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|Title: ||MALNUTRITION: MISSED OPPORTUNITIES FOR DIAGNOSIS|
|Authors: ||ANTWI, Sampson|
|Issue Date: ||2008|
|Publisher: ||GHANA MEDICAL JOURNAL|
|Abstract: ||Introduction: Malnutrition is a serious public health
problem particularly in developing countries where it is
responsible for 54% of under 5s mortality. Anthropometric
measurements are key tools for the assessment of
nutritional status and diagnosis of malnutrition. Height
and weight measurements are not routinely done in
most clinics and hospitals in Ghana. Children therefore
miss the opportunity for accurate nutritional assessment
and detection of malnutrition.
Objectives: To determine the prevalence of wasting
among children <5 years and to document extent of
Method: From June to August 2004, children aged >3
months to <5 years attending the outpatient clinic of
Komfo Anokye Teaching Hospital were systematically
assessed for wasting using weight-for-height standard
deviation score (Z-score).
Results: Of 1182 children (mean age 24.9 months),
251 (21.2%) were wasted, 48 (4.1%) of them severely.
Only 15 (5.9%) of the 251 children with wasting were
so identified by the attending physician.
Conclusion: Malnutrition is widespread yet underdiagnosed.
Anthropometric measurements should be
promoted in all child health clinics.
Keywords: wasting, malnutrition, weight-for-height,
Z-score, missed opportunities
Nutritional disorders stem from imbalance between
supply of protein-energy and the body’s demand for
them to ensure optimal growth and function. This imbalance
includes both inadequate and excessive nutrient
intake; the former leading to malnutrition in the
form of wasting, stunting and underweight whilst the
latter results in overweight and obesity.
Malnutrition, defined in this context as nutritional deficiency,
is a serious public health problem that has been
linked to a substantial increase in the risk of mortality
and morbidity.1 It is estimated that 9% of children below
5 years of age globally suffer from wasting.2 In
developing countries, however, prevalence of malnutrition
among the under 5s is estimated at 27%.3 Malnutrition
is responsible for 54% of all deaths among children
<5 years of age.4 It is important, therefore, that
children are properly assessed for evidence of malnutrition.
The assessment of nutritional status according to
weight-for-height, height-for-age and presence of nutritional
oedema is summarised in Table 1. Whilst the
child with oedematous malnutrition could easily be
identified by most clinicians, wasting as a form of malnutrition
could easily be missed if anthropometric
measurements are not done. Growth assessment in
terms of anthropometry is routinely done at child welfare
|Description: ||This article is published in GHANA MEDICAL JOURNAL|
|Appears in Collections:||College of Agric and Natural Resources|
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