Outcome and Effectiveness of Inpatient Care of Malnourished under Five Children in District Hospitals of Mwanza Region, North Western Tanzania

Download Download as PDF (Size:249KB)  HTML    PP. 293-298  
DOI: 10.4236/ojpm.2014.45036    2,660 Downloads   3,323 Views   Citations

ABSTRACT

Background: Malnutrition is a disease affecting commonly children from 0 to 5 years of age. In Tanzania it is still a problem with a prevalence of 36% and 28% mortality. Objective: This study aimed to compare the outcome and effectiveness of therapeutic regimes used by different district hospitals in the management of malnutrition of under five years old children in Mwanza Region. Methods: Patient charts were reviewed collecting social demographic attributes, diagnosis, type of therapeutic regimen given and treatment outcome. Results: The prevalence of malnutrition was found to be 30% with case fatality rate (CFR) of 8.8%, for the health facilities using WHO regime while 29% CFR for those using traditional regimen. The use of recommend malnutrition screening tests was generally poor. Conclusion: Malnutrition is still a public health problem with high mortality rate in Tanzania which is mainly caused by failure to use the WHO regimen. There is a need to use the available screening methods and recommended regimens to avert this.

Cite this paper

Ngallaba, S. , Makerere, D. , Kapesa, A. , Mongela, S. and Namanya, B. (2014) Outcome and Effectiveness of Inpatient Care of Malnourished under Five Children in District Hospitals of Mwanza Region, North Western Tanzania. Open Journal of Preventive Medicine, 4, 293-298. doi: 10.4236/ojpm.2014.45036.

References

[1] World Health Organization (2012) Health Statistics and Health Information Systems.
[2] Rohde, J., Cousens, S., Chopra, M., Tangcharoensathien, V., Black, R., et al. (2008) 30 Years after Alma-Ata: Has Primary Health Care Worked in Countries? The Lancet, 372, 950-961.
http://dx.doi.org/10.1016/S0140-6736(08)61405-1
[3] de Onis, M., Frongillo, E.A. and Blössner, M. (2000) Is Malnutrition Declining? An Analysis of Changes in Levels of Child Malnutrition since 1980. Bulletin of the World Health Organization, 78, 1222-1233.
[4] Ashworth, A., Chopra, M., McCoy, D., Sanders, D., Jackson, D., et al. (2004) WHO Guidelines for Management of Severe Malnutrition in Rural South African Hospitals: Effect on Case Fatality and the Influence of Operational Factors. The Lancet, 363, 1110-1115.
http://dx.doi.org/10.1016/S0140-6736(04)15894-7
[5] Alderman, H., Hoogeveen, J. and Rossi, M. (2005) Reducing Child Malnutrition in Tanzania: Combined Effects of Income Growth and Program Interventions. World Bank Publications.
http://dx.doi.org/10.1596/1813-9450-3567
[6] Schaible, U.E. and Stefan, H. (2007) Malnutrition and Infection: Complex Mechanisms and Global Impacts. PLoS Medicine, 4, e115.
http://dx.doi.org/10.1371/journal.pmed.0040115
[7] Mendelson, S. and Chaudhuri, S. (2009) Child Malnutrition in India: Why Does It Persist? Visto el 20.
[8] UNICEF (2006) Progress for Children: A Report Card on Nutrition.
[9] Fergusson, P. and Tomkins, A. (2009) HIV Prevalence and Mortality among Children Undergoing Treatment for Severe Acute Malnutrition in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. Transactions of the Royal Society of Tropical Medicine and Hygiene, 103, 541-548.
http://dx.doi.org/10.1016/j.trstmh.2008.10.029
[10] World Health Organization, Department of Child, Adolescent Health (2000) Management of the Child with a Serious Infection or Severe Malnutrition: Guidelines for Care at the First-Referral Level in Developing Countries.
[11] Maitland, K., Berkley, J.A., Shebbe, M., Peshu, N., English, M., et al. (2006) Children with Severe Malnutrition: Can Those at Highest Risk of Death Be Identified with the WHO Protocol? PLoS Medicine, 3, e500.
http://dx.doi.org/10.1371/journal.pmed.0030500
[12] Manary, M. and Brewster, D. (2000) Intensive Nursing Care of Kwashiorkor in Malawi. Acta Paediatrica, 89, 203-207.
http://dx.doi.org/10.1111/j.1651-2227.2000.tb01217.x
[13] Morrice, J. and Molyneux, E. (2003) Reduced Mortality from Severe Protein-Energy Malnutrition Following Introduction of WHO Protocol in Children in Malawi. Archives of Disease in Childhood, 88, A28.
[14] Kruizenga, H., Seidell, J., De Vet, H., Wierdsma, N. and van Bokhorst-de van der Schueren, M. (2005) Development and Validation of a Hospital Screening Tool for Malnutrition: The Short Nutritional Assessment Questionnaire (SNAQ©). Clinical Nutrition, 24, 75-82.
http://dx.doi.org/10.1016/j.clnu.2004.07.015
[15] McGregor, I.A., Billewicz, W. and Thomson, A. (1961) Growth and Mortality in Children in an African Village. British Medical Journal, 2, 1661.
http://dx.doi.org/10.1136/bmj.2.5268.1661
[16] Chen, L.C., Huq, E. and d’Souza, S. (1981) Sex Bias in the Family Allocation of Food and Health Care in Rural Bangladesh. Population and Development Review, 7, 55-70.
http://dx.doi.org/10.2307/1972764
[17] Wamani, H., Åstrøm, A.N., Peterson, S., Tumwine, J.K. and Tylleskär, T. (2007) Boys Are More Stunted than Girls in Sub-Saharan Africa: A Meta-Analysis of 16 Demographic and Health Surveys. BMC Pediatrics, 7, 17.
http://dx.doi.org/10.1186/1471-2431-7-17
[18] Caulfield, L.E., de Onis, M., Blössner, M. and Black, R.E. (2004) Undernutrition as an Underlying Cause of Child Deaths Associated with Diarrhea, Pneumonia, Malaria, and Measles. The American Journal of Clinical Nutrition, 80, 193-198.
[19] Collins, S., Dent, N., Binns, P., Bahwere, P., Sadler, K., et al. (2006) Management of Severe Acute Malnutrition in Children. The Lancet, 368, 1992-2000.
http://dx.doi.org/10.1016/S0140-6736(06)69443-9
[20] Müller, O. and Krawinkel, M. (2005) Malnutrition and Health in Developing Countries. Canadian Medical Association Journal, 173, 279-286.
http://dx.doi.org/10.1503/cmaj.050342
[21] Jackson, A., Ashworth, A. and Khanum, S. (2006) Improving Child Survival: Malnutrition Task Force and the Paediatrician’s Responsibility. Archives of Disease in Childhood, 91, 706-710. http://dx.doi.org/10.1136/adc.2006.095596
[22] Collins, S. (2007) Treating Severe Acute Malnutrition Seriously. Archives of Disease in Childhood, 92, 453-461.
http://dx.doi.org/10.1136/adc.2006.098327
[23] Deen, J.L., Funk, M., Guevara, V.C., Saloojee, H., Doe, J.Y., et al. (2003) Implementation of WHO Guidelines on Management of Severe Malnutrition in Hospitals in Africa. Bulletin of the World Health Organization, 81, 237-245.
[24] Brewster, D.R., Manary, M.J. and Graham, S.M. (1997) Case Management of Kwashiorkor: An Intervention Project at Seven Nutrition Rehabilitation Centres in Malawi. European Journal of Clinical Nutrition, 51, 139-147.
http://dx.doi.org/10.1038/sj.ejcn.1600367

  
comments powered by Disqus

Copyright © 2017 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.