The Protein-Energy Malnourished Child in a Nigerian Teaching Hospital

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Abstract
Over a five-year period, January 1972-December 1976, a total of 4624 patients were admitted to the paediatric wards of the University College Hospital Ibadan. 203 of these patients were suffering from PEM, 146 with kwashiorkor, 33 with marasmickwashiorkor and 24 with marasmus. PEM patients had significantly lower electrolyte values than the healthy Nigerian children (p < 0.001); their packed cell volumes (PCV) were within the lower limits of normal values for healthy Nigerian children and a low immunization rate to communicable diseases was also observed. 28.3 per cent gave a history of measles attack while 19.4 per cent had chronic diarrhoea during the period immediately before presentation with PEM. Hypothermia, hypoglycaemia and sepsis were not adequately documented on these patients, an indication that they were less rigorously looked for than they ought to have been and are presumed to have contributed to the high mortality rate of 28 per cent. Some ways of improving on the management of these patients while in the ward have also been discussed.

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