The prevalence of malnutrition in children admitted to a general paediatric ward at the Chris Hani Baragwanath Academic Hospital: A cross-sectional survey

Abstract

Background. The prevalence of malnutrition, an important contributor to childhood mortality, is poorly described in hospitalised South African (SA) children, many of whom are HIV-exposed or HIV-infected. 

Objectives. To describe the prevalence of malnutrition in infants and children <14 years of age admitted to a general paediatric ward at the Chris Hani Baragwanath Academic Hospital in Soweto, SA, and to compare the nutritional status of infants <18 months of age who were HIV-unexposed, HIV-exposed but uninfected (HEU) or HIV-infected. 

Methods. A cross-sectional nutritional survey was conducted on 222 admitted children. A total of 139 infants were <18 months of age.

Results. Stunting was the most common form of malnutrition (40.5%), followed by underweight-for-age (33.3%) and wasting (23.4%). Of 175 children aged <5 years, 22 (12.6%) were severely wasted. Twenty-four (10.8%) children were HIV-infected: 6 children were <18 months, 3 were ≥18 months but <5 years and 15 children were ≥5 years. For children ≤18 months, HEU children (n=56) were significantly more underweight and stunted than their HIV-unexposed peers (n=77); weight-for-age and height-for-age median z-scores for these groups were –1.81 v. –0.63 (p=0.0038) and –2.51 v. –0.51 (p=0.004), respectively. 

Conclusion. Malnutrition is prevalent in hospitalised children, with stunting being the most common form. The prevalence of HIV-infection is decreasing in younger children, but HEU children, who constitute a large proportion of total hospital admissions, have high rates of malnutrition, especially stunting.