Lee Way-Seah, Ahmad Zulfadly
Department of Paediatrics, University Malaya Medical Center, Kuala Lumpur, Malaysia; University Malaya Paediatric and Child Health Research Group, University Malaya, Kuala Lumpur, Malaysia.
Department of Paediatrics, University Malaya Medical Center, Kuala Lumpur, Malaysia.
Pediatr Neonatol. 2017 Oct;58(5):415-420. doi: 10.1016/j.pedneo.2016.08.010. Epub 2017 Feb 17.
Undernourished children who require hospital care have a longer duration of hospitalization and respond poorly to modern medical therapy. The objective of the present study was to ascertain the nutritional status of children admitted to a pediatric tertiary center in Malaysia and the risk factors leading to undernutrition upon admission.
In this cross-sectional, hospital-based study, anthropometric measurements [weight, length/height, mid-upper arm circumference (MUAC), triceps skinfold thickness were performed in 285 children aged from 3 months to 15 years who were admitted to University Malaya Medical Centre, Kuala Lumpur in November 2013. Acute (wasting) and chronic (stunting) undernutrition were defined as weight-for-height (WFH) and height-for-age (HFA) < -2 standard deviation (S.D.), respectively. Underweight was defined as weight-for-age < -2 S.D. For children aged between 1 and 5 years of age, World Health Organization definition for acute undernutrition (HFA < -2 S.D. and/or MUAC < 12.5 cm) was also noted.
Upon admission, the prevalence rates of acute and chronic undernutrition were 11% (n = 32) and 14% (n = 41), respectively. In addition, 7% (n = 21) had an MUAC of < 12.5 cm, 15% had body-mass index < -2 S.D., and 7% (n = 21) had triceps skinfold thickness < -2 S.D., while 17% (n = 47) were underweight. Using the World Health Organization definition of acute undernutrition, an additional eight patients were noted to have acute undernutrition (n = 40, 14%). No significant risk factors associated with undernutrition were identified.
The prevalence of undernutrition among children admitted to a tertiary hospital in Malaysia was 14%. Strategies for systematic screening and provision of nutritional support in children at risk of undernutrition as well as treatment of undernutrition in children requiring hospitalization are needed.
需要住院治疗的营养不良儿童住院时间更长，对现代医学治疗反应不佳。本研究的目的是确定马来西亚一家儿科三级中心收治儿童的营养状况以及入院时导致营养不良的风险因素。
在这项基于医院的横断面研究中，对2013年11月入住吉隆坡马来亚大学医学中心的285名年龄在3个月至15岁的儿童进行了人体测量[体重、身长/身高、上臂中部周长（MUAC）、三头肌皮褶厚度]。急性（消瘦）和慢性（发育迟缓）营养不良分别定义为身高别体重（WFH）和年龄别身高（HFA）＜-2标准差（S.D.）。体重不足定义为年龄别体重＜-2 S.D.。对于1至5岁的儿童，还记录了世界卫生组织对急性营养不良的定义（HFA＜-2 S.D.和/或MUAC＜12.5 cm）。
入院时，急性和慢性营养不良的患病率分别为11%（n = 32）和14%（n = 41）。此外，7%（n = 21）的MUAC＜12.5 cm，15%的体重指数＜-2 S.D.，7%（n = 21）的三头肌皮褶厚度＜-2 S.D.，而17%（n = 47）体重不足。根据世界卫生组织对急性营养不良的定义，另外有8名患者被发现患有急性营养不良（n = 40，14%）。未发现与营养不良相关的显著风险因素。
马来西亚一家三级医院收治儿童的营养不良患病率为14%。需要制定系统筛查策略，为有营养不良风险的儿童提供营养支持，并对需要住院治疗的儿童的营养不良进行治疗。
