Anemia and metabolic acidosis as risk factor of mortality in children with severe acute malnutrition

Katharina Yosephin Lakonawa; I Gusti Lanang Sidiartha; I Gusti Ayu Putu Eka Pratiwi

doi:10.29332/ijhs.v4n3.459

Authors

Katharina Yosephin Lakonawa Department of Child Health, Medical Faculty, Udayana University, Denpasar, Indonesia
I Gusti Lanang Sidiartha
lanangsidiartha@yahoo.com
Department of Child Health, Medical Faculty, Udayana University, Denpasar, Indonesia
I Gusti Ayu Putu Eka Pratiwi Department of Child Health, Medical Faculty, Udayana University, Denpasar, Indonesia

Keywords:

acute malnutrition, anemia, marasmus, metabolic acidosis, mortality

Abstract

Mortality is still high among children with severe acute malnutrition who require hospitalization. This study investigated the factors independently related to the mortality among hospitalized children with severe acute malnutrition. A cross-sectional study was conducted in a single tertiary referral hospital in Bali, Indonesia from January 2017 to December 2018. A logistic regression test was used to analyze the factors independently related to mortality. Significantly differences were considered if P-value less than 0.05. A total of 138 children with severe acute malnutrition was fulfilled the study criteria, 83 children (60.1%) were male, 79 children (57.2%) were a toddler and 133 children (96.4%) were classified as marasmus. The mortality was found in 60 children (43.4%). On multivariate logistic regression analysis found anemia (aOR 8.6, 95%CI: 2.4 to 30.5, P = 0.001) and metabolic acidosis (aOR 3.4, 95%CI: 1.3 to 9.1, P = 0.01) were statistically significant. It can be concluded that the mortality rate among children with severe acute malnutrition is still high and anemia as well as metabolic acidosis are factors independently related to this mortality.

Downloads

Download data is not yet available.

References

Abdullahi, S. M., Yakubu, A. M., Bugaje, M. A., & Akuyam, S. M. (2018). Serum total protein and albumin levels among malnourished children aged 6-59 months in Zaria. Nigerian Journal of Paediatrics, 45(1), 15-18.

Ali, S. M., & Meshram, H. S. (2017). Association of azotemia with hypoglycemia in severe acute malnutrition how much concerning?. International Journal of Contemporary Pediatrics, 4(1), 246.

Allison, S. P. (2000). Malnutrition, disease, and outcome. Nutrition (Burbank, Los Angeles County, Calif.), 16(7-8), 590-593.

Arya, A. K., Kumar, P., Midha, T., & Singh, M. (2017). Hematological profile of children with severe acute malnutrition: a tertiary care centre experience. Int J Contemp Pediatr, 4(5), 1577-80.

Barennes, H., Sayavong, E., & Pussard, E. (2016). High mortality risk in hypoglycemic and dysglycemic children admitted at a referral hospital in a non malaria tropical setting of a low income country. PloS one, 11(2), e0150076.

Cartmell, E., Natalal, H., Francois, I., Ferreira, M. H., & Grahnquist, L. (2005). Nutritional and clinical status of children admitted to the malnutrition ward, Maputo central hospital: a comparison of data from 2001 and 1983. Journal of tropical pediatrics, 51(2), 102-105.

Chisti, M. J., Salam, M. A., Bardhan, P. K., Faruque, A. S., Shahid, A. S., Shahunja, K. M., ... & Ahmed, T. (2015). Severe sepsis in severely malnourished young Bangladeshi children with pneumonia: a retrospective case control study. PLoS One, 10(10), e0139966.

Derseh, B., Mruts, K., Demie, T., & Gebremariam, T. (2018). Co-morbidity, treatment outcomes and factors affecting the recovery rate of under-five children with severe acute malnutrition admitted in selected hospitals from Ethiopia: retrospective follow up study. Nutrition journal, 17(1), 116.

Dinas Kesehatan Provinsi Bali. (2018). Profil Kesehatan Dinas Kesehatan Provinsi Bali 2018.

Indonesia Ministry of National Development Planning and United Nations Children’s Fund, (2019), Achieving the SDGs for children in Indonesia: Emerging findings for reaching the targets.

Joosten, K. F., & Hulst, J. M. (2008). Prevalence of malnutrition in pediatric hospital patients. Current opinion in pediatrics, 20(5), 590-596.

Kanan, H. R., Faez, K., & Gao, Y. (2008). Face recognition using adaptively weighted patch PZM array from a single exemplar image per person. Pattern Recognition, 41(12), 3799-3812. https://doi.org/10.1016/j.patcog.2008.05.024

Kanan, S. O., & Swar, M. O. (2016). Prevalence and outcome of severe malnutrition in children less than five-year-old in Omdurman Paediatric Hospital, Sudan. Sudanese Journal of Paediatrics, 16(1), 23.

Kementrian Kesehatan Republik Indonesia, (2010), Hasil Utama Riskesdas 2010 [online].

Kubrak, C., & Jensen, L. (2007). Malnutrition in acute care patients: a narrative review. International journal of nursing studies, 44(6), 1036-1054. https://doi.org/10.1016/j.ijnurstu.2006.07.015

Marino, L. V., Goddard, E., & Workman, L. (2006). Determining the prevalence of malnutrition in hospitalised paediatric patients. South African Medical Journal, 96(9), 993-995.

Mena, M. B., Dedefo, M. G., & Billoro, B. B. (2018). Treatment outcome of severe acute malnutrition and its determinants among pediatric patients in West Ethiopia. International journal of pediatrics, 2018.

Pinto, F., Suwiyoga, I. K., Widiana, I. G. R., & Yasa, I. W. P. S. (2017). Health behavior and status related to mother's death in Timor-Leste. International research journal of engineering, IT & scientific research, 3(4), 57-65.

Rocha, G. A., Rocha, E. J., & Martins, C. V. (2006). Hospitalização: efeito sobre o estado nutricional em crianças. Jornal de Pediatria, 82(1), 70-74.

Rusmil, V. K., Wiramihardja, S., Adhitya, A. P., & Gurnida, D. A. (2018). Factors Influencing Outcomes of Children Hospitalized with Acute Severe Malnutrition. Althea Medical Journal, 5(2), 87-92.

Sarni, R. O., Carvalho, M. D. F., Monte, C. M., Albuquerque, Z. P., & Souza, F. I. (2009). Anthropometric evaluation, risk factors for malnutrition, and nutritional therapy for children in teaching hospitals in Brazil. J Pediatr (Rio J), 85(3), 223-8.

Sastroasmoro, S., & Ismael, S. (2011). Dasar-dasar metodologi penelitian klinis. Jakarta: sagung seto, 55.

Shah, G. S., Das, B. K., Kumar, S., Singh, M. K., & Bhandari, G. P. (2007). Acid base and electrolyte disturbance in diarrhoea. Kathmandu University medical journal (KUMJ), 5(1), 60-62.

Sharifuzzaman, Sarmin, M., Ahmed, T., Alam, T., Islam, S. B., Islam, M. M., & Chisti, M. J. (2017). Determinants and outcome of metabolic acidosis in diarrheal children under 5 years of age in an urban critical care ward in Bangladesh. Global Pediatric Health, 4, 2333794X17740223.

Soeters, P. B., Reijven, P. L., Schols, J. M., Halfens, R. J., Meijers, J. M., & van Gemert, W. G. (2008). A rational approach to nutritional assessment. Clinical nutrition, 27(5), 706-716. https://doi.org/10.1016/j.clnu.2008.07.009

Tadesse, E., Worku, A., Berhane, Y., & Ekström, E. C. (2018). An integrated community?based outpatient therapeutic feeding programme for severe acute malnutrition in rural Southern Ethiopia: Recovery, fatality, and nutritional status after discharge. Maternal & child nutrition, 14(2), e12519.

Tesfai, C., Ratnayake, R., & Myatt, M. (2013). Measuring local determinants of acute malnutrition in Chad: a case-control study. The Lancet, 381, S144. https://doi.org/10.1016/S0140-6736(13)61398-7

Thakur, N., Chandra, J., Pemde, H., & Singh, V. (2014). Anemia in severe acute malnutrition. Nutrition, 30(4), 440-442. https://doi.org/10.1016/j.nut.2013.09.011

Wagnew, F., Tesgera, D., Mekonnen, M., & Abajobir, A. A. (2018). Predictors of mortality among under-five children with severe acute malnutrition, Northwest Ethiopia: an institution based retrospective cohort study. Archives of Public Health, 76(1), 64.