Peer-reviewed article
Wasting coexisting with underweight and stunting among children aged 6‒59 months hospitalised in Garissa County Referral Hospital, Kenya
Mutuvi Wambua, Symon M. Kariuki, Hassan Abdullahi, Osman A. Abdullahi, Moses M. Ngari ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study reviewed hospital records of 624 children aged 6 to 59 months admitted to Garissa County Referral Hospital in Kenya between 2017 and 2019. It looked at how often wasting occurred together with underweight and stunting. Almost all children were wasted (95%), most were underweight (83%), and just over a quarter were stunted (28%). Diarrhoea and anaemia were linked to some of the combined forms of undernutrition. The authors say the levels of undernourishment are unacceptably high and that care should continue after discharge.
Key points
- Wasting was present in 595 (95%), underweight in 518 (83%) and stunting in 176 (28%) of 624 children.
- 161 (26%) children had wasting with stunting, 506 (81%) wasting with underweight, and 161 (26%) all three (wasting, stunting and underweight).
- Diarrhoea was associated with wasting coexisting with stunting (aRR 2.96, 95% CI 2.06‒4.23).
- Anaemia was associated with wasting coexisting with underweight (aRR 1.23, 95% CI 1.03‒1.47).
- 50 (8.0%) children died before discharge; inpatient death risk did not differ significantly by nutrition status (p = 0.60).
Limitations
This is a retrospective review of records from one hospital, so the findings may not apply to all children in Kenya or to children not admitted to hospital. Only the abstract is available, and it cannot show cause and effect or what happened to children after discharge.
Abstract
AbstractManagement of undernourished children depends only on wasting yet it can coexist with underweight and/or stunting. Among children admitted to hospital with acute illness, we determined the proportion with wasting coexisting with underweight and/or stunting and their risk factors. A retrospective review of hospital records of children 6‒59 months old admitted at Garissa County referral hospital, Kenya, from January 2017 to December 2019 was conducted. Using World Health Organization 2006 growth standards, undernutrition were defined: wasting as Weight‐for‐height Z‐score < −2, stunting Height‐for‐age Z‐score < −2 and underweight Weight‐for‐age Z‐score < −2. We studied wasting coexisting with underweight and/or stunting. Among 624 children recruited, 347 (56%) were males and 511 (82%) <24 months old. Diarrhoea 210 (34%) and pallor/anaemia 310 (50%) were the most frequent admission diagnosis. HIV infection was present among 8 (1.3%) children. Wasting, underweight and stunting were present among 595 (95%), 518 (83%) and 176 (28%) children respectively. 161 (26%), 506 (81%) and 161 (26%) children had wasting coexisting with stunting, underweight and both stunting and underweight respectively. In the multivariable regression, diarrhoea was positively associated with wasting coexisting with stunting (adjusted risk ratio [aRR = 2.96] [95% CI = 2.06‒4.23]) and anaemia with wasting coexisting with underweight (aRR = 1.23) (95% CI = 1.03‒1.47). Overall, 343 (55%) children were discharged alive, 67 (11%) absconded from the wards, 164 (26%) were transferred to another hospital and 50 (8.0%) died before discharge. The risk of inpatient death was 10.3%, 7.9%, 8.4% and 6.8% among children not wasted, wasted only, wasted & underweight, and wasted and underweight and stunted respectively (Chi‐square p = 0.60). The study reports an unacceptably high levels of undernourishment, including coexisting forms of undernutrition among hospitalised children. This highlights a public health priority for current nutrition therapeutic care and need of continuity of care among those children discharged alive in the community‐based management of acute malnutrition programmes.