Body mass composition: a predictor of admission outcomes among hospitalized Nigerian under 5 children.

BACKGROUND

Malnutrition remains a public health problem and a significant contributor to morbidity and mortality among children less than 5 years, in spite of global efforts at improving nutrition.

OBJECTIVE

To examine the impact of nutritional status, by measured anthropometric indices and derived body composition, on disease outcomes in under-5 children hospitalised in an emergency unit.

METHODS

All (n=164) consecutive children aged 12-59 months admitted into the Children Emergency Ward of the University College Hospital, Ibadan over a 3 month period (May to July, 2007) had weight, length/height, mid upper arm circumference (MUAC) and skin fold thicknesses recorded. The BMI, Rohrer index, z-scores for weight-for-height and weight-for-age were calculated. Malnutrition was defined as z scores<-2. Other derived parameters included Arm-Fat-Area (AFA), Arm-Muscle-Area (AMA), Upper-Arm-Muscle-Estimate (UME), and Total-Upper-Arm-Area (TUA). Relative risk was calculated and logistic regression was used to determine which variables independently predict death.

RESULTS

There were 153 survivors and 11 deaths giving an overall death rate of 6.7%. The mean age of survivors (26.7+/-12.5 months) compared with those who died (23.1+/-12.1 months) were similar (p>0.05). The risk of death was significantly higher among the malnourished compared with the well nourished. The TUA, AMA and UME of those who died were significantly lower than survivors' (p<0.05). MUAC remained an independent predictor of death among other measured and derived anthropometric indices.

CONCLUSIONS

MUAC remains a useful anthropometric measurement for nutritional assessment and an independent predictor of survival among hospitalised under-5 children in Nigeria.