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Protein energy malnutrition: analysis of admission and outcome
Abstract
Background: Protein energy malnutrition (PEM) is a common condition in our environment. The morbidity and mortality is still high.
Method: A retrospective study of 136 children with PEM, aimed at evaluating the outcome of management of children with severe protein energy malnutrition in Ahmadu Bello University Teaching Hospital over a five-year period.
Results: There were 75 males and 63 females (M: F=1.2:1). Marasmus was the most common type of PEM, present in 55(40.4%). Poverty, poor weaning practices and communicable diseases such as measles and recurrent diarrhoeal disease were the major predisposing factor identified. There were 38 deaths (mortality rate of 27.9%) while 29 (21.3%) absconded from treatment. The case fatality rates for the different type of PEM were 42.9% for marasmic-kwashiorkor, 28.6 % for kwashiorkor, 21.8% for marasmus and 16.7% for underweight. The result further showed that only 7/38 (18.4%) died within the first 72 hours of admission and 16/38 (42.1%) within the first seven days while 15/38 (39.5%) survived into the third week of admission and beyond before dying. Also, of the 38 fatal cases, 22 (57.9%) died between the hours of 9.01pm and 7.00am with only 3/38 (7.9%) dying between the hours of 7.01am and 2.00pm.
Conclusion: This report has shown that, while the mortality of severe PEM still remains high, more of our patients died after the first week of admission and during the night. There is the need therefore for close monitoring of all cases of severe PEM throughout the period of admission particularly during the night.
Key words: Protein energy malnutrition, management, mortality
(Annals Af Med: 2002 1(2): 79-83)
Method: A retrospective study of 136 children with PEM, aimed at evaluating the outcome of management of children with severe protein energy malnutrition in Ahmadu Bello University Teaching Hospital over a five-year period.
Results: There were 75 males and 63 females (M: F=1.2:1). Marasmus was the most common type of PEM, present in 55(40.4%). Poverty, poor weaning practices and communicable diseases such as measles and recurrent diarrhoeal disease were the major predisposing factor identified. There were 38 deaths (mortality rate of 27.9%) while 29 (21.3%) absconded from treatment. The case fatality rates for the different type of PEM were 42.9% for marasmic-kwashiorkor, 28.6 % for kwashiorkor, 21.8% for marasmus and 16.7% for underweight. The result further showed that only 7/38 (18.4%) died within the first 72 hours of admission and 16/38 (42.1%) within the first seven days while 15/38 (39.5%) survived into the third week of admission and beyond before dying. Also, of the 38 fatal cases, 22 (57.9%) died between the hours of 9.01pm and 7.00am with only 3/38 (7.9%) dying between the hours of 7.01am and 2.00pm.
Conclusion: This report has shown that, while the mortality of severe PEM still remains high, more of our patients died after the first week of admission and during the night. There is the need therefore for close monitoring of all cases of severe PEM throughout the period of admission particularly during the night.
Key words: Protein energy malnutrition, management, mortality
(Annals Af Med: 2002 1(2): 79-83)
