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Social, dietary and clinical correlates of oedema in children with severe acute malnutrition: a cross-sectional study
BACKGROUND: Severe acute malnutrition is a serious public health problem, and a challenge to clinicians. Why some children with malnutrition develop oedema (kwashiorkor) is not well understood. The objective of this study was to investigate socio-demographic, dietary and clinical correlates of oedem...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383214/ https://www.ncbi.nlm.nih.gov/pubmed/25885808 http://dx.doi.org/10.1186/s12887-015-0341-8 |
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author | Rytter, Maren Johanne Heilskov Namusoke, Hanifa Babirekere-Iriso, Esther Kæstel, Pernille Girma, Tsinuel Christensen, Vibeke Brix Michaelsen, Kim F Friis, Henrik |
author_facet | Rytter, Maren Johanne Heilskov Namusoke, Hanifa Babirekere-Iriso, Esther Kæstel, Pernille Girma, Tsinuel Christensen, Vibeke Brix Michaelsen, Kim F Friis, Henrik |
author_sort | Rytter, Maren Johanne Heilskov |
collection | PubMed |
description | BACKGROUND: Severe acute malnutrition is a serious public health problem, and a challenge to clinicians. Why some children with malnutrition develop oedema (kwashiorkor) is not well understood. The objective of this study was to investigate socio-demographic, dietary and clinical correlates of oedema, in children hospitalised with severe acute malnutrition. METHODS: We recruited children with severe acute malnutrition admitted to Mulago Hospital, Uganda. Data was collected using questionnaires, clinical examination and measurement of blood haemoglobin, plasma c-reactive protein and α(1)-acid glycoprotein. Correlates of oedema were identified using multiple logistic regression analysis. RESULTS: Of 120 children included, 77 (64%) presented with oedematous malnutrition. Oedematous children were slightly older (17.7 vs. 15.0 months, p = 0.006). After adjustment for age and sex, oedematous children were less likely to be breastfed (odds ratio (OR): 0.19, 95%-confidence interval (CI): 0.06; 0.59), to be HIV-infected (OR: 0.10, CI: 0.03; 0.41), to report cough (OR: 0.33, CI: 0.13; 0.82) and fever (OR: 0.22, CI: 0.09; 0.51), and to have axillary temperature > 37.5°C (OR: 0.28 CI: 0.11; 0.68). Household dietary diversity score was lower in children with oedema (OR: 0.58, CI: 0.40; 85). No association was found with plasma levels of acute phase proteins, household food insecurity or birth weight. CONCLUSION: Children with oedematous malnutrition were less likely to be breastfed, less likely to have HIV infection and had fewer symptoms of other infections. Dietary diversity was lower in households of children who presented with oedema. Future research may confirm whether a causal relationship exists between these factors and nutritional oedema. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12887-015-0341-8) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4383214 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-43832142015-04-03 Social, dietary and clinical correlates of oedema in children with severe acute malnutrition: a cross-sectional study Rytter, Maren Johanne Heilskov Namusoke, Hanifa Babirekere-Iriso, Esther Kæstel, Pernille Girma, Tsinuel Christensen, Vibeke Brix Michaelsen, Kim F Friis, Henrik BMC Pediatr Research Article BACKGROUND: Severe acute malnutrition is a serious public health problem, and a challenge to clinicians. Why some children with malnutrition develop oedema (kwashiorkor) is not well understood. The objective of this study was to investigate socio-demographic, dietary and clinical correlates of oedema, in children hospitalised with severe acute malnutrition. METHODS: We recruited children with severe acute malnutrition admitted to Mulago Hospital, Uganda. Data was collected using questionnaires, clinical examination and measurement of blood haemoglobin, plasma c-reactive protein and α(1)-acid glycoprotein. Correlates of oedema were identified using multiple logistic regression analysis. RESULTS: Of 120 children included, 77 (64%) presented with oedematous malnutrition. Oedematous children were slightly older (17.7 vs. 15.0 months, p = 0.006). After adjustment for age and sex, oedematous children were less likely to be breastfed (odds ratio (OR): 0.19, 95%-confidence interval (CI): 0.06; 0.59), to be HIV-infected (OR: 0.10, CI: 0.03; 0.41), to report cough (OR: 0.33, CI: 0.13; 0.82) and fever (OR: 0.22, CI: 0.09; 0.51), and to have axillary temperature > 37.5°C (OR: 0.28 CI: 0.11; 0.68). Household dietary diversity score was lower in children with oedema (OR: 0.58, CI: 0.40; 85). No association was found with plasma levels of acute phase proteins, household food insecurity or birth weight. CONCLUSION: Children with oedematous malnutrition were less likely to be breastfed, less likely to have HIV infection and had fewer symptoms of other infections. Dietary diversity was lower in households of children who presented with oedema. Future research may confirm whether a causal relationship exists between these factors and nutritional oedema. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12887-015-0341-8) contains supplementary material, which is available to authorized users. BioMed Central 2015-03-22 /pmc/articles/PMC4383214/ /pubmed/25885808 http://dx.doi.org/10.1186/s12887-015-0341-8 Text en © Rytter et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Rytter, Maren Johanne Heilskov Namusoke, Hanifa Babirekere-Iriso, Esther Kæstel, Pernille Girma, Tsinuel Christensen, Vibeke Brix Michaelsen, Kim F Friis, Henrik Social, dietary and clinical correlates of oedema in children with severe acute malnutrition: a cross-sectional study |
title | Social, dietary and clinical correlates of oedema in children with severe acute malnutrition: a cross-sectional study |
title_full | Social, dietary and clinical correlates of oedema in children with severe acute malnutrition: a cross-sectional study |
title_fullStr | Social, dietary and clinical correlates of oedema in children with severe acute malnutrition: a cross-sectional study |
title_full_unstemmed | Social, dietary and clinical correlates of oedema in children with severe acute malnutrition: a cross-sectional study |
title_short | Social, dietary and clinical correlates of oedema in children with severe acute malnutrition: a cross-sectional study |
title_sort | social, dietary and clinical correlates of oedema in children with severe acute malnutrition: a cross-sectional study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383214/ https://www.ncbi.nlm.nih.gov/pubmed/25885808 http://dx.doi.org/10.1186/s12887-015-0341-8 |
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