Ifra Sameen, Khemchand N Moorani.
Morbidity patterns of severely malnourished children at tertiary care hospital.
Pak Paed J Jan ;38(1):3-8.

Objectives: To determine morbidity patterns of children with severe acute malnutrition. Methods: This cross section study was conducted at National Institute of Child Health, Karachi from January 2012 to June 2012.Children of 1-59 months age with severe acute malnutrition (WHZ score < -3 SD and or bilateral pitting edema) were included. All patients were assessed for clinical manifestations, various morbidities like infections, metabolic abnormalities, congenital/hereditary disorders and outcome as stabilization, left against medical advice (LAMA) or expired at exit. Data was collected and analyzed using descriptive statistics on SPSS version 17. Results: One hundred and thirty children with a mean age of patients was 16.8 months were studied. Severe wasting was observed in 80.8%, while edematous malnutrition was present in 19.2% cases. Anemia was found in 88% and 65.4% were febrile at presentation. Diarrhea (50.8%), pneumonia (20%) and sepsis (16.2%) were the most common infections; whereas hyponatremia (22.6%), hypokalemia (13.7%) and hypoglycemia (10.7%) were the commonest metabolic abnormalities. Rickets (7.7%) and congenital / hereditary diseases (14.6%) were the associated disorders. Outcome was stabilization in 83.1%, LAMA in 10.8% and death in 6.2% of cases. Conclusion: The spectrum of morbidity in severely malnourished children admitted to hospital includes both infections and congenital or hereditary disorders. Diarrhea and sepsis with metabolic abnormalities were the major contributors to mortality.

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