The profile and clinical picture of children with undernutrition admitted to National District Hospital

Abstract

Introduction: undernutrition has a profound effect on growth, development and susceptibility to infectious disease. In Africa, it was found that undernutrition is an underlying factor in around 35% of the preventable deaths of children under the age of 5 years. The first 1000 days of life is most crucial for childhood development. Undernourished children in their first 1000 days of development experience a significant reduction in brain development which cannot be regained later in life. The aim was to describe the profile and clinical picture of admitted children with undernutrition, in order to identify areas for intervention. Methods: a descriptive study design with an analytical component was used. Data for undernourished admitted children, ages 2-71 months, for the study period 2016-2017 at the study site were included in the study. Data were collected from patient files and summarised by frequencies and percentages. Results: data were collected from 172 patient files, which is > 80% of all children eligible for inclusion. Most (88.0%) of the children had a weight for age < -2 SD and 18.6% had bilateral pitting oedema. More than 80% of the children were still in their first 1000 days of life, 42.8% were born with low birth weight and 24.2% were not breastfed. Head circumference was only recorded for 16.3%. Presenting symptoms were cough, fever and diarrhoea - in line with those covered in the Integrated Management of Childhood Illness (IMCI). Conclusion: most children presented within the first 1000 days of life, making focussed interventions possible. Areas identified for intervention were babies with low birth weight and babies not breastfed. As most children presented with IMCI symptoms, nurses should also assess the nutritional status of these children in accordance with the guidelines. Lack of anthropometric measurements and poorly recorded feeding histories should be addressed.