Abstract

Aim: A retrospective descriptive study was carried out to evaluate and address some selected variables of admitted children with severe acute malnutrition to five selected nutritional rehabilitation wards in Basrah, three central Hospitals, and two district hospitals. As well as to assess the extent of implementation of world health organization guidelines for management of severe acute malnutrition.
Methods: The data registries of the selected nutritional rehabilitation wards are reviewed from 1st of January till 31st of December 2015. The following information were reviewed: date of birth, sex, Z score (weight for length), weight on admission and discharge, weight gain, oedema, days of hospitalization, clinical diagnosis on admission and the outcome on discharge.
Result: Total number of registered patients are 530 with males and females percentage of (53.2% and 46.8%) respectively. Sixty six percent of admitted patients were aged below 12 months. Clinical presentation of admitted patients reveals that more than 50% of patients had diarrhoea followed by pneumonia (21%) and poor weight gain (13%). Facilities of studied hospitals were limited regarding allocated wards, beds and nursing staff, only Basrah General Hospital has isolated nutritional rehabilitation ward with 12 beds and 7 trained staff, other wards are just a room within paediatrics wards with 4-6 beds and only 2 nursing staff. Although high percentage of severe wasting, underweight and stunting reported in nutritional rehabilitation wards with statistically significant result P-value 0.001 still moderate malnutrition reported in (27%) of admitted patients. Poor weight gain was reported in 48% of total studied patients, with higher percentage of good weight gain in nutritional rehabilitation ward of Basrah General Hospital (93.7%) and least recorded percentage was (9.3%) in Al-Zubair Hospital. The outcome of the studied patients reveals that; (56.8%) of patients recovered with improvement of clinical symptoms and weight gain, the higher percentage was in the nutritional rehabilitation ward of Basrah General Hospital(85.5%) and the least one was in Basrah Maternity and Children's Hospital (38.3%). Short hospitalizations period is obvious from registered data approximately 59.4% of patients stayed for (1-5) days and only 4.9% stayed for (11-15) days. Days of hospitalization, weight gain and clinical presentation can be regarded as dependent risk factors associated with good outcome in malnourished patients.
Conclusion: This study concludes that management of severe acute malnutrition was not satisfactory and incomplete with faulty recording of the registered data of admitted patients. Current study recommended that the documentation of all data and records seriously will result in better understanding of the reality of nutritional rehabilitation wards.