Prevalence and Outcome of Severe Acute Malnutrition among Children 6-59 Months, in Magumeri Local Government Area, Borno State, Attending General Hospital Magumeri, Borno State, Nigeria
This is a retrospective
observational hospital-based study aimed to determine the prevalence and
outcome of severe acute malnutrition (SAM) in children 6 – 59 months in
Magumeri local Government area admitted to Magumeri General Hospital – INTERSOS
Nigeria Stabilization centre during the period December 2018 to June 2019. A
total of 171 children with severe acute malnutrition were identified; 104 of
cases were male (60.8%) while 67 (39.2%) were females. The mean age of the
admitted children was 15.8 months. Children 36–59 months were least affected.
The overall prevalence of severe malnutrition was 4.0%, and the general
mortality rate was 3.8% while mortality rate among children with severe
malnutrition was 2.9%.
Amongst children admitted with SAM,
126 (73.7%) had marasmus, 30 (17.5%) had kwashiorkor and only 16 (9.4%) were
marasmic-kwashiorkor. The highest prevalence rates occurred in February and
April. The common clinical presentations were acute diarrhea disease, upper
respiratory tract infection, malaria, urinary tract infections, dermatitis,
measles, sepsis and pneumonia. Only 14.6% were fully vaccinated, while 49.7%
were not vaccinated. Overall 81.9% improved and were discharged, 8.2% were
transferred to the University of Maiduguri Teaching Hospital for management of
other severe medical complications, 7 % discharged against medical advice and
2.9 % died. In conclusion, the prevalence and mortality among children with SAM
at Magumeri Local Government area were high, and the current management
strategies were inadequate to cater for the high cases as a result of the
crisis in the region.
C, Parson TJ. Dietary advice and nutrition supplements in the management of
illness-related malnutrition: a systematic review. Journal of Clinical Nutrition. 2004; 23:1267–1279.
JP. Physical findings in nutritional deficiencies. Pediatr Clin North Am.
1998 Feb. 45(1):245-60
L, De la Rosa-Alvarez I, Mansilla-Olivares A. Dendritic spine pathology in
infants with severe protein-calorie malnutrition. Pediatrics. 1999 Aug.
U, Mehta DI, Davis R, et al. Nutritional problems in patients who have chronic
disease. Pediatr Rev. 2000 Jan. 21(1):29-32.
Monika, de Onis, Mercedes. Malnutrition: quantifying the health impact at
national and local levels. 2005. Available at
E, Natalal H, Francois I, Ferreira MH, Grahnquist L. Nutritional andclinical
status of children admitted to the malnutrition ward, Maputo Central Hospital:
A Comparison of data from 2001 and 1983.
LE, de Onis M, Blossner M. Undernutrition as an underlying cause of child
deaths associated with diarrhea, pneumonia, malaria, and measles. American
Journal of Clinical Nutrition. 2004 Jul. 80(1):193-8.
RK. Nutrition and the immune system: an introduction. American Journal Clinical Nutrition. 1997; 66:460S–463S.
AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA, et al. What
is subjective global assessment of nutritional status?. JPEN J Parenter
Enteral Nutr. 1987 Jan-Feb. 11 (1):8-13.
and Agriculture Organization of the United Nations (FAO), WFP, and
International Fund for Agricultural Development (IFAD). (2012). the State of
Food Insecurity in the World 2012. Economic growth is necessary but not
sufficient to accelerate reduction of hunger and malnutrition. Rome: FAO.
HB, Dechering WH, Voorhoeve WH. Mortality in severe protein-energy malnutrition
at Nchelenge, Zambia. Journal of Trop
Pediatr 1998; 44(4):211–217.
KM, Duggan C, Gallagher L, et al. Malnutrition in hospitalized pediatric
patients, current prevalence. Arch Pediatr Adolesc Med. 1995 Oct.
RG. Protein-Energy-Malnutrition. In: Hendrickse RG, Barr DGD, Matthews TS
(eds). Paediatrics in the Tropics. 1st Edition, Blackwell Scientific
Publications, Oxford. 1991: 119 -131.
VE, Ashworth A. Management of protein energy malnutrition in Nigeria: an
evaluation of the regimen at the Kersey Nutrition Rehabilitation Centre,
Nigeria. Trans R Soc Trop Med Hyg 1994; 88:594–595.
Lazzerini M, Ronfani L. Oral zinc for treating
diarrhoea in children. Cochrane Database Syst Rev. 2008 Jul 16. CD005436.
Lisa A.Barker, Belinda S. Gout and Timothy C.
Crowe. Hospital Malnutrition: Prevalence, Identification and Impact on Patients
and the Healthcare System. Int J
Environ Res Public Health. 2011 Feb; 8(2): 514–527. Published online 2011 Feb
JI. Practical aspects of nutrition support for wound healing patients. Am. J.
Surg. 2004; 188:52–56. [PubMed].
NM, Corkins MR, Lyman B, Malone A, Goday PS, Carney LN, et al. Defining
pediatric malnutrition: a paradigm shift toward etiology-related definitions. JPEN
J Parenter Enteral Nutr. 2013 Jul. 37 (4):460-81.
MH, Nazarenko G, Nivison-Smith I, Smerdely P. Prevalence of malnutrition and
12-month incidence of mortality in two Sydney teaching hospitals. Int. Med. J.
TH, Schermer T, deBree A, Nusteling K, Eggink L, Kruimel JW, Bakkeren J, van
Heereveld H, Katan MB. Prevalence of malnutrition in nonsurgical hospitalized
patients and its association with disease complications. Am. J.Clin. Nutr.
1997; 66:1232–1239. [PubMed].
Population Commission [Nigeria] and ICF Macro. 2013. Nigeria Demographic and
Health Survey (NDHS) 2013. Abuja, Nigeria: National Population Commission and
ICF Macro, Micronutrient Initiative. (2013). Nigeria Country Profile.
N. The effect and causes of protein-energy malnutrition in Nigerian children.
Nutr Res 1995; 15:785–794.
T A, Olarenwaju D M. Socio-demographic characteristics and appropriate halth
care-seeking behaviors for children illnesses. Journal of Tropical Pediatrics.
2010, 56(6) 379-385.
O H Kanan and Mohammed Osman Swar. Prevalence and outcome of severe
malnutrition in children less than five-year-old in Omdurman Pediatric
Hospital, Sudan. Sudan Journal of Pediatrics. 2016; 16(1): 23–30.
HC, Ryan KN, Kennedy JA, Grise JB, Crocker AH, Thakwalakwa C, et al. Including
whey protein and whey permeate in ready to-use supplementary food improves
recovery rates in children with moderate acute malnutrition: a randomized,
double-blind clinical trial. Am J Clin Nutr. 2016 Mar. 103 (3):926-33.
BF, Koola JI, Atkinson S. Infections associated with severe malnutrition among
hospitalized children in East Africa. Tanzan Hlth ResBull 2006; 8: 189-192.
AC, Ibeziako NS, Ndiokwelu CI, Uzoka CM, Nwafor CA. Under-five protein energy
malnutrition admittedat the University of Nigeria Teaching Hospital, Enugu: a 10-year
retrospective review. Nutr J 2012; 11:43–50.
Nations Children's Fund (UNICEF). (2011). At a glance: Nigeria. Retrieved from http://www.unicef.org/infobycountry/nigeria_statistics.html.
Malnutrition-The Global Picture. World Health Organization. Available at http://www.who.int/home-page/.
Health Organization. Report on malnutrition worldwide. WHO, Geneva: 2000.
L, Dibley MJ, Cheng Y, et al. Impact of micronutrient supplementation during
pregnancy on birth weight, duration of gestation and perinatal mortality in
rural western China: double blind cluster randomised controlled trial. BMJ.
2008 Nov 7. 337: a2001.