Abstract
Over a 5 year period January 1972 to December 1976 a total of 4624 patients were admitted to the pediatric wards of the University College Hospital Ibadan Nigeria. 203 of these patients were suffering from Protein Energy Malnutrition (PEM) 146 with kwashiorkor 33 with marasmic-kwashiorkor and 24 with marasmus. PEM patients have significantly lower electrolyte values than healthy Nigerian children. Their packed cell volumes were within the lower limits of normal values for health Nigerian children and a low immunization rate for communicable diseases was also observed. 28.3% gave a history of measles attack while 19.4% had chronic diarrhea during the period immediately before presentation with PEM. Hypothermia hypoglycemia and sepsis were not adequately documented on these patients an indication that they were less rigorously looked for than they ought to have been and are presumed to have contributed to the high mortality rate of 28%. Improved management of these patients while on the ward should include use of a low reading thermometer for detection of hypothermia use of dextrostix for quick bedside blood sugar estimation monitoring of packed cell volume or haemoglobin levels to watch for anemias and thorough screening for infection in addition to chest radiographs and tuberculin tests. Urine stool and blood cultures were incompletely carried out on the children in this study. (authors modified)
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