Social,dietaryandclinicalcorrelatesofoedemainchildrenwithsevereacutemalnutrition:across-sectionalstudy
MarenJohanneHeilskovRytter,HanifaNamusoke,EstherBabirekere-Iriso,PernilleKæstel,TsinuelGirma,VibekeBrixChristensen,KimFMichaelsenandHenrikFriis
BMCPediatrics2015,15:25doi:10.1186/s12887-015-0341-8
Published:22March2015
Abstract
Background
Severeacutemalnutritionisaseriouspublichealthproblem,andachallengetoclinicians.Whysomechildrenwithmalnutritiondevelopoedema(kwashiorkor)isnotwellunderstood.Theobjectiveofthisstudywastoinvestigatesocio-demographic,dietaryandclinicalcorrelatesofoedema,inchildrenhospitalisedwithsevereacutemalnutrition.
Methods
WerecruitedchildrenwithsevereacutemalnutritionadmittedtoMulagoHospital,Uganda.Datawascollectedusingquestionnaires,clinicalexaminationandmeasurementofbloodhaemoglobin,plaac-reactiveproteinandα1-acidglycoprotein.Correlatesofoedemawereidentifiedusingmultiplelogisticregressionysis.
Results
Of120childrenincluded,77(64%)presentedwithoedematoualnutrition.Oedematouschildrenwereslightlyolder(17.7vs.15.0months,p = 0.006).Afteradjustmentforageandsex,oedematouschildrenwerelesslikelytobebreastfed(oddsratio(OR):0.19,95%-confidenceinterval(CI):0.06;0.59),tobeHIV-infected(OR:0.10,CI:0.03;0.41),toreportcough(OR:0.33,CI:0.13;0.82)andfever(OR:0.22,CI:0.09;0.51),andtohaveaxillarytemperature > 37.5°C(OR:0.28CI:0.11;0.68).Householddietarydiversityscorewaslowerinchildrenwithoedema(OR:0.58,CI:0.40;85).Noassociationwasfoundwithplaalevelsofacutephaseproteins,householdfoodinsecurityorbirthweight.
Conclusion
Childrenwithoedematoualnutritionwerelesslikelytobebreastfed,lesslikelytohaveHIVinfectionandhadfewersymptomsofotherinfections.Dietarydiversitywaslowerinhouseholdsofchildrenwhopresentedwithoedema.Futureresearchmayconfirmwhetheracausalrelationshipexistetweenthesefactorsandnutritionaloedema.
