Determination of malnutrition status in hospitalized Turkish Republic citizen and refugee children with different diagnoses

Yıl 2023, , 1170 - 1174, 29.10.2023

Ramazan Dulkadir

https://doi.org/10.32322/jhsm.1351761

Öz

Aims: Malnutrition is defined as changes in the normal body structure due to inadequate nutrition. This study aimed to determine the malnutrition status of Turkish children and refugee children.
Methods: A total of 5528 patients between the ages of 1 month and 18 years who were admitted and followed up in our pediatric health and diseases department between January 2017 and January 2020 were evaluated. The Gomez classification was used to assess malnutrition status. Demographic data, admission diagnoses, and the degree of malnutrition were retrospectively recorded by examining medical records. Both groups were compared in terms of these parameters.
Results: In our study, 5528 patients between the ages between 1 month and 18 years were evaluated. The median age was 4.1 years (min:1 month, max:17 years), with 2274 (41.1%) being female and 3254 (58.9%) being male. Among the cases, 4994 (90.5%) were Turkish, 160 (2.8%) were Afghan, 198 (3.5%) were Iraqi, and 176 (3.2%) were Syrian. According to the Gomez classification, 4379 patients (79.2%) were normal and 1148 patients (20.8%) were malnourished. Among the malnourished patients, 995 (86.7%) were mildly malnourished, 117 (10.2%) were moderately malnourished, and 36 (3.1%) were severely malnourished. 44% (n=16) of severely malnourished patients were under the age of two. The malnutrition rates were 19.7%, 22.5 %, 30.8 %, and 36.4% in Turkish, Afghan, Iraqi, and Syrian patients, respectively. There was a significant difference between Syrian and Turkish patients with mild and moderate malnutrition (P <0.05). A total of 72.3% (n=830) of patients were admitted for reasons related to infections. Malnutrition is more frequently detected in patients with gastrointestinal diseases. None of the patients were admitted solely because of malnutrition.
Conclusion: The rate of malnutrition was significant in both Turkish and refugee children, with higher rates observed among refugee patients admitted to the hospital. Therefore, children admitted to the hospital for any reason should be carefully evaluated for growth and development. Early recognition and appropriate treatment of malnutrition are believed to lead to faster treatment of the underlying diseases causing hospitalization and may help prevent recurrent admissions.

Anahtar Kelimeler

Children, Gomez Classification, Malnutrition, Refugee

Kaynakça

• Pettigrew RA, Charlesworth PM, Farmilo RW et al. Assessment of nutritional depletion and immune competence: a comparison of clinical examination and objective measurements. JPEN J Parenter Enteral Nutr. 1984;8(1):21-24.
• Meakins JL, Pietsch JB, Bubenick O, et al. Delayed hypersensitivity: indicator of acquired failure of host defenses in sepsis and trauma. Ann Surg. 1977;186(3):241-250.
• Cameron JW. Malnutrition in hospitalized children with congenital heart disease. Arch Pediatr Adolesc Med. 1995;149(10):1098.
• Dewan N, Faruque A, Fuchs G. Nutritional status and diarrhoeal pathogen in hospitalized children in Bangladesh. Acta Paediatrica. 1998;87(6):627-630.
• Ooi PH, Thompson-Hodgetts S, Pritchard-Wiart L, Gilmour SM, Mager DR. Pediatric Sarcopenia: A Paradigm in the Overall Definition of Malnutrition in Children?. JPEN J Parenter Enteral Nutr. 2020;44(3):407-418.
• Training course on the management of severe malnutrition. World Health Organization. Accessed July 1, 2023. Available at: https://apps.who.int/iris/bitstream/handle/10665/70449/WHO_NHD_02.4_F_eng.pdf
• Dündar N, Dündar B. Assessment of a child with malnutrition. Med J SDU. 2009;13(4):39-42.
• Benjamin DR. Laboratory tests and nutritional assessment: protein-energy status. pediatric clinics of North America. Pediatr Clin North Am. 1989;36(1):139-161.
• Graham AM. Assessment of nutritional intake. Proc Nutr Soc. 1982;41(3):343-348.
• Sayed S, El-Shabrawi MHF, Abdelmonaem E, El Koofy N, Tarek S. Value of nutritional screening tools versus anthropometric Measurements in evaluating nutritional status of children in a low/middle-income country. Pediatr Gastroenterol Hepatol Nutr. 2023;26(4):213-223.
• Gómez F, Ramos Galvan R, Frenk S et al. Mortality in second and third degree malnutrition. J Tropic Pediatr. 1956;2(2):77-83.
• Grammatikopoulou MG, Theodoridis X, Poulimeneas D, Maraki MI, Gkiouras K, Tirodimos I, Dardavessis T, Chourdakis M. Malnutrition surveillance among refugee children living in reception centres in Greece: a pilot study. Int Health. 2019;11(1):30-35.
• AbuKishk N, Gilbert H, Seita A, Mukherjee J, Rohloff PJ. Under-five malnutrition among Palestine refugee children living in camps in Jordan: a mixed-methods study. BMJ Glob Health. 2021;6(8):e005577.
• Saengnipanthkul S, Chongviriyaphan N, Densupsoontorn N, et al. Hospital-acquired malnutrition in paediatric patients: a multicentre trial focusing on prevalence, risk factors, and impact on clinical outcomes. Eur J Pediatr. 2021;180(6):1761-1767.
• Güleç SG, Urgancı N, Polat S et al. Evaluation of malnutrition in hospitalized children under three years old. Med Bull Sisli Etfal Hosp. 2011;45(4):124-129.
• Neyzi O, Günöz H, Furman A, et al. Turkish children's reference values for body weight, height, head circumference and body mass index. J Pediatr Child Health. 2008;51:1-14.
• Malnutrition. World Health Organization. Accessed July 1, 2023. Available at: https://www.who.int/health-topics/malnutrition
• Waterlow JC. Note on the assessment and classification of protein -energy malnutrision in children. Lancet. 1973;302(7820):87-89.
• Bélanger V, McCarthy A, Marcil V, et al. Assessment of malnutrition risk in canadian pediatric hospitals: a multicenter prospective cohort study. J Curr Pediatr. 2019;205:160-167.e6.
• Gül F, Zengin NŞ, Geylani Güleç S. Evaluation of nutritional status in children consulted to polyclinics. JAREM. 2020;10(1):27-31.
• Şahin S, Energin VM. The assessment of malnutrition in child inpatients. J Curr Pediatr. 2023;21(1):69-76.
• Mevlitoğlu Ş, Yilmaz A, Özel D. The assessment of malnutrition in child inpatients. Turkiye Klinikleri J Pediatr. 2019;28(2):63-70.
• Cao J, Peng L, Li R, et al. Nutritional risk screening and its clinical significance in hospitalized children. Clin Nutr. 2014;33(3):432-436.
• Pars H, Kazanci H, Bayram GS. Evaluation of malnutrition development in hospitalized children. JOHUFON. 2020;7(1):15-22.
• Mroue T, Heras B, Soriano JM, Morales-Suarez-Varela M. Prevalence of malnutrition among syrian refugee children from Lebanon. Life (Basel). 2023;13(2):453.