Contribution of Dehydration and Malnutrition to the Mortality of Children 0-59 Month of Age in a Senegalese Pediatric Hospital
DOI:
https://doi.org/10.6000/1929-4247.2014.03.02.4Keywords:
Mortality, child malnutrition, dehydration, Senegal.Abstract
In-hospital mortality is an indicator of the quality of care. We analyzed the mortality of under five years children of Pediatric ward of Aristide Le Dantec teaching hospital to update our data, after an previous study conducted ten years earlier.
Methods: This was a retrospective study involving children 0-59 months of age, hospitalized from January 1, 2012 to December 31, 2012.
For each child, nutritional status was assessed according to 2006 World Health Organization growth standards; clinical and biological data were recorded. The outcome of the disease was specified. Bivariate and multivariable were used to identify risk factors for death.
Results: 393 children were included. Overall mortality rate was 10% (39/393). Factors associated with death were severe wasting [OR = 8.27, 95% CI [3.79-18], male gender (OR = 2.98, 95% CI [1.25-7.1]), dehydration (OR = 5.4, 95% CI [2.54-13.43]) in the model using the weight-for- height z score, male gender (OR = 2.5, 95% CI [1.11-5.63]), dehydration (OR = 8.43, 95% CI [3.83-18.5]) in using the height- for- age z score, male gender (OR = 2.7, 95% CI [1.19-6.24]), dehydration (OR = 7.5, 95% CI [3.39-16.76]), severe underweight (OR = 2.4, 95% CI [1.11-5.63]), in the model using the weight-for- age z score, and male gender (OR = 2.5, 95% CI [1.11-5.63]), dehydration (OR = 8.43, 95% CI [3.83-18.5]) in that using MUAC.
Dehydration and malnutrition are two independent factors of mortality. Our management protocols of dehydration and malnutrition have to be updated. Screening malnutrition has to be done systematically for each child by anthropometric measurements using WHO growth standards.
References
World Health Organisation. Handbook IMCI-integrated management of childhood illness. Geneva: UNICEF/WHO, 2000: 173p.
Ndiaye S, Mohamed A. Demographic health survey in Sénégal 2005. Calverton, Maryland, USA: Centre de Recherche pour le Développement Humain [Sénégal] et ORC Macro.
National agency of statistics and demography (NASD)[Senegal], et ICF International. Demographic health survey 2010-2011. Calverton, Maryland, USA: NASD et ICF International.
Sylla A, Diouf S, Sall MG, Ndiaye O, Moreira C, Kuakuvi N. Predictive factors of death in a pediatric service from Dakar: diarrhea and brachial perimeter. Arch Pediatr 2002; 9: 557- 58. http://dx.doi.org/10.1016/S0929-693X(01)00841-7
Mabiala-Babela JR, Pandzou N, Nkanza Kaluwako ST, Senga P. Epidemiological aspects of severe dehydration in infants at CHU of Brazzaville (Congo). Arch Pediatr 2007; 14: 1366-73.
Diouf S, Sylla A, Diop F, Diallo A, Sarr M. Anemia among apparently healthy senegalese children. Arch Pediatr 2013; 20: 311-16.
Sylla A, Diouf S, Sall MG, Ndiaye O, Moreira C, Kuakuvi N. Epidemiology and management of malnutrition in hospitalized children 0-5 years of age in Dakar. Arch Pediatr 2002; 9: 101-102. http://dx.doi.org/10.1016/S0929-693X(01)00703-5
Camara B, Diouf S, Faye PM, Ba A, Ba M, Sow D, et al. Morbidity and mortality in a pediatric hospital at Dakar (Senegal). Arch Pediatr 2005; 12: 1772-78. http://dx.doi.org/10.1016/j.arcped.2005.09.022
Koffi KS, Guédéhoussou T, Djadou KE, Gbadoe JAD, Gnamey DK, Atakouma DY. Morbidity and mortality of children 0-15 years old hospitalized in pediatric unit at the hospital of Be (Togo) in 2005. Arch Pediatr 2010; 17:
-13.
Okechukwu AA, Nwalozie C. Morbidity and mortality pattern of admissions into the Emergency Paediatric Unit of University of Abuja Teaching Hospital, Gwagwalada. Niger J Med 2011; 20: 109-13.
O’Reilly CE, Jaron P, Ochieng B, Nyagara A, Tate JE, Parsons MB, et al. Risk factors for death among children less 5 years old hospitalized with diarrhea in Western rural Kenya 2005-2007: a cohort study. Plos Med 2012; 9: e1001256. http://dx.doi.org/10.1371/journal.pmed.1001256
Talbert A, Thuo N, Karisa J, Chesaro C, Ohuma E, Ignas J, et al. Diarrhoea complicating severe acute malnutrition in Kenyan children: a prospective descriptive study of risk factors and outcome. PLoS One 2012; 7: e38321. http://dx.doi.org/10.1371/journal.pone.0038321
Irena AH, Mwambasi M, Mulenga V. Diarrhea is a major killer of children with severe acute malnutrition admitted to inpatient set-up in Lusaka, Zambie. Nutr J 2011; 10: 110. http://dx.doi.org/10.1186/1475-2891-10-110
Bejon P, Mohammed S, Mwangi I, Atkinson SH, Osier F, Peshu N, et al. Fraction of all hospital admissions and deaths attributable to malnutrition among children in rural Kenya. Am J Clin Nutr 2008; 88: 1626-31. http://dx.doi.org/10.3945/ajcn.2008.26510
Briend A, Maire B, Fontaine O, Garenne M. Mid-upper arm circumference and weight-for-height to identify high-risk malnourished under-five children. Matern Child Nutr 2012; 8: 130-3. http://dx.doi.org/10.1111/j.1740-8709.2011.00340.x
McDonald CM, Olofin I, Flaxman S, Fawzi WW, Spiegelman D, Caulfield LE, et al. Nutrition Impact Model Study. The effect of multiple anthropometric deficits on child mortality: meta-analysis of individual data in 10 prospective studies from developing countries. Am J Clin Nutr 2013; 97: 896-901. http://dx.doi.org/10.3945/ajcn.112.047639
Ngirabega JDD, Munyanshongore C, Donnen P, Dramaix M. Influence of malnutrition on childhood mortality in a rural hospital in Rwanda. Rev Epidemiol Sante Publique 2011; 59: 313-18. http://dx.doi.org/10.1016/j.respe.2011.05.002
Downloads
Published
How to Cite
Issue
Section
License
Policy for Journals/Articles with Open Access
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
Policy for Journals / Manuscript with Paid Access
Authors who publish with this journal agree to the following terms:
- Publisher retain copyright .
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .