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Wasting coexisting with underweight and stunting among children aged 6‒59 months hospitalised in Garissa County Referral Hospital, Kenya
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Wasting coexisting with underweight and stunting among children aged 6‒59 months hospitalised in Garissa County Referral Hospital, Kenya
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Journal Article
Wasting coexisting with underweight and stunting among children aged 6‒59 months hospitalised in Garissa County Referral Hospital, Kenya
2025
Overview
Management 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. In this population of hospitalised children, we found critically high levels of wasting and underweight. The most frequent form of undernutrition coexistence was wasting and underweight. Early detection and effective treatment of hospitalised children with coexisting forms of undernutrition deserves more attention in the current nutrition therapeutic care and those discharged alive linked with community‐based management of acute malnutrition programmes. Key messages In this population of hospitalised children, we found critically high levels of wasting and underweight. The most frequent form of undernutrition coexistence was wasting and underweight. Early detection and effective treatment of hospitalised children with coexisting forms of undernutrition (CFU) deserves more attention in the current nutrition therapeutic treatment programmes. Routine reporting of CFU in hospital settings should be encouraged. Future research to increase our understanding of its mechanism and need for robust interventions should be prioritised.
Publisher
John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
Subject
