Validation of the Subjective Global Nutrition Assessment (SGNA) and Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) to Identify Malnutrition in Hospitalized Malaysian Children

by Shu Hwa Ong, Winnie Siew Swee Chee, L Mageswary Lapchmanan, Shan Ni Ong, Zhi Chin Lua, and Jowynna Xia-Ni Yeo

Published in Journal of Tropical Pediatrics, 01 February 2019. https://doi.org/10.1093/tropej/fmy009

 

Early detection of malnutrition in hospitalized children helps reduce length of hospital stay and morbidity. A validated nutrition tool is essential to correctly identify children at risk of malnutrition or who are already malnourished. This study compared the use of the Subjective Global Nutrition Assessment (SGNA, nutrition assessment tool) and Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP, nutrition screening tool) with objective nutritional parameters to identify malnutrition in hospitalized children.

 

A cross-sectional study was carried out in two general paediatric wards in a public hospital. SGNA and STAMP were performed on 82 children (52 boys and 30 girls) of age 1–7 years. The scores from both methods were compared against Academy of Nutrition and Dietetics/American Society of Parental and Enteral Nutrition Consensus Statement for identification of paediatric malnutrition. The objective measurements include anthropometry (weight, height and mid-arm circumference), dietary intake and biochemical markers (C-reactive protein, total lymphocytes and serum albumin). Kappa agreement between methods, sensitivity, specificity and cross-classification were computed.

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Pneumonia in HIV-exposed and Infected Children and Association With Malnutrition

by Iroh Tam, Pui-Ying, MD; Wiens, Matthew O., PhD; Kabakyenga, Jerome, PhD; Kiwanuka, Julius, MBChB; Kumbakumba, Elias, MB ChB; Moschovis, Peter P., MD

Published in the Pediatric Infectious Disease Journal, October 2018

 

 

"We evaluated the association between HIV exposed-uninfected (HEU) status, malnutrition and risk of death in Ugandan children hospitalized with pneumonia. Both HIV exposure and infection were associated with lower anthropometric indices on univariate analysis, and mid-upper arm circumference was significantly associated with overall mortality (odds ratio (OR), 0.96) in a multivariable model. HIV infection (OR 5.0) but not HEU status was associated with overall mortality. Malnutrition may contribute to poor pneumonia outcomes among HIV-infected and HEU children requiring hospitalization."

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Reduction in child mortality in Ethiopia: analysis of data from demographic and health surveys

by Doherty T, Rohde S, Besada D, Kerber K, Manda S, Loveday M, Nsibande D, Daviaud E, Kinney M, Zembe W, Leon N, Rudan I, Degefie T, Sanders D. 

 

Using the Lives Saved Tool in combination with coverage of child survival interventions and nutritional status of children in Ethiopia between 2000 and 2011, researchers estimated  the impact of changes in coverage of child survival interventions on under-5 lives saved. These estimates were generated using 3 Ethiopia Demographic and Health Surveys (between 2000 and 2011):

 

"The mortality rate in children younger than 5 years decreased rapidly from 218 child deaths per 1000 live births in the period 1987-1991 to 88 child deaths per 1000 live births in the period 2007-2011. The prevalence of moderate or severe stunting in children aged 6-35 months also declined significantly. Improvements in the coverage of interventions relevant to child survival in rural areas of Ethiopia between 2000 and 2011 were found for tetanus toxoid, DPT3 and measles vaccination, oral rehydration solution (ORS) and care-seeking for suspected pneumonia. The LiST analysis estimates that there were 60 700 child deaths averted in 2011, primarily attributable to decreases in wasting rates (18%), stunting rates (13%) and water, sanitation and hygiene (WASH) interventions (13%)." 

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Relationship between growth and illness, enteropathogens and dietary intakes in the first 2 years of life: findings from the MAL-ED birth cohort study

Published in BMJ Global Health

 

While factors like diet and illness affect the risk of growth faltering, the role that enteropathogens play is less clear. As part of the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study, researchers aimed to quantify the effects of enteropathogen infection, diarrhoea and diet on child growth.

 

Using a linear piecewise spline model researchers "quantified associations of each factor with growth velocity in seven of eight MAL-ED sites; cumulative effects on attained size at 24 months were estimated for mean, low (10th percentile) and high (90th percentile) exposure levels. Additionally, the six most prevalent enteropathogens were evaluated for their effects on growth."

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Changes in susceptibility to life-threatening infections after treatment for complicated severe malnutrition in Kenya

by authors Ngari MM, Mwalekwa L, Timbwa M, Hamid F, Ali R, Iversen PO, Fegan GW, Berkley JA

 

To treat severe acute malnutrition (SAM) and prevent short-term mortality, better understanding how quickly and how much the risk of serious illness changes during rehabilitation could inform improving intervention design and scope. Researchers aimed to investigate changes in the risk of life-threatening events (LTEs) in relation to anthropometric recovery from SAM. 

 

Through a secondary analysis of a clinical trial, researchers found that "anthropometric response was associated with a rapid and substantial reduction in risk of LTEs. However, reduction in susceptibility lagged behind anthropometric improvement. Disease events, together with anthropometric assessment, may provide a clearer picture of the effectiveness of interventions." Furthermore, researchers call for "robust protocols for detecting and treating poor anthropometric recovery and addressing broader vulnerabilities that complicated SAM indicates" to help save lives. 

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