Bushra Siddique, Iqbal Memon, Ammara Jamal, Rizwan Aslam.
Assessment of risk factors & case fatality rate of malnourished admitted children.
Med Channel Jan ;12(4):47-51.

OBJECTIVE: To assess the risk factors & case fatality rate of malnutrition in children admitted in the hospital. STUDY DESIGN: It is a descriptive type of study. PLACE & DURATION OF STUDY: Department of Paediatrics (unit III), Dow University of Health Sciences & Civil Hospital Karachi. Study included patients admitted from July 2001 to July of 2003. PATIENTS & METHODS: Case files of 240 patients were reviewed who had been admitted in the hospital for Protein Calorie Malnutrition (PCM) & Failure to Thrive (FTT) (according to low weight for age). Range of age was from 1 month to 12 years. Nutritional status of child was assessed with the help of anthropometric measurements. Data regarding social & medical risk factors that are responsible for malnutrition was collected. Case fatality was also calculated. RESULTS: Most (73.3%) of patients were 1-24 months old. Medical risk factors were present in all cases where as social risk factors were observed in 68.8% of the children. The more prominent medical risk factors recorded are inadequate feeding (100%), incomplete vaccination (65.4 %), and either chronic or recurrent diarrhea (64.6%), mixed or bottle feeds (52.5 %) & recurrent respiratory infections (42%). Other medical risk factors recorded were delayed weaning (27.9%), Congenital anomalies (22%), low birth weight (15.8 %), history of measles in 10.8%, history of treatment /underwent treatment TB (7.9%), twin births & otitis media were individually observed in 5.4% cases. Most prominent social risk factors included uneducated mothers (50.4%), more than 2 children under 5 in families of 36.3 % & previous child death noted in 15.8% cases. Less common risk factors included unemployed fathers (5.8%), parental absence (3.8%), ill mothers (3.3%), incompetent mothers (2.9%), ill fathers (2.5%), working mothers (0.8%), & drug addiction in families (0.4 %). Case fatality rate was calculated as 16.2%. CONCLUSIONS: The most common medical risk factors are: Inadequate feeding, incomplete vaccinations, chronic & recurrent diarrhea, and bottle-feeding and the results are comparable to previous studies. Prominent social risk factors include uneducated mothers, more than 2 children under 5 & Previous child death. Further research needs to be carried out to establish the correct relationship between certain medical risk factors like incomplete vaccinations & respiratory infections. A prospective study should also be conducted to establish the exact association of worm infestation with PCM so that this relation could be added in the protocols of malnutrition to ensure proper documentation, treatment & cure of this menace. Case fatality rate is comparable to international standards

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