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Open Access Research article

Predictors of oedema among children hospitalized with severe acute malnutrition in Jimma University Hospital, Ethiopia: a cross sectional study

Tsinuel Girma1*, Pernille Kæstel2, Christian Mølgaard2, Kim F Michaelsen2, Anne-Louise Hother2 and Henrik Friis2

Author Affiliations

1 Department of Pediatrics and Child Health, Jimma University Specialized Hospital, Jimma, Ethiopia

2 Department of Nutrition, Exercise and Sports University of Copenhagen Frederiksberg Campus, Rolighedsvej 30, Frederiksberg C DK-1958, Denmark

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BMC Pediatrics 2013, 13:204  doi:10.1186/1471-2431-13-204

Published: 6 December 2013

Abstract

Background

Severe acute malnutrition has two main clinical manifestations, i.e., oedematous and non-oedematous. However, factors associated with oedema are not well established.

Methods

Children 0.5-14 years of age with SAM (MUAC < 11.0 cm or weight-for-height < 70 % of median and/or nutritional oedema) admitted to the nutrition unit were included. Information on infections before and during admission was collected together with anthropometry. Predictors of oedema was analysed separately for younger (< 60 months) and older children (≥ 60 months).

Results

351 children were recruited (median age: 36 months (interquartile range 24 to 60); 43.3% females). Oedema was detected in 61.1%. The prevalence of oedema increased with age, peaked at 37–59 months (75%) and declined thereafter. Infection was more common in the younger group (33% vs. 8.9%, p < 0.001) and in this group children with oedema had less infections (25.2% vs. 45.1%, p = 0.001). In the older group the prevalence of infections was not different between oedematous and non-oedematous children (5.5% v. 14.3%, p = 0.17). In the younger group oedema was less common in children with TB (OR = 0.20, 95% CI: 0.06, 0.70) or diarrhea (OR = 0.40, 95% CI: 0.21, 0.73).

Conclusions

The proportion of oedema in SAM peaked at three to five years of age and a considerable proportion was above 5 years. Furthermore, the prevalence of infection seemed to be lower among children with oedema. Further studies are needed to better understand the role of infection-immunity interaction.

Keywords:
Severe acute malnutrition; Oedema; Infection; Risk; Predictors