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Editor's Choice : Clinical Outcomes and Determinants of Recovery Rates of Pediatric Inpatients Treated for Severe Acute Malnutrition
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Abstract: Background: Though treatment of severe acute malnutrition cases in both the in-patient care and the out-patient care has been going on since 2011 at the Tamale Teaching Hospital, little is known about the clinical treatment outcomes and factors that may be associated with the recovery rate in the in-patient setting. This study investigated the clinical treatment outcomes and determinant factors likely to be associated with recovery rates at the Hospital. Methods: We performed a retrospective chart review (RCR) of all pediatric patients aged (0-11 years of age) who were diagnosed of severe acute malnutrition between March 2011 and December 2013. Logistic regression modeling was used to determine the risk factors of severe malnutrition. Results: Of the 630 cases that were reviewed, only 19.5 % recovered (having mid-upper-arm-circumference measure ≥125 mm, or oedema resolved, or gained 5g/kg/body weight for 2 consecutive days at the time of discharge), 1.7 % defaulted, and 65.2 % were referred to out-patient care units for continued treatment. The observed case fatality rate was 13.5 %. Marasmic cases had more chronic co-morbid conditions at admission compared to kwashiorkor patients (81.7% vs. 69.3%, p=0.01). Conclusions: Case fatality rate in this population was quite high. Case referral to out-patient care unit was appropriately high. Malaria was the most common co-morbid condition diagnosed among the cases reviewed. Younger age, 15% or more increase in weight, and type of malnutrition were the main predictors of recovery from severe acute malnutrition in the in-patient care setting.
Keywords: In-patient care, severe acute malnutrition, under-five children, recovery rate, fatality rate, medical complications, Tamale Teaching Hospital, Northern Ghana. |
Editor’s Choice : Evaluation of an Afterschool Children’s Healthy Eating and Exercise Program
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Abstract: Background: The purpose of this study was to examine the feasibility of the Children’s Healthy Eating and Exercise Program (CHEE) in an afterschool program of an elementary school. Methods:Students in a low-income elementary school were recruited to participate in the program. Thirty-three children were in the intervention group. Twenty-four children in the comparison group were recruited from after school clubs in the same elementary school.The CHEE Program consisted of 18 sessions, featuring nutrition (20 min) and physical activity (40 min) lessons. Nutrition lessons were adapted from the Traffic Light Diet. Other lessons included MyPlate, my refrigerator, my lunchbox, and a healthy foods tasting activity. Multiple physical activities were utilized in the program including soccer, dance, relay races, tag, and other fun games. Data were collected at the beginning and end of the program. Results: Children in both groups reported eating more vegetables at the post-intervention measurement. Children in the intervention group indicated that they learned about healthy eating and new physical activities due to their participation in the program. Conclusions: Future studies are needed to discover barriers to behavior change as well as apply a more rigorous design to examine the impact of the CHEE Program. Keywords: Afterschool health education program, low-income children, healthy eating, nutrition education, physical activity. |
Editor’s Choice : Experiences of those Taking Part in the BeeZee Bodies Family-Based Weight Management Intervention: A Qualitative Evaluation
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Abstract: The need for effective community, child weight management interventions continues. The BeeZee Bodies (BZB) family-based child weight management programme for 7-11-year-olds and 12-15–year-olds has been developed iteratively over five years, with quantitative and qualitative evaluations refining the programmes. The aim of this study was to present the experiences and opinions of those taking part in BZB programmes as part of a real world evaluation. Three focus groups, following a semi-structured protocol, were conducted with 20 participants (15 parents, 5 adolescents) 3 months post-intervention. Analyses were thematic, iterative and underpinned by Grounded Theory. Two themes emerged; (1) programme contents, (2) social interactions, with each sub-divided. Parents described increased appreciation of physical activity and dietary components, improvements in parenting and good relationships with personnel. A wide range of positive personal outcomes and changes within the family were perceived by parents and adolescents including: changes in physical activity take-up, eating habits, portion sizes, and an improved understanding of parenting an overweight child. The parenting skills element further enhanced the social cohesion fostered through attendance. There were opportunities to build new friendships for both parents and adolescents, and for parents to interact with their offspring in a different context, all of which supported behaviour change. The BZB programme was viewed by participants as successful and delivered by engaging personnel. Key strengths were social cohesion generated by including parenting sessions and inclusiveness of the physical activities on offer. BZB has been refined in response to qualitative evaluations and reviews and this process continues. Keywords:Child obesity, evaluation, qualitative, focus groups, social impact. |
Editor’s Choice : Assessment of Serum Calcium, Serum Iron and Nutritional Status among Under-Five Children in Six Municipalities of Abidjan District, Côte d’Ivoire
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Abstract: Malnutrition occurs in various forms in the world, especially in African countries. It affects two-thirds of the children in sub-Saharan Africa. In addition to the protein-energy malnutrition (PEM), micronutrient deficiencies also affect many children. The aim of this study was to evaluate the nutritional status, serum iron and serum calcium among under-five children. This study was conducted on a cohort from 480 children in six municipalities of Abidjan: Abobo, Cocody, Koumassi, Marcory, Treichville and Yopougon. A blood sample and anthropometric measurements (weight, height) were performed to determine the hematological profile and nutritional status of children. The results showed that stunting was the most widespread form of malnutrition among children surveyed. Depending on age, children from 0 to 6 months have a low prevalence of PEM than those from 7 to 59 months: wasting (1.2% vs 3.5%), stunting (8.6% vs 25.2%) and underweight (3.4% vs 10.7%). Also, the results reveal a lowest serum iron (µmol/l) among children from low households income (9.77 ± 2.4), illiterate mothers (8.92 ± 1.3) compared to those from mothers with a high level of education (21.75 ± 4.1) and high living standard (21.28 ± 2.1). There was no notable difference (p>0.05) between serum calcium whatever socio-demographic parameters considered. The parameters under study such as nutritional status, serum calcium and serum iron have shown a variation of malnutrition in Abidjan. Keywords: Malnutrition status, prevalence, wasting, stunting, underweight, serum iron and calcium. |
