Indications, medical conditions, and services related to gastrostomy placement in infants and children at a tertiary hospital in South Africa

Abstract

Infants and children with feeding and swallowing difficulties may require a gastrostomy to ensure safe feeding and optimal nutrition.
Objectives. To describe South African infants and children requiring gastrostomies in a tertiary hospital, including the indications, medical conditions and health services, during a 5-year period (2005 - 2009).
Design. The research design was a retrospective descriptive survey of medical records.
Setting. A tertiary paediatric state hospital in South Africa.
Subjects. One hundred and forty-two patients between the ages of 0 and 17 years.
Results. Dysphagia (N=80, 56%), aspiration (N=70, 49%) and need for nutritional support (N=63, 44%) were the most common indicators for gastrostomy placement. Most participants (N=85, 75% of the subset of 114 with feeding and swallowing difficulties) presented with multiple medical conditions, and neurological impairment (N=94, 82%) and gastro-intestinal problems (N=96, 84%) were the most prominent. Services were required from a variety of health care professionals for a period ranging from 6 to 103 months (mean 18 months). The speech-language therapist was consulted most frequently before gastrostomy placement (85%), while the stoma sister (97%) and dietician (97%) were consulted after placement.
Conclusions. South African infants and children requiring gastrostomies frequently present with multiple medical conditions and dysphagia. These children are likely to benefit from extended services provided by a specialised team of health care professionals.