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Prognostic factors in children with severe acute malnutrition at a tertiary hospital in Cape Town, South Africa
Thesis (MMed)--Stellenbosch University, 2014.
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| Format: | Thesis |
| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2015
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| _version_ | 1867613803977375744 |
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| access_status_str | Open Access |
| author | Swanson, Lenise C. |
| author2 | Nel, Etienne |
| author_browse | Nel, Etienne Swanson, Lenise C. |
| author_facet | Nel, Etienne Swanson, Lenise C. |
| author_sort | Swanson, Lenise C. |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MMed)--Stellenbosch University, 2014. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/95784 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:41:57.021Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2015 |
| publishDateRange | 2015 |
| publishDateSort | 2015 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/95784 Prognostic factors in children with severe acute malnutrition at a tertiary hospital in Cape Town, South Africa Swanson, Lenise C. Nel, Etienne Cooke, Melissa Louise Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health. Severe acute malnutrition -- South Africa -- Cape Town Malnutrition in children -- Prognosis Edema UCTD Thesis (MMed)--Stellenbosch University, 2014. ENGLISH ABSTRACT: Severe acute malnutrition (SAM) remains a common problem worldwide and causes many childhood deaths. The World Health Organisation (WHO) aims for a case-fatality rate of <5% and has an established protocol to optimally manage patients. AIMS AND METHODS: We aimed to identify prognostic factors affecting the outcome of children under the age of 5 years admitted with severe acute malnutrition with oedema. This was a retrospective descriptive study over 2 years at a tertiary hospital in Cape Town, South Africa, documenting demographic details, co-morbidity including HIV exposure or infection, referral pattern, laboratory results, complications and clinical outcome. RESULTS: There were 59 patients with a median age of 12 months of whom 33 (56%) were male. Thirty-two children (54%) already had documented growth faltering and 9 of these 32 children (28.1%) died. There were 24 patients (40.6%) transferred from other hospitals, and they did significantly worse than children referred from community clinics (mortality rate 58.3% vs. 5.7%) (p<0.01). Fourteen children (23.7%) were HIV positive with a mortality rate of 42.8%. The overall mortality was 28.9%, with 81% of deaths occurring within the first 72 hours. Liver impairment (p<0.05), very low serum phosphate (p<0.01), and positive blood cultures (p<0.02) were all significantly associated with an increased risk of dying. CONCLUSION: Our mortality rate for SAM is high. Children with SAM need to be carefully assessed and managed, particularly during the first 72 hours, when mortality is highest, with additional vigilance in those who have poor prognostic factors. Growth faltering should be identified early and appropriately acted upon. 2015-01-13T11:46:55Z 2016-02-28T03:00:08Z 2014-12 Thesis http://hdl.handle.net/10019.1/95784 en_ZA Stellenbosch University 33 pages application/pdf application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Severe acute malnutrition -- South Africa -- Cape Town Malnutrition in children -- Prognosis Edema UCTD Swanson, Lenise C. Prognostic factors in children with severe acute malnutrition at a tertiary hospital in Cape Town, South Africa |
| title | Prognostic factors in children with severe acute malnutrition at a tertiary hospital in Cape Town, South Africa |
| title_full | Prognostic factors in children with severe acute malnutrition at a tertiary hospital in Cape Town, South Africa |
| title_fullStr | Prognostic factors in children with severe acute malnutrition at a tertiary hospital in Cape Town, South Africa |
| title_full_unstemmed | Prognostic factors in children with severe acute malnutrition at a tertiary hospital in Cape Town, South Africa |
| title_short | Prognostic factors in children with severe acute malnutrition at a tertiary hospital in Cape Town, South Africa |
| title_sort | prognostic factors in children with severe acute malnutrition at a tertiary hospital in cape town south africa |
| topic | Severe acute malnutrition -- South Africa -- Cape Town Malnutrition in children -- Prognosis Edema UCTD |
| url | http://hdl.handle.net/10019.1/95784 |
| work_keys_str_mv | AT swansonlenisec prognosticfactorsinchildrenwithsevereacutemalnutritionatatertiaryhospitalincapetownsouthafrica |