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Research Article | | Peer-Reviewed

Therapeutic and Evolutionary Profiles of Children Aged 0-59 Months: A Case Study of Severe Acute Malnourished Treated at Hôpital Notre Dame Des Apôtres, N'Djamena

Kemoral Aristide,  Abdelsalam Adoum Doutoum*,  Alhadj Markhous Nazal,  Barka Abakoura,  Kodji Laurent,  Gondimo Gabdibe Elysée,  Tog-Yangue Allanidjimte,  Abdelsalam Tidjani
Published in International Journal of Nutrition and Food Sciences (Volume 13, Issue 2)
Received: 26 February 2024     Accepted: 14 March 2024     Published: 2 April 2024
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Abstract

According to the World Health Organization, malnutrition is a pathological condition resulting from the relative or absolute insufficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biological, anthropometric or physiological analyses. It remains a major public health problem. The aim of this study was therefore to determine the therapeutic and evolutionary profiles of Severe Acute Malnutrition patients at Notre Dame des Apôtres Hospital in N'Djaména (Chad). This was a prospective, descriptive study carried out on 7 months, from January 1 to July 31, 2023. This included all severely acutely malnourished children with medical complications admitted to the hospital's therapeutic nutrition unit. The variables studied were therapeutic and evolutionary. Data were entered and analyzed using Excel 2016 spreadsheet and SSPS 18.0 software. Among the 1454 children admitted to the unit during our study, 41.82% were stabilized, 6.75% cured and 0.79% abandoned, with an average length of stay of 8.67 days. The mortality rate was 1.76%. Children on F75 accounted for 46%, 37% on plumpy nut and 10% on F100. Antibiotics and multivitamins are routinely used in the management of malnourished children. The results of this study show that parent education could be an asset in the management of severe acute malnutrition.

Published in International Journal of Nutrition and Food Sciences (Volume 13, Issue 2)
DOI 10.11648/j.ijnfs.20241302.12
Page(s) 20-23
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

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Copyright © The Author(s), 2024. Published by Science Publishing Group
Previous article
Keywords

Children Aged 0-59 Months, Severe Acute Malnutrition, Therapeutic, Evolutionary, N'Djaména

1. Introduction
Severe acute malnutrition is caused by a very low weight/height ratio (below -3 z score compared to the WHO median reference value), by visible and severe emaciation or by the presence of nutritional edema. In children aged between 6 and 59 months, an arm circumference of less than 110 mm is also an indication
[1]
. According to the WHO, it can be a direct cause of mortality in children, or have indirect effects by considerably increasing the case-fatality rate of children suffering from common illnesses such as diarrhea or pneumonia. It is estimated that nearly 20 million children in the World suffer from severe acute malnutrition, most of them in South Asia and sub-Saharan Africa
[2]
. About one million children die each year as a result of severe acute malnutrition
[3]
. According to WHO estimates, 19 million pre-school children suffer from severe wasting
[4, 5]
, a large proportion of them living in the African Region (26%), (70%) in the South-East Asian Region and 4% in Latin America and the Caribbean
[6]
.
The SMART 2022 survey revealed that in Chad, the prevalence of Global Acute Malnutrition in 2022 was 8.6% below the high threshold of 10% set by the WHO, placing the country in a situation of average precariousness in terms of public health
[7]
. Chad had the 10th highest infant mortality rate in the world in 2005
[8]
. Almost one Chadian child in eight (8) dies before reaching the age of five (5), and over 322,000 suffer from severe acute malnutrition every year
[9]
. The frequency of severe acute malnutrition, which is still close to the WHO's high threshold, suggests that the programs implemented to eradicate it, such as the mosquito net distribution program, the national deworming program and the vaccination campaigns, have failed by 2021, the SMART nutrition survey showed that the main causes of this mortality are related to infectious diseases such as malaria (20.4%), pneumonia (15.7%) and diarrhea (13.5%), parasitized children (67.1%) etc., with malnutrition a major contributing factor
[7]
. The nutritional status of children under the age of 5 remains a public health problem in Chad. This is the context of our study, the general aim of which is to determine the therapeutic and evolutionary profiles of Severe Acute Malnutrition patients at Notre Dame des Apôtres Hospital in N'Djamena.
2. Material and Methods

2.1. Study Framework

The Therapeutic Nutritional Unit (TNU) of the Notre Dame des Apostles Hospital (HNDA) served as our study site. This hospital is located in the southwest of the city of N'Djamena in 15°04'50''East of Longitude and 12°05'38'' North of Latitude, at approximately 280 meters above sea level
[10]
.

2.2. Type and Period of Study

This was a prospective descriptive study carried out during a period of 07 months from January 1 to July 31, 2023.

2.3. Study Population

The study concerned all cases of SAM children aged 0 to 59 months with one or more medical complications admitted to the HNDA TNU.

2.4. Data Collection

The collection of our data consisted of systematic recruitment of all patients seen during the period of our study. Data collection was done by interviewing patient guards. The clinical examination, the additional assessment and collected information were recorded in a previously prepared data collection sheet. The dependent variable of this study is the occurrence of severe acute malnutrition in children under 59 months. As part of our study, the WHO 2006 standards were used for classification
[11]
. The independent variables concerned the characteristics of the child and the parents.

2.5. Data Analysis

Word processing and tables were carried out using Microsoft Word software version 2016. Graphs were created using Excel 2016. Data entry and analysis were done using the software SPSS 18.0.
3. Results

3.1. Characteristics of Surveyed Children

During the study period, 1454 children were admitted to the Therapeutic Nutritional Unit at Notre Dame des Apôtres Hospital, N'Djamena. Males represented 54% of cases and females 46%. Emaciation accounted for 74.27% of cases, edematous children for 6.18%.
Figure 1. Distribution of cases by food type.

3.2. Therapeutic Data

3.2.1. Feeding

With regard to therapeutic foods, F75, F100, diluted F100 and Plumpy NUT were the main diets used in the nutritional management of our patients, with frequencies of 46%, 10%, 7% and 37% respectively.

3.2.2. Drug Treatments

Antibiotics and multivitamins were administered to 100% of our patients following the protocol, 80.81% were on antifungals and 70.63% of children were malarial. 72.07% of children were dewormed.
Figure 2. Summary of drug treatments (%).

3.3. Evolutionary Data

3.3.1. Progression

41.82% of patients were stabilized during the study period. Cured patients accounted for 6.75% of cases, while 0.79% of dropouts were recorded. 1.76% of malnourished children died, and 0.30% of patients were referred.
Figure 3. Variation in evolutionary data according to sample type (p<0.05).
Figure 4 shows the variation in evolutionary data according to sample type. With p <0.05, there is a significant difference, as the rates of stabilized, discharged and cured children are much higher than those of dropouts, referrals and deaths.

3.3.2. Length of Hospital Stay

The average length of hospitalization for a SAM child at TNU was 8.67 days. 53% of children stayed between 0 and 7 days, while 5% stayed more than 21 days.
Figure 4. Distribution of cases by length of hospital stay.
4. Discussion
In terms of therapeutic foods, F75 and Plumpy nut were the main diets used in the nutritional management of our patients. This could be justified by the fact that therapeutic milk-based formulas such as F75 and Plumpy nut enable effective nutritional recovery probably due to their high protein and nutrient content. Antibiotics and multivitamins are used systematically in the management of malnourished patients, in accordance with the national management protocol. Children aged 6 months and over are systematically dewormed when released from hospital. The cases of abandonment observed in this study are due to the non-cooperation of parents in the care of their children. The case of deceased children is due to the delay in referral, to the serious state of the patients at reception and to the occurrence of progressive complications. Our results are lower than those observed at the Makélékélé base hospital in Brazzaville (Congo), where the average hospital stay was 12 days and the mortality rate was 11.4%
[12]
. In Côte d'Ivoire and Mali
[13, 14]
respectively, 36.7% and 16.2% of cases were fatal. In the therapeutic nutrition unit at Bouaké University Hospital (Côte d'Ivoire), the average length of stay was 8.5 days, comparable to our results, with a higher cure rate (78.67%) and a higher drop-out rate (12%)
[15]
. The differences observed could be explained by the severity of the complications presented by our malnourished patients, resulting in a low mortality rate, and a shorter hospital stay responsible for the low drop-out rate observed
[16]
.
5. Conclusion
Malnutrition is still a public health problem, particularly in developing countries such as Chad. Our study made it possible to control the therapeutic and progressive aspects of severe acute malnutrition under five years of age. However, for these malnourished children who took F75 milk to restore the disorders or who had long stayed at TNU or not will have repercussions on their growth and their lifestyle. The basic diet of a child under the age of five is still essentially breast milk. The best children caring way is the education of their parents and additional studies are necessary to find adequate means that will facilitate treatment and reduce prevalence of malnutrition.
Abbreviations
WHO: World Health Organization
HNDA: Notre Dame des Apôtres Hospital
SMART: Specific Measurable Attainable Relevant Time
NUT: Therapeutic Nutritional Unit
SAM: Sever Acute Malnutrition
ReSoMal: Rehydration Solution for Malnutrition
Conflicts of Interest
The authors declare no conflicts of interest.
References
[1] nourrisson et chez l’enfant [Guidelines, updates on the management of severe acute malnutrition in infants and children]. Genève, 19p.

https://www.who.int/publications/i/item/9789241506328

[2] UNICEF, WHO, The World Bank, United Nations Population Division, (2015). The Inter-Agency Group for Child Mortality Estimation (UN IGME). Levels and Trends in Child Mortality. Report 2013. New York, USA.

https://childmortality.org/wpcontent/uploads/2015/10/Levels-andTrends-in-Child-Mortality-Report-2015.pdf

[3] Organisation Mondiale de la Santé. Prise en charge communautaire de la malnutrition aiguë sévère [Community-based management of severe acute malnutrition].
[4] Institut National de la Statistique (INSTAT) (2016). Enquête nutritionnelle et de mortalité rétrospective [Retrospective Nutrition and Mortality Survey]. Mali, 75p.
[5] Mudekereza, (2017). Malnutrition chez l’enfant de moins de 5 ans à Lubumbashi et ses environs: Approche épidémio-clinique et biochimique dans un milieu minier [Malnutrition in children under 5 years of age in Lubumbashi and its surroundings: Epidemio-clinical and biochemical approach in a mining environment]. [République démocratique du Congo]: Université de Lubumbashi; p207.

http://www.researchgate.net/scientific-contributions/MUDEKEREZA-MUSIMWA-2141573676

[6] UNICEF, (2011). Rapport annuel de l’UNICEF sur la prise en charge de la malnutrition sévère [UNICEF Annual Report on the Management of Severe Malnutrition]. URL:

http://www.unicef.org/french/publications/files/pub_ar01-fr.pdf (juin 2019).

[7] DNTA, (2022). Rapport final de l’enquête nationale de nutrition et de mortalité rétrospective SMART 2021 [Final Report of the 2021 SMART National Retrospective Nutrition and Mortality Survey]. Ministère de la santé publique et de la prévention, Ndjamena, Tchad 51p.
[8] Nations Unie, (2018). Agenda des Nations Unies pour la nutrition au Tchad: Réduction de la malnutrition sous toutes ses formes [UN Nutrition Agenda in Chad: Reducing malnutrition in all its forms]. Tchad: UN; 27p.
[9] DNTA, (2019). Rapport final de l’enquête nationale de nutrition et de mortalité rétrospective SMART 2020 [Final Report of the 2020 SMART National Retrospective Nutrition and Mortality Survey]. Ministère de la santé publique et de la prévention, Ndjamena, Tchad.
[10] Adibord M. Y., (1998). Sites urbains, les problèmes des inondations à N’Djamena [Urban sites, the problems of flooding in N'Djamena]. Mémoire de fin d’étude en Géographie, Université de Provence Aix Marseille (France).
[11] Organisation Mondiale de la Santé, (2019). Les normes de croissance de l’enfant [The norms of the child's growth]. [En ligne]. [Consulté le 22 Septembre 2023].

https://www.who.int/childgrowth/standards/fr/

[12] Malonga D A, Mouyokani E I, Baghamboula P, Ndoundi L, Ndoudi M, Ndoumba T, (2008). Prise en charge des enfants malnutris sévères à l’hôpital de base de Makélékélé Brazzaville-Congo [Care for severely malnourished children at the basic hospital in Makélékélé Brazzaville-Congo]. Méd. Afr. Noire; 55(6): 258-62.
[13] Diarrassouba G. et coll, (2010). « Causes d’hospitalisation des enfants infectés par le VIH en Côte d’Ivoire» [Causes of hospitalization of HIV-infected children in Ivory Coast]. Arch. Péd, 2010, 17(6): 168.
[14] Koné A., (2014). Causes d’hospitalisation des enfants infectés par le VIH dans le service de Pédiatrie du CHU-GT [Causes of hospitalization of HIV-infected children in the Pediatrics Department of the CHU-GT]. Thèse de médecine, Bamako; (230): 51-54.
[15] Yenan JP, Plo KJ, Asse KV, Kondji YS, Yeboua YKR, Ouattara KS, Yao KC, Aka KMAH, (2014). Prise en charge de la malnutrition aiguë sévère à l’unité de nutrition thérapeutique du CHU de Bouaké [Management of severe acute malnutrition at the therapeutic nu-trition unit of the Bouaké University Hospital]. Rev Int Sc Méd; 16(2): 94-99.
[16] Mbusa Kambale R, Bwija Kasengi J, Mutendela Kivukuto J, Murhula Cubaka L, Masumbuko Mungo B, Bisimwa Balaluka G, (2016). Profil infectieux et mortalité des enfants âgés de 0 à 5 ans admis pour malnutrition aiguë sévère: étude de cohorte rétrospective au Centre Nutritionnel et Thérapeutique de Bukavu, République Démocratique du Congo [Infectious profile and mortality of children aged 0-5 years admitted for severe acute malnutrition: a retrospective cohort study at the Nutritional and Therapeutic Centre of Bukavu, Democratic Republic of Congo]. Pan African Medical Journal.; 23: 139.

http://doi.org/10.11604/pamj.2016.23.139.8370

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    Aristide, K., Doutoum, A. A., Nazal, A. M., Abakoura, B., Laurent, K., et al. (2024). Therapeutic and Evolutionary Profiles of Children Aged 0-59 Months: A Case Study of Severe Acute Malnourished Treated at Hôpital Notre Dame Des Apôtres, N'Djamena. International Journal of Nutrition and Food Sciences, 13(2), 20-23. https://doi.org/10.11648/j.ijnfs.20241302.12

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    ACS Style

    Aristide, K.; Doutoum, A. A.; Nazal, A. M.; Abakoura, B.; Laurent, K., et al. Therapeutic and Evolutionary Profiles of Children Aged 0-59 Months: A Case Study of Severe Acute Malnourished Treated at Hôpital Notre Dame Des Apôtres, N'Djamena. Int. J. Nutr. Food Sci. 2024, 13(2), 20-23. doi: 10.11648/j.ijnfs.20241302.12

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    AMA Style

    Aristide K, Doutoum AA, Nazal AM, Abakoura B, Laurent K, et al. Therapeutic and Evolutionary Profiles of Children Aged 0-59 Months: A Case Study of Severe Acute Malnourished Treated at Hôpital Notre Dame Des Apôtres, N'Djamena. Int J Nutr Food Sci. 2024;13(2):20-23. doi: 10.11648/j.ijnfs.20241302.12

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  • @article{10.11648/j.ijnfs.20241302.12,
  author = {Kemoral Aristide and Abdelsalam Adoum Doutoum and Alhadj Markhous Nazal and Barka Abakoura and Kodji Laurent and Gondimo Gabdibe Elysée and Tog-Yangue Allanidjimte and Abdelsalam Tidjani},
  title = {Therapeutic and Evolutionary Profiles of Children Aged 0-59 Months: A Case Study of Severe Acute Malnourished Treated at Hôpital Notre Dame Des Apôtres, N'Djamena},
  journal = {International Journal of Nutrition and Food Sciences},
  volume = {13},
  number = {2},
  pages = {20-23},
  doi = {10.11648/j.ijnfs.20241302.12},
  url = {https://doi.org/10.11648/j.ijnfs.20241302.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijnfs.20241302.12},
  abstract = {According to the World Health Organization, malnutrition is a pathological condition resulting from the relative or absolute insufficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biological, anthropometric or physiological analyses. It remains a major public health problem. The aim of this study was therefore to determine the therapeutic and evolutionary profiles of Severe Acute Malnutrition patients at Notre Dame des Apôtres Hospital in N'Djaména (Chad). This was a prospective, descriptive study carried out on 7 months, from January 1 to July 31, 2023. This included all severely acutely malnourished children with medical complications admitted to the hospital's therapeutic nutrition unit. The variables studied were therapeutic and evolutionary. Data were entered and analyzed using Excel 2016 spreadsheet and SSPS 18.0 software. Among the 1454 children admitted to the unit during our study, 41.82% were stabilized, 6.75% cured and 0.79% abandoned, with an average length of stay of 8.67 days. The mortality rate was 1.76%. Children on F75 accounted for 46%, 37% on plumpy nut and 10% on F100. Antibiotics and multivitamins are routinely used in the management of malnourished children. The results of this study show that parent education could be an asset in the management of severe acute malnutrition.},
 year = {2024}
}

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T1  - Therapeutic and Evolutionary Profiles of Children Aged 0-59 Months: A Case Study of Severe Acute Malnourished Treated at Hôpital Notre Dame Des Apôtres, N'Djamena
AU  - Kemoral Aristide
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AU  - Alhadj Markhous Nazal
AU  - Barka Abakoura
AU  - Kodji Laurent
AU  - Gondimo Gabdibe Elysée
AU  - Tog-Yangue Allanidjimte
AU  - Abdelsalam Tidjani
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T2  - International Journal of Nutrition and Food Sciences
JF  - International Journal of Nutrition and Food Sciences
JO  - International Journal of Nutrition and Food Sciences
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AB  - According to the World Health Organization, malnutrition is a pathological condition resulting from the relative or absolute insufficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biological, anthropometric or physiological analyses. It remains a major public health problem. The aim of this study was therefore to determine the therapeutic and evolutionary profiles of Severe Acute Malnutrition patients at Notre Dame des Apôtres Hospital in N'Djaména (Chad). This was a prospective, descriptive study carried out on 7 months, from January 1 to July 31, 2023. This included all severely acutely malnourished children with medical complications admitted to the hospital's therapeutic nutrition unit. The variables studied were therapeutic and evolutionary. Data were entered and analyzed using Excel 2016 spreadsheet and SSPS 18.0 software. Among the 1454 children admitted to the unit during our study, 41.82% were stabilized, 6.75% cured and 0.79% abandoned, with an average length of stay of 8.67 days. The mortality rate was 1.76%. Children on F75 accounted for 46%, 37% on plumpy nut and 10% on F100. Antibiotics and multivitamins are routinely used in the management of malnourished children. The results of this study show that parent education could be an asset in the management of severe acute malnutrition.
VL  - 13
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Author Information

  • Kemoral Aristide

    Department of Biology and Human Health, University of N’Djamena, N’Djamena, Republic of Chad

    http://orcid.org/0009-0008-3203-5300

  • Abdelsalam Adoum Doutoum

    Department of Biomedical and Pharmaceutical Sciences, Adam Barka University of Abéché, Abéché, Republic of Chad

    Contact Email

    http://orcid.org/0009-0009-7224-6409

  • Alhadj Markhous Nazal

    Department of the Environment Sciences, University of Sarh, Sarh, Republic of Chad

    http://orcid.org/0009-0000-1306-7130

  • Barka Abakoura

    Department of Engineering Sciences, Polytechnic University of Mongo, Mongo, Republic of Chad

  • Kodji Laurent

    Department of Microbiology, Food Quality Control Center (CECOQDA), N'Djamena, Republic of Chad

  • Gondimo Gabdibe Elysée

    Department of Biology and Human Health, University of N’Djamena, N’Djamena, Republic of Chad

  • Tog-Yangue Allanidjimte

    Department of Nutrition, Notre Dame des Apôtres Hospital, N’Djamena, Republic of Chad

  • Abdelsalam Tidjani

    Department of Biology and Human Health, University of N’Djamena, N’Djamena, Republic of Chad

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  • Abstract
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  • Document Sections

    1. 1. Introduction
    2. 2. Material and Methods
    3. 3. Results
    4. 4. Discussion
    5. 5. Conclusion
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  • Abbreviations
  • Conflicts of Interest
  • References
  • Cite This Article
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