Screening for wasting and underweight in children aged 6-59 months presenting to the outpatients’ clinic of a Tertiary Hospital: a retrospective study

Abstract

Background: Malnutrition is a major underlying factor in under-five mortality and morbidity. Early detection and management are key in preventing the associated complications. However, the nutritional status of children is not frequently assessed at outpatient clinics. Objective: This study aimed to determine the degree of wasting and underweight and their associated factors in children presenting at the outpatients’ department (OPD) of the Tamale Teaching Hospital. Methods: A 5-month retrospective chart review was conducted at the paediatric OPD of the Tamale Teaching Hospital. Children (6-59 months) who presented to the clinic after implementation of Mid-Upper-Arm Circumference (MUAC)measurement during weighing and taking of other vital signs were selected. Data retrieved included the child’s age and gender, mother’s educational status, marital status and occupation. Weight and MUAC measurements were also recorded from the folders. Descriptive analysis was performed, and univariate associations were determined using cross-tabulation and compared using Chisquare tests. Results: One hundred and ninety-nine children, with a median age of 24 months were included in the study of whom 113(56.8%) were males. Using the MUAC, 8 (4%) of the children had moderate and severe wasting respectively and 22 (11%) were classified as being at risk of wasting. The weight for age Z scores showed that 31 (16%) and 18 (9.3%) of children were moderately and severely underweight respectively. Younger age≤ 24 months (p= 0.01) and low or no maternal formal education (p= 0.002) were factors significantly associated with children being wasted or underweight. Conclusion: While 4% of the children were classified by their MUAC measurement as being severely wasted, only 3% had a diagnosis of Severe Acute Malnutrition made by the attending doctor. The routine measurement of MUAC could be a useful tool for the early detection of children with severe wasting at the OPD