[Evaluation of the nutritional status of children less than 5 years of age in Moundou, Chad: correlations with morbidity and hospital mortality]

Abstract

The purpose of this study carried out in the pediatric ward of the regional hospital in Moundou, Chad, between June 1992 and May 1993 was to assess the prevalence of protein-energy malnutrition in children under 5 years of age and its relationship with various diseases and in-hospital mortality. A total of 1050 children ranging in age from 1 to 59 months were hospitalized in the ward during the study period and included in the study. Nutritional status was assessed using weight-for-height (W/H) and height-for-age (H/A) charts. Diarrhea, dehydratation, malaria, anemia, acute respiratory infection, and meningitis accounted for 85.5% of the underlying diseases and for 76% of deaths. At entry into study the prevalence of malnutrition was 63.1% (W/H < -2 Z-score) including 37% with severe malnutrition (W/H < -3 Z-score) and 16.1% with stunted growth (H/A < -2 Z-score). Malnutrition was more prevalent in children under than over 2 years of age (80% vs. 42.7% respectively). The same trend was observed with regard to severe malnutrition. The prevalence of malnutrition was highest in children with acute respiratory infections or diarrhea (61.3% and 89.8% respectively). Mortality was significantly higher in severely malnourished children and malnourished children with respiratory infection especially at ages under 1 year. Death was attributed to malnutrition in 30% of cases. Better low cost nutritional care is currently feasible. The most cost efficient methods of fighting against this problem are prevention and education especially concerning breast feeding.