Clinical Profile and Treatment Outcome among Patients Managed for Severe Acute Malnutrition in a Tertiary Facility in Sokoto State

Abstract

Background: Severe acute malnutrition (SAM) affects more than 20 million children worldwide, and it is highly prevalent in the African region where health systems are also coping with other highly prevalent infectious and non-infectious diseases. World Health Organization (WHO) recommends more research in facilities on treatment outcomes in relation to risk factors and standards of follow up care. This study evaluated the clinical profile at presentation and outcome of treatment of SAM among patients admitted into a tertiary hospital in Sokoto Methods: A retrospective review of records of children aged six months to 5 years who were admitted for SAM over a two-year period. A proforma was used to collect the information on their socio-demographics, type of malnutrition, anthropometric characteristics, packed cell volume, complications, therapy received and outcome. Data were analysed using IBM SPSS version 25. Results: Out of the 1862 patients admitted during the period, 159 (8.5%) had SAM, and of these, 107 records were available. Most cases were admitted in the rainy months of July to September. The male to female ratio was 1.43:1. The mean age was 21.0 ± 8.6 months. There were 66 (61.7%) cases of non-oedematous SAM and 41 (38.3%) cases of oedematous SAM. Oedematous SAM had lower pack cell volume and higher occipitofrontal circumference than non-oedematous SAM (p=0.03). Nutritional rehabilitation diet given included WHO formula milk and the hospital prepared nutrient kwash pap. Mean weight gain was 14g/kg/day, mortality was 45.8%, recovery rate 17%, and a large proportion 70.6% did not attend follow up. Weight was the only anthropometry documented subsequently till discharge. Conclusions: There was high mortality and poor follow up among the SAM patients. The managing team needs to improve refeeding practices with uniform diet, monitor all anthropometric indicators of recovery and ensure follow up of these patients in the community by appropriate referral.