Severity and Outcomes of Acute Malnutrition in Children Aged 0-59 Months at Guzara District Hospital, Herat: A Retrospective Study.

BACKGROUND AND AIMS: Recent reports indicate a rising prevalence of acute malnutrition among children in Afghanistan. This retrospective hospital-based study was conducted at Guzara District Hospital in Herat and aimed to investigate the severity, treatment outcomes, and monthly trends of acute malnutrition among children aged 0-59 months and potential determinants from May 2020 to March 2022.

METHODS

For this study, the data were collected from the hospital malnutrition treatment register, a standardized logbook in which demographic, anthropometric, treatment, and outcome data of admitted children were recorded. The study included 253 children, with malnutrition severity assessed using weight-for-height Z-scores (WHZ), mid-upper arm circumference (MUAC), and bilateral oedema. Information on age, sex, and location was also collected. In addition, treatment outcomes were obtained from the hospital registration book. WHZ, MUAC, age, sex, location, and oedema refer to characteristics recorded at baseline (admission). Group differences were analysed using Chi-squared and Kruskal-Wallis tests, with Monte Carlo simulations for small counts.

RESULTS

Results showed a high burden of severe acute malnutrition (SAM). Based on WHZ, 77.9% of children were classified as SAM, and 14.68% presented with bilateral oedema. Among children older than 6 months, and among children with available MUAC data (n = 109), 74.3% had a MUAC < 115 mm. Moderate acute malnutrition (MAM) was identified in 11.46% using WHZ and 18.34% using MUAC. Regarding outcomes, 42.29% recovered, and 41.50% were referred to outpatient care, while 7.11% were referred to inpatient care, 3.55% defaulted, and 5.53% had missing outcome data. Treatment outcomes varied, with children aged 6-59 months and those with oedema requiring more extended care. Additionally, malnutrition cases increased in summer 2021.

CONCLUSION

This study highlights the significant burden of SAM at Guzara Hospital, especially among children under 12 months, a seasonal rise in cases, and the association between treatment outcomes and malnutrition indicators.