Severe Malnutrition in Children Not Always Recognised

A study by researchers at the Manhiça Health Research Centre (CISM) and ISGlobal's research centre CRESIB has been published in the journal Public Health Nutrition. The aim of the study was to investigate the burden, clinical characteristics and risk factors associated with mortality in children under five years of age with severe malnutrition in southern Mozambique. While common among children treated in this setting, severe malnutrition often went undetected despite its association with a high risk of death.

Malnutrition is highly prevalent in developing countries and contributes significantly to premature death in children, playing a key role in one-third of the 8.8 million deaths affecting children under five worldwide every year. It is the result of a combination of environmental, nutritional, clinical, cultural and socioeconomic factors and must be addressed using a comprehensive approach if we are to reverse the vicious cycle that leads to clinical disease. The management of severe malnutrition in children is complex and these patients require prolonged hospitalization.

Quique Bassat, the ISGlobal researcher who participated in the study highlights the fact that "severe malnutrition is difficult to recognise in children and measures are urgently needed to ensure that physicians responsible for the initial assessment of outpatients detect the problem so as to improve the children's chances of survival". Moreover, the rapid management of complications (hypoglycaemia, acute diarrhoea, and co-infections such as bacteraemia, oral candidiasis, or HIV/AIDS) may help to reduce the unacceptable death toll due to malnutrition among children in rural Africa.

These findings are based on a retrospective study of data collected systematically between 2001 and 2010 in a rural district hospital and peripheral health facilities in the Manhiça district of Mozambique. Of the 274,813 children seen in this programme, almost half presented with some indication of malnutrition, which was severe in 6% of cases. However, only 15% of the severely malnourished children were eventually admitted to hospital. The highest incidence of malnutrition was observed in children aged between one and two years.

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Severe malnutrition among children under the age of 5 years admitted to a rural district hospital in southern Mozambique