Department of Pediatrics, University College of Medical Sciences, Associated GTB Hospital, Dilshad Garden, New Delhi110095, India.
Public Health Nutr. 2021 Dec;24(17):5847-5856. doi: 10.1017/S1368980021003268. Epub 2021 Aug 6.
To assess the outcome of severe wasting in infants below 6 months of age.
A prospective observational study conducted between January 2017 and October 2018.
A medical college-affiliated hospital in Eastern Delhi, catering mainly to the urban poor population.
All children with severe wasting (weight-for-length Z-score (WLZ) < -3 sd) between 1 and 6 months of age, requiring hospitalisation.
Out of fifty children enrolled, during hospitalisation, forty-two (84 %) recovered (WLZ > -3 sd) and discharged; the median (interquartile range (IQR)) duration of stay was 9·5 (6·5, 13·0) d. After 100 d of enrolment, sustained cure (WLZ > -2 SD) could be achieved in only fifteen (30 %) infants, while another fourteen (28 %) recovered from severe wasting, but remained in moderately wasted state (WLZ between -2 and -3 sd). Overall, there were three (6 %) deaths (all during first week of hospitalisation); three (6 %) relapses and fifteen (30 %) defaulters (5, 5, 2, 1 and 2 defaulted during hospitalisation at day 15, day 60, day 75 and day 90, respectively).
The overall recovery rate from severe wasting in infants below 6 months of age was below the acceptable levels. In order to achieve better long-term outcome, community linkage services after discharge from hospital are required for supervised feeding, close monitoring and supportive care.
评估 6 月龄以下严重消瘦婴儿的结局。
2017 年 1 月至 2018 年 10 月进行的前瞻性观察性研究。
德里东部一所医学院附属医院,主要为城市贫困人群服务。
所有 1 至 6 月龄严重消瘦(身长别体重 Z 评分(WLZ)<-3sd)且需要住院的儿童。
50 名入组儿童中,住院期间 42 名(84%)恢复(WLZ>-3sd)并出院;中位(四分位间距(IQR))住院时间为 9.5(6.5,13.0)d。入组后 100d,仅 15 名(30%)婴儿持续治愈(WLZ>-2sd),而另外 14 名(28%)严重消瘦儿童恢复,但仍处于中度消瘦状态(WLZ 在-2 和-3sd 之间)。总共有 3 名(6%)儿童死亡(均在住院第 1 周);3 名(6%)患儿病情复发,15 名(30%)患儿失访(5、5、2、1 和 2 名患儿分别在住院第 15、60、75 和 90d 失访)。
6 月龄以下严重消瘦婴儿的整体恢复率低于可接受水平。为了获得更好的长期结局,需要在出院后提供社区联系服务,以进行监督喂养、密切监测和支持性护理。