The prevalence and impact of malnutrition in hospitalized adult patients in Mbagathi District Hospital, Nairobi – Kenya

Achar, Esther Amondi (2019-03)

Thesis (MNutr)--Stellenbosch University, 2019.

Thesis

ENGLISH SUMMARY : Introduction: Malnutrition is a public health problem that is affecting both the developed and developing world, and in Africa, little focus has been placed on the presence of malnutrition in hospitalized adults in recent years. Its prevalence among hospitalized patients ranges between 30% and 76%. Malnutrition was first identified by Florence Nightingale in soldiers of war and was first reported by Charles Butterworth in 1974. Both persons identified malnutrition as a problem that was undiagnosed and overlooked in most settings. Most studies conducted in Africa have not highlighted the burden of adult malnutrition within the hospital setting, yet malnutrition is associated with negative treatment outcomes in affected patients. The aim of this study was to determine the prevalence of risk of malnutrition among hospitalized adult patients in Mbagathi District Hospital, a public hospital in Kenya. Methods: Patients above 18 years old were screened for eligibility within 48 hours of their admission. The nutrition risk screening tool (NRS-2002) was used to identify the prevalence of risk of malnutrition in patients among the various disease categories at both admission and discharge. Patients were drawn from medical, surgical and gynaecological wards. Referral of malnourished patients for nutrition support was also investigated. Results: The study included 384 adult patients, of which 55.2% (n=212) were female. Discharge information was obtained from 94 patients. The mean age on admission was 39.61 ±13.86 years, average BMI of 19.0 ±4.7 kg/m2, mean nutritional risk score was 3.39 ±1.09 SD and the average length of hospital stay was 7.5 ±5.0 days. The prevalence of the risk of malnutrition was 81.9% on admission and 77.6% on discharge. The highest prevalence of malnutrition was among patients diagnosed with HIV/TB, followed by those with gastrointestinal tract and respiratory infections. Despite the malnutrition risks being high on admission, the number of referrals made for nutrition support was low at 33%. Conclusion: The prevalence of risk of malnutrition is high among hospitalized adult patients. In most cases patients are not referred for nutrition support despite studies having shown its negative impact on treatment outcomes.

AFRIKAANSE OPSOMMING : Inleiding: Wanvoeding is ‘n probleem van publieke gesondheid omvang wat beide ontwikkelde en ontwikkelende lande betrek. Min fokus word geplaas op die voorkoms van wanvoeding in gehospitaliseerde volwassenes in Afrika. Die prevalensie van risiko tot wanvoeding onder gehospitaliseerde pasiënte wissel tussen 30% en 76%. Florence Nightingale was die eerste persoon om wanvoeding te identifiseer onder oorlog soldate en dit is die eerste keer rapporteer deur Charles Butterworth in 1974. Beide hierdie persone het wanvoeding identifiseer as ‘n probleem wat onderdiagnoseer is en oorgesien word in die meerderheid gevalle. Die meerderheid studies gedoen in Afrika het nie die las van volwasse wanvoeding in die hospitaal omgewing uitgelig nie. Tog word wanvoeding geassosieer met negatiewe uitkomste wat pasiënte affekteer. Die doel van hierdie studie was om die prevalensie van risiko tot wanvoeding onder gehospitaliseerde volwasse pasiënte in Mbagathi Distrik Hospitaal, ‘n publieke hospitaal in Kenia, te identifiseer. Metodes: Pasiënte ouer as 18 jaar waas gesif vir geskiktheid binne 48 uur na toelating. Die voeding siftingstoets (NRS-2002) was gebruik om die prevalensie van risiko tot wanvoeding in pasiënte (met verskillende siekte kategorieë) met toelating en ontslag te identifiseer. Pasiënte van mediese, chirurgiese en ginekologiesale is ingesluit. Verwysing van wangevoede pasiënte vir voedingsondersteuning is ook bepaal. Resultate: ‘n Totaal van 384 volwasse pasiënte, waarvan 55.2% (n=212) vroulik, is ingesluit. Ontslag inligting is verkry van 94 pasiënte. Die gemiddelde ouderdom met toelating was 39.61 ±13.86 jaar, gemiddelde liggaamsmassa indeks BMI was 19.0 ±4.7 kg/m2, gemiddelde voedings risiko telling was 3.39 ±1.09 SD en die gemiddelde duurte van hospitaalverblyf was 7.5 ±5.0 dae. Die prevalensie van risiko tot wanvoeding was 81.9% met toelating en 77.6% met ontslag. Die hoogste prevalensie van risiko tot wanvoeding was onder pasiënte met HIV/TB, gevolg deur diegene met gastrointestinale siektes en respiratorieses infeksies. Al was die risiko vir wanvoeding hoog met toelating, was die aantal verwysings vir voedingsondersteuning laag op 33%. Gevolgtrekking: Die prevalensie van risiko tot wanvoeding is hoog onder gehospitaliseerde volwasse pasiënte. In baie gevalle word die pasiënte nie verwys vir voedingondersteuning nie, ten spyte van studies wat die negatiewe effek van wanvoeding op behandelingsuitkomste bewys het.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/105646
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