TITLE:
Nutritional Outcome and Growth Monitoring in Under-Five Children of Severe Acute Malnutrition with and without Edema in Bangladesh: A Five-Year Retrospective Review of Facility-Based Inpatient Care
AUTHORS:
Zabeen Choudhury, Mohammad Musa Meah, Aparup Kanti Das, Pranab Kumar Chowdhury, Dhiman Das
KEYWORDS:
Severe Acute Malnutrition (SAM), Nutritional Outcome, Growth Monitoring
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.12 No.4,
August
30,
2022
ABSTRACT: Introduction: Severe acute malnutrition (SAM) is an important cause of death in
children. Bangladesh has a huge burden of SAM in under-five children, but documentation of their protocolized management
and outcome is not so frequent. Objective: Our aim was to
identify the pattern of the nutritional outcome and growth monitoring of 0-59
months old children with severe acute
malnutrition treated with identified medical complications where the
presence or absence of edema is an important clinical factor. Methods: This
was a facility-based retrospective observational study that was conducted in
the Severe Acute Malnutrition block of Chittagong Medical College Hospital,
Chittagong. Here, a total of 485 patients were admitted during the period from 2013 to 2017. Based on WHO & National
guidelines, admission and discharge criteria were considered and determined. A
structured and prescribed data format
was prepared and data were collected from the hospital records.
Daily clinical follow-ups and weight monitoring of the patients were also
documented. Both descriptive and analytic analyses were executed. After Data collection, it was cleaned, edited, and stored
in excel, epi-INFO, and analyzed by SPSS. P-value Results: 54.84% of the
admitted patients were cured and discharged during the study period. The mean
age of the observed patients was 22.35 ± 15.8607 months. The majority of the
patients came from rural areas and about 50% of them belonged to lower-middle-class families. The median weight gain of the
children at SAM block during the clinical review was found to be
moderate (7.35g/kg/day). About 2/3rd of the admitted patients stayed
in the hospital for two weeks. The mean duration of hospital stay (in days) of
the patients with edema (15.64 ± SD 7.133 days) was higher than that of the
patients without edema (9.47 ± SD 5.881
days). 4.3% of patients did not gain weight during their hospital stay,
and overall 8.04% of patients died during this period. Conclusion: More
than half of the admitted patients showed moderate to good weight gain during
their hospital stay. Non-edematous patients started to gain weight early
and their mean weight gain was also higher. A greater portion of patients who
had edema was cured (117, 81.8%) but defaulter & death rates, where
contributed to a significant overall outcome (188, 38.76%), were more in
non-edematous patients.