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Abstract
In low-income countries there are few data on hospital malnutrition. Reduced food intake combined with nutrient-poor foods served in hospitals contribute to nutritional risk. This study investigated whether reported dietary intake and disease state of hospitalized adults in critical care units was related to malnutrition determined by mid-upper arm circumference (MUAC). Adult in-patients (n = 126) in tuberculosis, burn, oncology, and intensive care units in two public tertiary hospitals in Malawi were screened for nutritional status using MUAC and a question on current dietary intake. The hospital menu was reviewed; portion sizes were weighed. The prevalence of moderate and severe malnutrition was 62%. Patients with organ-related diseases and infectious diseases had the highest rates of reduced reported dietary intake, 71.4% and 57.9%, respectively; however, there was no association between reported dietary intake and MUAC. In those unable to eat, however, the rate of severe malnutrition was 50%. The menu consisted of porridge and thickened corn-based starch with fried cabbage; protein foods were provided twice weekly. There was a nutrient gap of 250 calories and 13 gm protein daily. The findings support the need for increasing dietetic/nutrition services to prevent and treat malnutrition in hospitals using simple screening tools.
Highlights
In Africa, 25 to 72.3% of hospitalized patients are at risk for malnutrition [1,2,3]
It included the nutritional assessment and screening of patients, identified the types and amounts of food served in the hospital, and whether the hospitals or units have clear steps on how to identify and provide nutrition care to critically ill patients. This secondary analysis focused on the relationship between reported dietary intake and the prevalence of malnutrition determined by mid-upper arm circumference (MUAC) and further assessed by medical diagnosis
Determined by MUAC, the prevalence of mild to no malnutrition was 38%, moderate malnutrition was 20.7%, and severe malnutrition was 41.3%, which was similar for both hospital locations, only
Summary
In Africa, 25 to 72.3% of hospitalized patients are at risk for malnutrition [1,2,3]. Hospital-based malnutrition is related to decreased food/fluid intake, altered nutrient metabolism due to severe injury and disease-associated inflammatory conditions, and nutrient losses from malabsorption or vomiting [4]. These conditions are commonly seen in critical care patients and are associated with poor nutritional status and poor health outcomes which include reduced immune function, impaired wound healing, muscle wasting, prolonged hospital stays, high treatment costs, and increased mortality [5,6,7,8]. In order to prevent this, patients at risk for malnutrition need to be identified early in their hospital stay to ensure prompt and adequate nutritional support [10]
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