Body mass composition: a predictor of admission outcomes among hospitalized Nigerian under 5 children

Abstract

Background: Malnutrition remains a public health problem and a significant contributor to morbidity and mortality among children less than 5 years, in spite of global efforts at improving nutrition.

Objective: To examine the impact of nutritional status, by measured anthropometric indices and derived body composition, on disease outcomes in under-5 children hospitalised in an emergency unit.

Methods: All (n=164) consecutive children aged 12-59 months admitted into the Children Emergency Ward of the University College Hospital, Ibadan over a 3 month period (May to July, 2007) had weight, length/height, mid upper arm circumference (MUAC) and skin fold thicknesses recorded. The BMI, Rohrer index, z-scores for weight-for-height and weight-for-age were calculated. Malnutrition was defined as z scores<-2. Other derived parameters included Arm-Fat-Area (AFA), Arm-Muscle-Area (AMA), Upper-Arm-Muscle-Estimate (UME), and Total-Upper-Arm-Area (TUA). Relative risk was calculated and logistic regression was used to determine which variables independently predict death.

Results: There were 153 survivors and 11 deaths giving an overall death rate of 6.7%. The mean age of survivors (26.7+/-12.5 months) compared with those who died (23.1+/-12.1 months) were similar (p>0.05). The risk of death was significantly higher among the malnourished compared with the well nourished. The TUA, AMA and UME of those who died were significantly lower than survivors' (p<0.05). MUAC remained an independent predictor of death among other measured and derived anthropometric indices.

Conclusions: MUAC remains a useful anthropometric measurement for nutritional assessment and an independent predictor of survival among hospitalised under-5 children in Nigeria.