Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul;13(3):e12345.
doi: 10.1111/mcn.12345. Epub 2016 Jul 25.

Admission profile and discharge outcomes for infants aged less than 6 months admitted to inpatient therapeutic care in 10 countries. A secondary data analysis

Affiliations

Admission profile and discharge outcomes for infants aged less than 6 months admitted to inpatient therapeutic care in 10 countries. A secondary data analysis

Carlos S Grijalva-Eternod et al. Matern Child Nutr. 2017 Jul.

Abstract

Evidence on the management of acute malnutrition in infants aged less than 6 months (infants <6mo) is scarce. To understand outcomes using current protocols, we analysed a sample of 24 045 children aged 0-60 months from 21 datasets of inpatient therapeutic care programmes in 10 countries. We compared the proportion of admissions, the anthropometric profile at admission and the discharge outcomes between infants <6mo and children aged 6-60 months (older children). Infants <6mo accounted for 12% of admissions. The quality of anthropometric data at admission was more problematic in infants <6mo than in older children with a greater proportion of missing data (a 6.9 percentage point difference for length values, 95% CI: 6.0; 7.9, P < 0.01), anthropometric measures that could not be converted to indices (a 15.6 percentage point difference for weight-for-length z-score values, 95% CI: 14.3; 16.9, P < 0.01) and anthropometric indices that were flagged as outliers (a 2.7 percentage point difference for any anthropometric index being flagged as an outlier, 95% CI: 1.7; 3.8, P < 0.01). A high proportion of both infants <6mo and older children were discharged as recovered. Infants <6mo showed a greater risk of death during treatment (risk ratio 1.30, 95% CI: 1.09; 1.56, P < 0.01). Infants <6mo represent an important proportion of admissions to therapeutic feeding programmes, and there are crucial challenges associated with their care. Systematic compilation and analysis of routine data for infants <6mo is necessary for monitoring programme performance and should be promoted as a tool to monitor the impact of new guidelines on care.

Keywords: anthropometry; infant and child nutrition; malnutrition; management of acute malnutrition; mortality; wasting.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Forest plot of the risk ratio (RR) of death during treatment for infants aged <6 months compared with children aged 6–60 months, by country, from a sample of 24 045 children aged 0–60 months from 10 countries (Burundi, Kenya, Liberia, Myanmar, Niger, Democratic Republic of Congo, Somalia, Sudan, Tajikistan and Uganda). Test for heterogeneity χ 2 = 67.0 (degrees of freedom = 9; P < 0.01). I‐squared (variation in RR attributable to heterogeneity) = 86.6%. Test of RR = 1: z = 2.96 (P < 0.01).

References

    1. Angood C., McGrath M., Mehta S., Mwangome M., Lung'aho M., Roberfroid D. et al. (2015) Research priorities to improve the management of acute malnutrition in infants aged less than six months (MAMI). PLoS Medicine 12 (4), e1001812. - PMC - PubMed
    1. Black R.E., Victora C.G., Walker S.P., Bhutta Z.A., Christian P., de Onis M. et al. (2013) Maternal and child undernutrition and overweight in low‐income and middle‐income countries. Lancet 382 (9890), 427–451. - PubMed
    1. Crowe S., Seal A., Grijalva‐Eternod C. & Kerac M. (2014) Effect of nutrition survey 'cleaning criteria' on estimates of malnutrition prevalence and disease burden: secondary data analysis. PeerJ 2, e380. - PMC - PubMed
    1. ENN & CIHD , A. (2010), MAMI Project. Technical review: current evidence, policies, practices & programme outcomes. Available at: http://www.ennonline.net/mamitechnicalreview
    1. Fomon S.J. & Nelson S.E. (2002) Body composition of the male and female reference infants. Annual Review of Nutrition 22, 1–17. - PubMed

Publication types