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Original Articles
Epidemiological data on nutritional disorders and outcomes in hospitalized Thai children: an analysis of data from the National Health Database 2015-2019
Suchaorn Saengnipanthkul, Jeeraparn Phosuwattanakul, Kaewjai Thepsuthammarat, Nalinee Chongviriyaphan
Epidemiol Health. 2022;44:e2022047.   Published online May 16, 2022
DOI: https://doi.org/10.4178/epih.e2022047
  • 7,666 View
  • 263 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Malnutrition in hospitalized patients is a frequently overlooked health issue. We aimed to assess the prevalence and pattern of nutritional disorders in hospitalized Thai children from the National Health Database.
METHODS
Hospitalized children aged 1 month to 18 years diagnosed with nutritional disorders between 2015 and 2019 were retrospectively reviewed using the National Health Security Office data. Based on the International Classification of Diseases, 10th revision, Clinical Modification, nutritional disorders were classified into 3 major forms of malnutrition: undernutrition (E40-E46), overweight and obesity (E66), and micronutrient deficiencies (D50-D53, E50-E56, E58, E60-E61, and E63).
RESULTS
Out of 5,188,033 hospitalized children, malnutrition was identified in 115,254 (2.2%). Protein-energy malnutrition (PEM), overweight and obesity, and micronutrient deficiencies were prevalent in 0.21%, 0.27%, and 1.81%, respectively. Among those with micronutrient deficiencies, 95.0% had iron deficiency anemia, 2.2% had vitamin D deficiency, and 0.7% had zinc deficiency. Children aged under 5 years mostly had PEM, followed by iron deficiency anemia. Teenagers commonly had obesity and vitamin D deficiency. Patients with PEM who were admitted with common diseases had significantly longer hospital stays and higher hospital costs and mortality rates than those without PEM.
CONCLUSIONS
Hospitalized children had various nutritional disorders, particularly PEM, which was associated with higher morbidity and mortality. Nutritional screening tools should be utilized for the early detection and treatment of malnutrition. Specific International Classification of Diseases codes for nutritional care services and intervention should be available. Additionally, nutritional interventions should be reimbursed, along with nutritional education and empowerment of healthcare providers, to improve hospital care service and improve patient outcomes.
Summary
Key Message
Malnutrition is common among hospitalized Thai children, particularly protein energy malnutrition; it increases mortality, length of hospital stay, and hospital costs as well as exerts long-term effects on growth and development. Prevalence of overweight and obesity is increasing over the past 5 years, the vast majority involved patients 5 – 13 years of age.

Citations

Citations to this article as recorded by  
  • The Low Sensitivity and Specificity of a Nutrition Screening Tool in Real Circumstances in a Tertiary Care Hospital Setting
    Nithit Semsawat, Oraporn Dumrongwongsiri, Phanphen Phoonlapdacha
    Children.2023; 10(4): 747.     CrossRef
Impact of early-life weight status on urinary tract infections in children: a nationwide population-based study in Korea
Hyung Eun Yim, Kyung Do Han, Bongseong Kim, Kee Hwan Yoo
Epidemiol Health. 2021;43:e2021005.   Published online December 29, 2020
DOI: https://doi.org/10.4178/epih.e2021005
  • 11,376 View
  • 335 Download
  • 2 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
We aimed to evaluate the association between early-life weight status and urinary tract infection (UTI) risk in children.
METHODS
A nationwide study was conducted using Korean National Health Screening (NHS) data and National Health Insurance Service data. A sample cohort was selected using data from the 2014 and 2015 NHS for infants and children (4-71 months) and followed up until the end of 2017. Participants were divided into 4 groups (underweight, normal weight, overweight, and obese) based on the weight-for-age (< 2 years) or body mass index (≥ 2 years). Hazard ratios (HRs) with 95% confidence intervals (CIs) for developing UTIs, cystitis, and acute pyelonephritis (APN) were calculated using a Cox proportional hazard model.
RESULTS
Of 1,653,106 enrolled children, 120,142 (7.3%) developed UTIs, cystitis, and APN during follow-up. The underweight, overweight, and obese groups had higher risks of UTIs than the reference group after adjusting for age, sex, birth weight, and preterm birth. Between 2 years and 6 years of age, boys with underweight had a high risk of UTI and APN, while girls with overweight and obesity revealed elevated risks of UTIs, cystitis, and APN. The HRs for APN in boys with underweight and in girls with obesity were 1.46 (95% CI, 1.03 to 2.07) and 1.41 (95% CI, 1.13 to 1.75), respectively, after adjusting for age, sex, birth weight, and preterm birth. The incidence of APN did not decrease with age in underweight and obese children aged 2-6 years.
CONCLUSIONS
Children with underweight, overweight, and obesity may be at high risk for UTIs.
Summary
Korean summary
1. 영유아 및 소아에서 과소체중, 과체중 및 비만은 요로감염 발생 증가와 관련이 있다. 2. 본 전국적인 인구 기반 연구에서 2-6세 남아에서 과소체중을 보인 경우 요로감염과 신우신염 발생빈도가 증가하였으며, 2-6세 여아에서 과체중 및 비만을 보이는 경우 요로감염, 방광염, 신우신염 발생이 증가하였다. 3. 소아에서 적정체중을 유지하는 것이 요로감염, 방광염, 신우신염의 발생을 예방함에 있어서 중요하다.
Key Message
1. Being underweight, overweight, or obese can be associated with an increased risk of urinary tract infection in infants and children. 2. The underweight boys aged 2–6 years had a high risk of urinary tract infection and acute pyelonephritis, while the overweight and obese girls aged 2–6 years revealed increased risks of urinary tract infection, cystitis, and acute pyelonephritis in our nationwide population-based study on urinary tract infections. 3. Body weight control would be significant for the primary prevention of urinary tract infections, cystitis, and acute pyelonephritis in children.

Citations

Citations to this article as recorded by  
  • Risk factors for recurrent urinary tract infections in young infants under the age of 24 months
    Min Hwa Son, Hyung Eun Yim
    Childhood Kidney Diseases.2024; 28(1): 35.     CrossRef
  • Childhood Body Mass Index (BMI) and the Risk of Infection: A Narrative Review
    Houman Hashemian, Mohammad Ali Esfandiari, Setila Dalili
    Journal of Comprehensive Pediatrics.2023;[Epub]     CrossRef
  • Kidney Considerations in Pediatric Obesity
    Alexandra Sawyer, Evan Zeitler, Howard Trachtman, Petter Bjornstad
    Current Obesity Reports.2023; 12(3): 332.     CrossRef
  • Association of body weight and urinary tract infections during infancy: a nationwide comparative matched cohort study
    Peong Gang Park, Ji Hyun Kim, Yo Han Ahn, Hee Gyung Kang
    Childhood Kidney Diseases.2023; 27(2): 111.     CrossRef
  • Obesity and chronic kidney disease: prevalence, mechanism, and management
    Hyung Eun Yim, Kee Hwan Yoo
    Clinical and Experimental Pediatrics.2021; 64(10): 511.     CrossRef
Recovery time from severe acute malnutrition and associated factors among under-5 children in Yekatit 12 Hospital, Addis Ababa, Ethiopia: a retrospective cohort study
Mekonen Adimasu, Girum Sebsibie, Fikrtemariam Abebe, Getaneh Baye, Kerebih Abere
Epidemiol Health. 2020;42:e2020003.   Published online February 2, 2020
DOI: https://doi.org/10.4178/epih.e2020003
  • 13,853 View
  • 393 Download
  • 8 Web of Science
  • 10 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Recovery time from severe acute malnutrition (SAM) is often a neglected topic despite its clinical impact. Although a few studies have examined nutritional recovery time, the length of hospitalization in those studies varied greatly. Therefore, the aim of this study was to determine the recovery time from SAM and to identify predictors of length of hospitalization among under-5 children.
METHODS
A retrospective cohort study was conducted among 423 under-5 children with SAM who had been admitted to Yekatit 12 Hospital. Kaplan-Meier analysis was used to estimate time to nutritional recovery, and Cox proportional hazard regression analysis was performed to determine independent predictors.
RESULTS
The nutritional recovery rate was 81.3%, and the median recovery time was 15.00 days (95% confidence interval [CI], 13.61 to 16.39). Age, daily weight gain per kilogram of body weight, vaccination status, and the existence of at least 1 comorbidity (e.g., pneumonia, stunting, shock, and deworming) were found to be significant independent predictors of nutritional recovery time. The adjusted hazard ratio (aHR) for nutritional recovery decreased by 1.9% for every 1-month increase in child age (aHR, 0.98; 95% CI, 0.97 to 0.99).
CONCLUSIONS
The overall nutritional recovery time in this study was within the Sphere standards. However, approximately 13.0% of children stayed in the hospital for more than 28.00 days, which is an unacceptably large proportion. Daily weight gain of ≥8 g/kg, full vaccination, and deworming with albendazole or mebendazole reduced nutritional recovery time. Conversely, older age, pneumonia, stunting, and shock increased nutritional recovery time.
Summary

Citations

Citations to this article as recorded by  
  • Stabilizing time and its predictors among 1–59 months old children managed for severe acute malnutrition during the humanitarian crisis in Tigray regional state of Ethiopia, 2023: a prospective cohort study
    Wagnew Tesfay, Mebrahtu Abay, Berhane Fseha Teklehaimanot, Ataklti Gebremedhin
    BMC Pediatrics.2024;[Epub]     CrossRef
  • Predictors of recovery from severe acute malnutrition among 6–59 months children admitted to a hospital
    Assefa Andargie, Segenet Zewdie
    Frontiers in Public Health.2024;[Epub]     CrossRef
  • Time to recovery from severe acute malnutrition and its predictors among under five children admitted to therapeutic feeding units of general and referral hospitals in Tigray, Ethiopia, 2020: a prospective cohort study
    Gebretsadkan Fisseha Kidane, Kidane Zereabruk, Woldu Aberhe, Abrha Hailay, Guesh Mebrahtom, Gebreamlak Gebremedhn Gebremeskel, Teklehaimanot Gereziher Haile, Desalegn Massa Teklemichael
    BMC Pediatrics.2023;[Epub]     CrossRef
  • Impact of malnutrition on the outcome and length of hospital stay in elective pediatric surgical patients: prospective cohort study at tertiary hospitals in Ethiopia
    Belachew D. Wondemagegnehu, Woubedel K. Aklilu, Milliard D. Beyene, Bareng A. Sanny Nonyane
    BMC Nutrition.2023;[Epub]     CrossRef
  • Comorbidities of Child Malnutrition in Low- and Medium-Income Countries: A Systematic Review
    Tshepiso Moate, Tinda Rabie, Catharina Minnie, Anne Mäenpää
    Journal of Pediatric Gastroenterology & Nutrition.2022; 75(4): 400.     CrossRef
  • Severe acute malnutrition’s recovery rate still below the minimum standard: predictors of time to recovery among 6- to 59-month-old children in the healthcare setting of Southwest Ethiopia
    Seyum Ebissa Eyi, Gebiso Roba Debele, Efrem Negash, Kebebe Bidira, Debela Tarecha, Kabtamu Nigussie, Mohammedamin Hajure, Mohammedjud Hassen Ahmed, Bilisumamulifna Tefera Kefeni
    Journal of Health, Population and Nutrition.2022;[Epub]     CrossRef
  • Preparation and quality characterization of marine small pelagic fish powder: A novel ready-to-use nutritious food product for vulnerable populations
    Abdullah-Al Mamun, Shuva Bhowmik, Md. Shahid Sarwar, Sharmin Akter, Tanjina Pias, MUM Abu Zakaria, Md. Monirul Islam, Hillary Egna, Ford Evans, Md Abdul Wahab, Shakuntala Haraksingh Thilsted, David C. Little
    Measurement: Food.2022; 8: 100067.     CrossRef
  • Assessment, outcomes and implications of multiple anthropometric deficits in children
    Idzes Kundan, Rajalakshmi Nair, Shashwat Kulkarni, Aparna Deshpande, Raju Jotkar, Mrudula Phadke
    BMJ Nutrition, Prevention & Health.2021; 4(1): 267.     CrossRef
  • Risk factors for severe acute malnutrition among children aged 6–59 months: A community-based case-control study from Vellore, Southern India
    SamM David, RubyA Pricilla, SherinS Paul, Kuryan George, Anuradha Bose, JasminH Prasad
    Journal of Family Medicine and Primary Care.2020; 9(5): 2237.     CrossRef
  • Time to Recovery and Its Predictors among Children 6–59 Months Admitted with Severe Acute Malnutrition to East Amhara Hospitals, Northeast Ethiopia: A Multicenter Prospective Cohort Study
    Telahun Kasa Tefera, Solomon Mekonnen Abebe, Melkamu Tamir Hunegnaw, Freezer Girma Mekasha
    Journal of Nutrition and Metabolism.2020; 2020: 1.     CrossRef
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