Prevalence and impact of malnutrition on outcomes and mortality of under-five years children with pneumonia: a study from Upper Egypt

Abstract

Malnutrition has adverse impacts on under-five children with pneumonia. The purpose of this study was to address the prevalence and impact of malnutrition on under-five years children with pneumonia, admitted to a tertiary large children hospital in Upper Egypt. This study is a prospective case-control study. All under-five children diagnosed with pneumonia who were admitted to Assiut University Children’s Hospital (AUCH) from January 1st to December 31st, 2021, were enrolled. Based on their nutritional assessment, the studied participants were classified into 2 groups: (1): Children with pneumonia and with nutritional deficiency considered as cases, and (2): Children with pneumonia and without nutritional deficiency considered as controls. Three hundred-fifty cases and 154 control subjects were enrolled, respectively. 93.4%, 31.1%, and 61.7% of the cases had underweight, stunting, and wasting, respectively. Among those cases, there were significant differences between survivors and non-survivors with regard to some clinicodemographic factors, laboratory parameters, and anthropometric parameters. Lack of compulsory vaccination, presence of sepsis, and blood transfusion (OR 2.874, 95% CI 0.048 – 2.988, p = 0.004, 2.627, 0.040 – 2.677, p = 0.009, and 4.108, 0.134 – 3.381, p < 0.001, respectively) were significant independent predictors for mortality among malnourished children with pneumonia. Conclusion: Malnutrition has a high prevalence in under-five children with pneumonia in our locality. It has adverse effects on the outcomes and in-hospital mortality of those children. Lack of compulsory vaccination, presence of sepsis, and blood transfusion were significant independent predictors of mortality in malnourished children with pneumonia. Larger multicenter studies are warranted. What is Known:• Malnutrition has adverse impacts on under-five children with pneumonia.• Malnutrition could be a reason for in-hospital mortality among under-five children with pneumonia. What is New:• Malnutrition has a high prevalence in under-five children with pneumonia in Upper Egypt, with its adverse effects on the outcomes and mortality of those children.• Lack of vaccination, presence of sepsis, and blood transfusion are significant independent predictors of mortality in malnourished children with pneumonia in Upper Egypt.

The Diagnostic Association of Radiological and Clinicopathological Parameters in Community-Acquired Pneumonia in Children: A Cross-Sectional Study

“…In Pakistan, 23% of children under the age of five years are underweight, and 8% are severely underweight [ 4 ]. Many studies have demonstrated the association of low weight and malnutrition with pneumonia in children [ 10 , 13 ]. Malnutrition can be a factor for increased hospitalizations in children with pneumonia, who, according to WHO 2013 guidelines, can be managed with oral antibiotics at home.…”

Health Expenditure, Institutional Quality, and Under-Five Mortality in Sub-Saharan African Countries

“…Thus, a positive effect of the prevalence of HIV on the U5MR is expected. Studies such as Panagariya (2013)[72], Uribe-Quintero et al (2022)[73], andGamal et al (2023) [74] suggest that undernourishment has an adverse effect on under-five health outcomes. As a result, the current study expects a positive relationship between the prevalence of undernourishment and under-five mortality rates.…”