The prevalence of undernutrition upon hospitalization in children in a developing country: A single hospital study from Malaysia

Abstract

Undernourished children who require hospital care have a longer duration of hospitalization and respond poorly to modern medical therapy. The objective of the present study was to ascertain the nutritional status of children admitted to a pediatric tertiary center in Malaysia and the risk factors leading to undernutrition upon admission. In this cross-sectional, hospital-based study, anthropometric measurements [weight, length/height, mid-upper arm circumference (MUAC), triceps skinfold thickness were performed in 285 children aged from 3 months to 15 years who were admitted to University Malaya Medical Centre, Kuala Lumpur in November 2013. Acute (wasting) and chronic (stunting) undernutrition were defined as weight-for-height (WFH) and height-for-age (HFA) < -2 standard deviation (S.D.), respectively. Underweight was defined as weight-for-age < -2S.D. For children aged between 1 and 5 years of age, World Health Organization definition for acute undernutrition (HFA<-2 S.D. and/or MUAC<12.5cm) was also noted. Upon admission, the prevalence rates of acute and chronic undernutrition were 11% (n=32) and 14% (n=41), respectively. In addition, 7% (n=21) had an MUAC of < 12.5cm, 15% had body-mass index < -2S.D., and 7% (n=21) had triceps skinfold thickness < -2S.D., while 17% (n=47) were underweight. Using the World Health Organization definition of acute undernutrition, an additional eight patients were noted to have acute undernutrition (n=40, 14%). No significant risk factors associated with undernutrition were identified. The prevalence of undernutrition among children admitted to a tertiary hospital in Malaysia was 14%. Strategies for systematic screening and provision of nutritional support in children at risk of undernutrition as well as treatment of undernutrition in children requiring hospitalization are needed.