The outcome of severe malnutrition in northwest Ethiopia: retrospective analysis of admissions.

OBJECTIVE

To assess the clinical profile and treatment outcome of children with severe malnutrition.

PATIENTS AND

METHODS

A retrospective study of 335 children with severe malnutrition was conducted in Gondar University hospital over a period of four years; September 1997 - August 2000.

RESULTS

There were 175 (52.2%) males and 160 (47.8%) females with severe malnutrition. Children below the age of 24 months constituted for 60.3% of all the admissions. Marasmus was the most common type of malnutrition, present in 174 (52.0%) of the patients. Kwashiorkor and marasmic kwashiorkor were seen in 78 (23.3%) and 83 (24.7%) of the patients respectively. The overall case fatality rate was 61 (18.4%) while 30 (9.1%) abandoned treatment. Two hundred forty (72.5%) of the patients were discharged improved. The case fatality rates for the different types of malnutrition were 28.4% for marasmic kwashiorkor, 16.9% for kwashiorkor and 14.5% for marasmus. A statistically significant risk of death was observed in those with history of bottle feeding (OR 4.5, P-value < 0.01), diarrhea with severe dehydration (OR 3.05, P-value < 0.01), altered level of consciousness (OR 7.08, P-value < 0.001), total serum protein of 5 g/dl and less (OR 3.45, P-value < 0.05) and patients having marasmic kwashiorkor (OR 2.55, P-value < 0.01).

CONCLUSION

This study shows a high mortality rate of severe malnutrition despite hospitalization. The findings confirm the need for intensive management of severe malnutrition.