Mortality outcome of hospitalized children aged six to fifty-nine months in relation to different anthropometric indices: an observational cohort study

Authors

  • Praveen Kumar Department of Paediatric, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India
  • Abner Daniel Child Development and Nutrition, UNICEF, New Delhi, India
  • Rajesh Kumar Sinha National Centre for Excellence on SAM Management (NCoE-SAM), Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India
  • Virendra Kumar Department of Paediatric, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India
  • Anju Seth Department of Paediatric, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India
  • Harish Pemde Department of Paediatric, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India
  • Srikanta Basu Department of Paediatric, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India
  • Jagdish Chandra Department of Paediatric, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India
  • Arjan de Wagt Child Development and Nutrition, UNICEF, New Delhi, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20205724

Keywords:

Children aged 6-59 months, In-patient mortality, Malnutrition, Mid-upper-arm-circumference, Weight-for-height z-score

Abstract

Background: Malnutrition among children is a major public health problem and an underlying cause of millions of child deaths across the globe. The WHO has provided criteria for identifying malnourished children aged 6-59 months however, these criteria have not been fully evaluated against the risk of in-patient mortality. The observational study was conducted to assess the predictability of in-patient mortality of children aged 6-59 months for different anthropometric criteria to understand which diagnostic criteria most accurately predict in-patient mortality.

Methods: Data from a cohort of children aged 6-59 months, admitted to Kalawati Saran Children’s Hospital, New Delhi between January to October 2019 was analysed. The effect of anthropometric indexes, individually and in combinations, to predict in-patient mortality was assessed using cox regression survival analysis and receivers operating characteristics curves.

Results: A total of 3101 children aged 6-59 months were admitted, of which 123 (4.0%) died in the hospital. Among them, 30.1% were severely underweight, 19.3% were severely wasted and 23.0% were severely stunted. WHZ<˗3 and/or MUAC<115 mm was the most sensitive predictor of mortality (sensitivity: 75.0%; specificity: 42.3%; PPV: 6.5%; NPV: 96.9%; AUC: 0.59, 95% CI: 0.53-0.64) with the largest adjusted hazard ratio (aHR=1.53; p value <0.05).

Conclusions: WHZ<˗3 and/or MUAC<115 mm was the most sensitive predictor out of all individual and combined anthropometric indexes in identifying children aged 6-59 months at risk of mortality. Children in this category should be properly managed during their inpatient stay.

Author Biographies

Praveen Kumar, Department of Paediatric, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India

Director Professor

Abner Daniel, Child Development and Nutrition, UNICEF, New Delhi, India

Nutrition Specialist

Rajesh Kumar Sinha, National Centre for Excellence on SAM Management (NCoE-SAM), Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India

Program Manager

Virendra Kumar, Department of Paediatric, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India

Head of the Department (HOD)

Anju Seth, Department of Paediatric, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India

Director Professor

Harish Pemde, Department of Paediatric, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India

Director Professor

Srikanta Basu, Department of Paediatric, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India

Professor

Jagdish Chandra, Department of Paediatric, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India

Director Professor

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Published

2020-12-25

How to Cite

Kumar, P., Daniel, A., Sinha, R. K., Kumar, V., Seth, A., Pemde, H., Basu, S., Chandra, J., & de Wagt, A. (2020). Mortality outcome of hospitalized children aged six to fifty-nine months in relation to different anthropometric indices: an observational cohort study. International Journal Of Community Medicine And Public Health, 8(1), 372–378. https://doi.org/10.18203/2394-6040.ijcmph20205724

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Original Research Articles