment and other harsh economic conditions. Objectives:The study aimed at assessingthe sociodemographic and Nutritional status of underfive Children in Benue State North Central Nigeria. Methods: A cross sectional survey was conducted using quantitative data collection methods. The study involved interviews using questionnaires for sociodemographic variables, immunization, breast feeding practices and anthropometric measurements. Data were analyzedusing SPSS version 21. Ninety five percent confidence interval was used while a p value of ≤ 0.05 was considered statistically significant.Results:Two hundred and twenty three under five children and their mothers were assessed for nutritional status using selected and sensitive anthropometric methods. The results showed that children with mothers/caregiverswithout formal education had weight and height 36.4% and 70.5% below normal respectively.Mothers with income less than twenty thousand per annum had children with height 53.3% below normal while those earning above twenty thousand naira per year had weight 41.0% and height 62.9% below average respectively. Furthermore, children without appropriate immunization for age had 29.9%, 53.2%, and 36.9% below normal for weight, height and mid upper arm circumference respectively. There was a statistically significant relationship betweenweight, height and mid upper arm circumference with the age of children (p=0.00, 0.002, 0.001respectively) with respect to their nutritional status. Conclusion: The nutritional need of a childis complex. There is need for proper nutritional education

La dénutrition chez un groupe de patients atteints d'insuffisance rénale chronique : étude prospective

Introduction : La dénutrition est fréquente chez les patients en insuffisance rénale chronique. Elle affecte 35% des patients au début de la dialyse et représente une des causes de morbi-mortalité. L'objectif de ce travail est de déterminer la fréquence de la dénutrition chez des patients à différents stades d'Insuffisance rénale chronique Matériels et méthodes : Une étude longitudinale descriptive portant sur 162 patients en insuffisance rénale chronique à différents stades (2, 3,4, 5 et 5D) a été réalisée au service de Néphrologie du CHU Nafissa Hamoud à Alger. Nous avons étudié les paramètres nutritionnels biologiques et anthropométriques chez les patients en IRC à différents stades. Résultats : L'âge moyen des patients est de 56,5±17 ans avec un sex-ratio de 1,43. Les taux de l'indice de masse corporelle, de l'albumine et de la pré-albumine moyens sont respectivement : (21,98 ± 0,28), (37,84g/l ± 0,47) et (302, 93 mg/l ± 5,4). Les trois paramètres diminuent significativement (p<0,05) avec la dégradation de la fonction rénale (du stade 2 vers le stade 5D). Les patients les plus dénutris se retrouvent aux stades 5 et 5D. La dénutrition est plus importante chez les patients avec IRC grave et chez les hémodialysés. Conclusion : L'insuffisance rénale chronique représente un véritable problème de santé publique. La dénutrition est l'une des causes de morbi-mortalité chez ces patients surtout après l'épuration extra rénale notamment l'hémodialyse, ce qui nous incite à nous intéresser au statut nutritionnel des patients en IRC

Prise en charge de la malnutrition aigüe chez l'enfant dans un hôpital secondaire sahelien

La malnutrition chez les enfants de moins de cinq ans est un problème majeur de santé publique dans les pays à faibles revenus, et contribue de manière significative à la mortalité dans cette tranche d'âge.Le but de ce travail était d'évaluer le profil épidémioclinique et thérapeutique des enfants malnutris pris en charge au centre de santé de référence de Nara.Méthode:IL s'est agi d'une étude rétrospective et descriptive,allant du 01/01/2016 au 31/12/2016.Tous les enfants d'âge compris entre 6 mois et 59 mois, admis pour malnutrition aigüe ont été inclus.Résultats:La malnutrition a été diagnostiquée chez quatre cent soixante un enfant, soit 15% des consultations et 50% des hospitalisations.L'âge médian était de 26 mois (2 mois 93 mois). Le sex ratio était 0,92 (M=222;F=239).Dixneuf pour cent des patients ont eu un sevrage progressif (n=90), et il a été brutal chez 371patients, soit 80%. La répartition des patients selon le Z score était le suivant: Z-score <-1 (n=15;3%), Z-score <-2 (n=46; 10%), Z-score <-3 (n=400; 87%). Le périmètre brachial moyen était de 105mm (99mm-124mm). A l'admission, l'hypoglycémie a été notée chez 45% (n=204). Les cas de marasme représentaient 80% (n=367) kwashiorkor 10% (n=48). La forme mixte de la malnutrition a représentée10% (n=46). Les pathologies associées à la malnutrition étaient: les pneumopathies (n=219; 47%), lepaludisme (n=115;25%) et les gastroentérites (n=68; 15%).Le F75 a été administré majoritairement pendant 3 mois dans 93% des cas. Pour la phase 2 du traitement, le Plumpy Nut et le F100 ont été respectivement administré à 88% et 12%.Le taux de récupération nutritionnelleétait de 95% (n=435).Cinq pour cent des patients sont décédés (n=26). La pneumonie a été la cause du décès dans 85% des cas. Le taux de guérison pour les cas de marasme et de kwashiorkor était respectivement de 94% et 93%.Conclusion:la malnutrition aigüe demeure fréquente et préoccupante en milieu pédiatrique sahelien. Une meilleure connaissance des mères sur le sevrage et la diversification alimentaire permettront d'améliorer l'état nutritionnel des enfants

Spatial and temporal variations in women undernutrition in Ethiopia- a multilevel analysis

Background: Women's undernutrition is a major concern in many sub-Saharan African countries including Ethiopia; however, little information exists on its spatial and temporal variation within a single national context. This paper examines spatial and temporal variations in women's undernutrition and its determinants in Ethiopia between 2000 and 2016. Data source and methods: We use data from the Ethiopia Demographic and Health Surveys from 2000 to 2016. We used multilevel logistic regression models with region-level random effects to estimate determinants of undernutrition. Results: The results show substantial regional variations in women's undernutrition in Ethiopia, which show mixed patterns over time. Also, the regional variations are significantly affected by age, education level, marital status, wealth, occupational status and type of residence as well as some aggregate factors. Undernutrition risks are considerably higher for teenage women, no education, never-married, unemployed, and rural women, as well as women from poor households than their counterparts. Additionally, in regions with lower levels of women's education, the risk of undernutrition was higher. Conclusions: Regional variations in women's undernutrition in Ethiopia are significantly determined by individual sociodemographic, economic and community levelcharacteristics. Policy decisions should focus on bridging the regional disparities in the country, especially in areas that have made little progress in reducing women's undernutrition

Magnitude and factors associated with optimal complementary feeding practices among children aged 6-23 months in Bensa District, Sidama Zone, South Ethiopia

BACKGROUND: Prevalence of optimal complementary feeding practices are lower than expected. Undernutrition contributes 35% of children mortality. Our study was aimed to assess magnitude and factors associated with optimal complementary feeding practices among children 6-23 months in Bensa Dstrict, Sidama Zone, South Ethiopia, 2016. METHOD: A community based cross sectional study was conducted from January to February 2016 in (8) randomly selected kebles found in Bensa District. Respondents were selected by using simple random sampling technique after sampling frame was prepared from rapid survey. Pre-tested questionnaire was used to collect information. Then, data were entered into SPSS version 20, Then, crude odds ratio (COR) and adjusted odds ratio (AOR) with 95% confidence interval were computed to examine statistical significance. RESULT: This study revealed that only 8.6% (95%CI: 6.4, 10.7%) of 6-23 months children had optimal complementary feeding practices. Mother's knowledge on optimal complementary feeding (AOR=5.4, 95%CI: 2.7, 11), postnatal care service utilization (AOR=3.4, 95%CI: 1.7, 7), and household food security (AOR=5, 95%CI: 2.5, 10.5) were positively associated with optimal complementary feeding practices. CONCLUSION: Mother's knowledge, postnatal care utilization and household food security positively affected optimal complementary feeding practices.Thus, Bensa District Health Office, Sidama Zone Health Departiment and other respective stakeholders should cooperatively work to enhance knowledge of mothers/care takers on optimal complementary feeding practices, household food security and on advantages of postnatal care service utilization

Chronic malnutrition among under five children of Ethiopia may not be economic. A systematic review and meta-analysis

Background: Ethiopia is one of the four low income countries in achieving MDG4, however, minimizing child undernutrition became critical undertaking thus far. This review aimed at identifying the predictors of under-5 children nutrition in Ethiopia. Methods: Databases searched were Med Line, HINARY, MedNar and Embase. Furthermore, gray literatures were also sought. All papers selected for inclusion in the review were subjected to a rigorous critical appraisal using standardized critical appraisal instruments from the Joanna Briggs Institute. Quantitative papers were pooled for statistical analysis and narrative synthesis. Odds ratios and their 95% confidence intervals were calculated for analysis. Papers of optimal quality but without optimal data set for meta-analysis were subjected for narrative synthesis. Results: Nonadherence towards Optimal feeding recommendations was the most reported predictor of stunting and wasting, while, maternal education and 'Water, Sanitation and Hygiene' factors were the second. The findings of the Meta-analysis showed no evidence of association between household income/wealth and stunting of children in Ethiopia (OR=1.14, 95% CI= 0.97, 1.34), heterogeneity test:i2 = 92%, df = 20, (P < 0.00001). On the other hand, children in low income/wealth group were 1.73 times more likely to have wasting compared to children of the higher income/wealth households (OR=1.73, 95% C I= 1.51, 1.97) heterogeneity test: i2 = 71%, df = 20, (P < 0.00001). Conclusion: An over-reliance on macroeconomic growth as a solitary factor towards undernutrition should not be the way forward. Supplementary and more focused nutrition specific and sensitive interventions are needed in Ethiopia

The association between under-nutrition, school performance and perceptual motor functioning in first-grade South African learners: The North-West Child Health Integrated with Learning and Development study

Background: Early childhood is characterised by an immense spurt of growing and learning where under-nutrition can have adverse effects on the neuro-developmental health and school performance of children. A full understanding of the relationship between school performance and motor functioning skills and malnourishment in school beginners is still lacking. Aim: To determine the association between indices of under-nutrition and how it relates to school performance and motor functioning skills of first-grade learners. Setting: North West province (NWP) of South Africa (SA). Method: The baseline data of the stratified, randomised North-West Child Health Integrated with Learning and Development (NW-CHILD) longitudinal study were used. Grade 1 learners (N= 816, 420 boys, 396 girls, mean age 6.78+ years) from four school districts in the NWP of SA took part in the study. Indices of under-nutrition were determined by Z-scores (−2standard deviation [s.d.]) for stunting (height-for-age [HAZ]) and wasting and underweight (Z-score for body mass index) using the 2007 World Health Organization reference sample. The Bruininks­Oseretsky Test of Motor Proficiency Short Form and the Visual Motor Integration fourth edition were used to assess different aspects of motor functioning, while school performance in mathematics, reading and writing was assessed by teachers according to the National South African standards of assessments. Results: Both HAZ and Z-score for weight-for-age correlated significantly with school performance and motor functioning skills (r> 2.0, p< 0.05), while visual perception was moderately associated (r< 0.30) with mathematics in HAZ and Z-score for weight-for-height (WHZ) children. Motor functioning of HAZ and WHZ children was significantly poorer (p<0.05) compared to typical children, while underweight was not associated with any outcome variables.Conclusion: Moderate forms of stunting and wasting influence school performance and motor functioning of school beginners negatively, while an association between visual perceptual abilities and inferior mathematics, reading and writing suggests a close link with inferior cognitive information processing in stunted and wasted children. These barriers should be addressed as poor scholastic success in Grade 1 may influence future school performance and the subsequent well-being of children

Adult malnutrition: prevalence and use of nutrition-related quality indicators in South African public-sector hospitals

Objectives: The aim of this study was to describe the prevalence of malnutrition among adult hospitalised patients in three South African public hospitals and to determine the availability of nutrition-related quality indicators at ward and institutional level.Method: A descriptive, cross-sectional, multi-centre study was used to determine the prevalence of malnutrition, whilst a descriptive exploratory design was used to determine the use of nutrition-related quality indicators for the identification and treatment of malnutrition. A total of 141 adult hospitalised patients in three public hospitals in an urban setting participated.Mid-upper arm circumference (MUAC), body mass index (BMI), and malnutrition universal screening tool (MUST) were used to determine the prevalence of malnutrition or malnutrition risk. A Hospital Nutrition Review Tool (HNRT) determined the use of nutrition-related quality indicators.Results: The overall malnutrition risk according to MUST was 72.3% (48.2% high risk and 24.1% medium risk), whilst 45.4% were malnourished based on MUAC. No routine nutritional screening was conducted in any of the wards to identify patients at nutritional risk. The majority of nurses reported inadequate training or knowledge to calculate patients' BMI or percentage weight loss, or to perform nutritional screening.Conclusion: Both malnutrition prevalence and malnutrition risk among adult hospitalised patients are high in the public sector.Inadequate resources may lead to delays in malnutrition identification and appropriate nutritional intervention, which may adversely affect both the patient and the institution. This study contributes to baseline data on adult malnutrition in the South African public hospital setting

Pre-albumin as a marker for predicting weight loss in hospitalised children

Objectives: This study sought to determine the diagnostic utility of serum pre-albumin in predicting weight loss in hospitalised children.Design: A hospital-based longitudinal survey was carried out between December 2013 and February 2014.Setting: Aga Khan University Hospital, Nairobi, Kenya, a tertiary care hospital.Subjects: A total of 170children aged 29 days to 15 years who met the inclusion criteria were included in the study.Outcome measures: Serum prealbumin levels and weight were measured at admission and repeated after 48­96 h. Sensitivity,specificity, and positive and negative predictive values were calculated to determine the diagnostic utility of serum pre-albumin in predicting weight loss in hospitalised children.Results: Of the 170 children studied, 57% and 60% had a drop in serum pre-albumin level and weight within the first four days of hospitalisation respectively. A drop in pre-albumin occurred in 68% of the 103 patients who had weight loss (p < 0.001).Using a serum pre-albumin cut off point of < 0.15 g/l at admission, sensitivity and specificity of serum pre-albumin in predicting weight loss were 76.7% and 29.0% (negative predictive value = 42.9%; positive predictive value = 64.2%). Positive and negative likelihood ratios were low at 1.08 and 0.8. The majority of the patients (72.3%) were already at risk of malnutrition as determined by the pre-albumin risk stratification on admission.Conclusion: Serum pre-albumin is not an accurate surrogate for weight loss during hospitalisation.It is, however, useful in identifying patients at risk of malnutrition on admission and during hospitalisation

Analysis of trends in SMART Nutrition Survey datafrom South Sudan between 2004 and 2016

Introduction: Emergency levels of Global Acute Malnutrition (GAM) persist in former Northern Bar el Ghazal State in South Sudan despite ongoing interventions. Reasons for long-term trends in GAM in South Sudan have not been explored despite decades of nutrition and health interventions. Objective: This project aimed to identify and analyse changes in patterns of malnutrition and key factors associated with malnutrition from 2004 to 2016.Methods: Secondary data analysis was carried out using Standardized Monitoring and Assessment of Relief and Transitions (SMART) nutrition surveys. Anthropometric data collected from children under five years of age from 2004 to 2016 were analysed to estimate seasonal differences in the prevalence of GAM (weight-for-height z-score (WHZ) <-2) and severe acute malnutrition (WHZ <-3). Risk factors for GAM were explored using data collected in 2014 and 2015 and analysed using logistic regression. Adjusted Wald tests investigated which variables were associated with GAM (p<0.05).Results: In Aweil West and North a reduction in GAM was observed between September 2004 (21.0%, CI 18.2-23.9) and November 2009 (16.2%, CI: 13.7-18.9). However, this apparent decline likely reflects a seasonal difference because the 5-year overall mean GAM was 20.4% (SD: 0.403) and 17.5% (SD: 0.380) in pre- and post-harvest seasons respectively. In multivariable linear regression modelling, not having been sick in the past two weeks (aOR 0.78, 95% CI 0.61, 0.99, p=0.047), and not having consumed juice (aOR 0.67, 95% CI 0.45, 0.99, p=0.045) were protective against GAM after adjusting for all potential confounders.Conclusion: This study highlights the impact of instability on the nutritional status of a generation, with the high prevalence of GAM and severe acute malnutrition remaining unchanged since 2004. Regular collection of representative nutrition data is useful to inform decision making. The results of this study suggest that a focus on care seeking behaviours and hygiene practices would be beneficial. The persistent prevalence of GAM identifies a need, not just for nutrition programmes but also effective prevention programmes

Prevalence and associated factors of undernutrition among school adolescents in Gobu Seyo District, East Wollega Zone, Oromia regional state of West Ethiopia, 2016

Adolescence is the transitional period between childhood and adulthood. During this, nutrient needs are greatest. There is so little data on adolescents' nutrition and research needs are immense. The objective of the study was to assess prevalence and associated factors of undernutrition in school adolescents aged 10 to 19 years. A cross-sectional study was conducted at GobuSeyo district in December, 2016. Using multi-stage sampling technique and interviewer administered questionnaire data was collected from 640 adolescents. Statistical package for social science version 20 for data entry and analysis and World health organization Anthroplus for determination of nutritional status of adolescents were used. Multivariable logistic regression analysis was used to identify independent predictors. Prevalence of stunting and underweight composed 17.0 and 18.8% respectively. Adolescents who were stunted and underweight were 22.9%. Severely stunted and underweight adolescents were 1.7 and 2.8% respectively. Single predictor of stunting was fathers' occupation (Adjusted odds ratio-AOR- 5.82; 95%; CI-1.15, 29.38). Sex and age of the respondents and fathers' occupation were significant predictors of undernutrition. Thus, adolescent nutrition program focusing on age and sex of adolescents needs to be designed and implemented to address nutritional problem specifically in the study area

Assessment of wasting and associated factors among under five children of Wukro town, Tigray regional, North Ethiopia: a cross sectional study

Introduction: globally, 50 million children under 5 were wasted; of which 16 million were severely wasted. A severely wasted child is at a nine times higher risk of dying. To prevent this problem, it is necessary to determine the magnitude and factors associated with childhood wasting. In Ethiopia specifically Wukro town, Tigray regional state there is no clear information regarding under five wasting. Therefore, the study assessed the prevalence and associated factors of wasting among under five children in wukro town,North Ethiopia. Objective: to assess the prevalence of wasting and associated factors among under five children of Wukro town, Tigray, North Ethiopia, 2017/2018.Methods: community based cross-sectional study design with a single population proportion formula was used with a total sample size of 400 children. Wukro town has three kebele, two kebelle were included in the study through simple random sampling method. There was proportional allocation of subjects to each kebelle and final study subject was selected using systematic method. In case there were more than one child in the household one child was selected randomly. The data were collected by face to face interview and measuring of weight and height after the instrument was pre-tested. The anthropometric results were entered in to Emergency nutritional assessment (ENA) to calculate Z-Score. The collected data and result of Z-score were entered in to Statistical package for social science (SPSS) version 20. Finally, results were presented in texts, graphs and tables. Results: a total of 394 under five children were participated in this study, which gave a response rate of 98.5%. The respondents were females 222(56.3%) and 106(26.95%) were in the age group of 12-23 month. The overall prevalence of wasting was 28(7.2%). Out of this 14(3.6%) were wasted and 14(3.6%) were severely wasted. Under five children those, whose family does not live together were 3.086 times more likely to be wasted compared to under five children those, whose family live together (P=.038, OR=3.086, & 95% CI= (1.061, 8.970)). Under five children those, whose mother did not taken family planning were 2.530 times more likely to be wasted compared to under five children those, whose mother take family planning (P=.038, OR=2.530, & 95% CI= (1.054, 6.074)).Conclusion: significant numbers of mothers were not taken extra food during pregnancy and lactation. There was significant prevalence of wasting of under five children in the study area. Living condition of family and usage of family planning were associated with increased risk of wasting

A comparison of mid upper arm circumference with other Indices for discharge from community-based management of malnutrition clinics in Jigawa State, Nigeria

Background: Community-based management of acute malnutrition (CMAM) program has saved millions of children with severe acute malnutrition (SAM) globally. World Health Organization recommended discharge indices include Midupper arm circumference (MUAC) =12.5cm, =15-20% weight gain and weight-for-height Z score (WHZ) =-2. We compared MUAC with WHZ and percentage weight gain as discharge criteria from CMAM. Methods: It was a community based cohort study of children aged 6-59 months with SAM discharged from CMAM clinics in Jigawa State, Nigeria. Socio-demographic data, nutrition history and anthropometry were recorded at enrolment and discharge. Results: Of a total of 405 children studied, 209(51.6%) were females and had a peak age group of 12-23months (43.7%, range 6-42 months). At discharge, 353(87.2%) had MUAC = 12.5cm while 231(57.0%) and 204(50.4%) had percentage weight-gain =15% and WHZ=-2 respectively. There was weak agreement between MUAC and WHZ (agreement 50.8%, ê=0.012) and MUAC and percent weight-gain (agreement 54.8%, ê=-0.004). Children aged between 11-23 months (OR 2.12, p=0.006) and 24-35 months (OR 2.60, p=0.002) had increased risk of discharge with inadequate percentage weight gain. WHZ <-3 at enrolment was associated with increased risk of discharge with WHZ <-3 (OR 3.21, p<0.001) and reduced risk of discharge with inadequate percentage weight gain (OR 0.45, p<0.001). Age sex, WHZ at enrollment were not associated with MUAC at discharge. Conclusion: The use of MUAC alone as discharge criterion allows a significant proportion of children still needing urgent care exiting CMAM clinic prematurely. Stratifying these criteria may lead to better recovery before discharge

Food insecurity, social welfare and low birth weight: Implications for childhood malnutrition in an urban Eastern Cape Province township

Background. Limited information is available regarding the impact of food insecurity, low birth weight (LBW) and the protective effect of the child support grant (CSG) on malnutrition in South Africa (SA).Objectives. To describe malnutrition in the context of food insecurity, CSG and LBW history among children younger than 24 months from an underprivileged urban settlement in the Eastern Cape Province of SA.Methods. A descriptive study using a cross-sectional design was used to collect data from a non-probability sample of 400 young children from October 2015 to February 2016. Inferential statistics included t-tests to compare anthropometric data from different birth weight categories and analysis of covariance (ANCOVA) to allow for the effect of covariates.Results. Of the sample, 9% were stunted, 1% were wasted, 16% were overweight, 23% were food secure, 47% were at risk of hunger, and 31% were classified as hungry. LBW history was significantly associated with stunting but not with wasting. CSG holders and 'hungry'households' children had significantly lower mean height-for-age z-scores (HAZ) than non-CSG holders and food-secure households.Despite these apparent associations, when LBW is considered as a covariate, it becomesapparent that neither the CSG nor CCHIP category is significantly related to any of the anthropometric indicators. Conclusion. The Department of Health has to recognise the significant impact of LBW on the prevalence of stunting and thus the need to prioritise antenatal care. Policymakers could aim to make the CSG available to mothers as close after birth as possible, or during pregnancy,in order to be more effective in reducing the long-term effects of LBW