喀麦隆儿童严重急性营养不良的临床谱：喀麦隆雅温得一项基于医院的研究。
The clinical spectrum of severe acute malnutrition in children in Cameroon: a hospital-based study in Yaounde, Cameroon.
作者信息
Chiabi Andreas, Malangue Berthe, Nguefack Seraphin, Dongmo Félicitée Nguefack, Fru Florence, Takou Virginie, Angwafo Fru
机构信息
Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon;; Gynaeco-Obstetric and Pediatric Hospital Yaounde, Yaounde, Cameroon.
Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.
出版信息
Transl Pediatr. 2017 Jan;6(1):32-39. doi: 10.21037/tp.2016.07.05.
BACKGROUND
Severe acute malnutrition (SAM) is a major health problem, and the cause of more than half of childhood deaths in children less than 5 years in developing countries. Globally, 20 million children under 5 years of age are severely malnourished according to the World Health Organization (WHO). In Cameroon, the prevalence of SAM remains high and estimated at 1.9% in 2011 and 1.3% in 2014. The aim of this study was to determine the epidemiology, clinical aspects and outcome of SAM at the Yaounde Gynaeco-Obstetric and Pediatric Hospital (YGOPH).
METHODS
We retrospectively reviewed the medical records of children hospitalized in the YGOPH for SAM over a period of 8 1/2 years (from September 2006 to March 2015). We included the medical records of children under 15 years of age who were hospitalized in the pediatric unit of the YGOPH for the management of SAM. Data was collected using a data entry form and was analyzed with Epi info version 3.5.4 software. Data was considered statistically significant for P less than 0.05.
RESULTS
The prevalence of SAM was 2.72%. The median age was 9 months (range, 23 days-112 months). The most represented age group was 6 to 12 months with 34.6% of the children. The most frequent symptoms on admission were: wasting (58.1%) and fever (53.6%). The mean interval between the onset of symptoms and admission was 30.36 days. Marasmus was the most frequent clinical form of SAM observed in 88.8% of the children. Respiratory tract infections were the most common comorbidities and were present in 45 patients (25.1%), followed by malaria in 15.1% of cases. The sero-prevalence of human immuno deficiency virus (HIV) was 43.75% amongst the 32 children whose HIV status was known. Dehydration was the most frequent complication, with an occurrence of 29.6%. A total of 58.7% of patients were discharged following clinical improvement and the mortality rate was 15%. The average duration of hospitalization was 8.25 days.
CONCLUSIONS
SAM is a frequently encountered pathology in this context with a high mortality, thus the need to step up prevention strategies. Health education during pediatric consultations and vaccination sessions on the appropriate feeding of the young infant and the child should be reinforced.
背景
重度急性营养不良是一个主要的健康问题，也是发展中国家5岁以下儿童半数以上死亡的原因。据世界卫生组织（WHO）统计，全球有2000万5岁以下儿童严重营养不良。在喀麦隆，重度急性营养不良的患病率仍然很高，2011年估计为1.9%，2014年为1.3%。本研究的目的是确定雅温得妇产科和儿科医院（YGOPH）重度急性营养不良的流行病学、临床特征及转归。
方法
我们回顾性分析了在YGOPH住院治疗重度急性营养不良的儿童8年半（从2006年9月至2015年3月）的病历。纳入在YGOPH儿科病房住院治疗重度急性营养不良的15岁以下儿童的病历。使用数据录入表格收集数据，并采用Epi info 3.5.4版软件进行分析。P值小于0.05的数据被认为具有统计学意义。
结果
重度急性营养不良的患病率为2.72%。中位年龄为9个月（范围：23天至112个月）。最具代表性的年龄组是6至12个月，占儿童的34.6%。入院时最常见的症状是：消瘦（58.1%）和发热（53.6%）。症状出现至入院的平均间隔时间为30.36天。消瘦型是观察到的重度急性营养不良最常见的临床类型，88.8%的儿童为此类型。呼吸道感染是最常见的合并症，45例患者（25.1%）存在该合并症，其次是疟疾，占15.1%的病例。在已知HIV状况的32名儿童中，人类免疫缺陷病毒（HIV）的血清阳性率为43.75%。脱水是最常见的并发症，发生率为29.6%。共有58.7%的患者在临床症状改善后出院，死亡率为15%。平均住院时间为8.25天。
结论
在这种情况下，重度急性营养不良是一种常见的疾病，死亡率很高，因此需要加强预防策略。应加强在儿科咨询和疫苗接种期间关于婴儿和儿童适当喂养的健康教育。
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