SEVERE PROTEIN-ENERGY MALNUTRITION IN LESOTHO, DEATH AND SURVIVAL IN HOSPITAL, CLINICAL FINDINGS

  • 1 December 1986
    • journal article
    • research article
    • Vol. 38  (4) , 351-358
Abstract
In Lesotho''s central hospital 55 (25%) of 218 admissions for severe PEM died during 1981 and 1982. Most deaths (62%) occurred in the first week. The most important causes of death were acute GE and pneumonia in marasmus and Kwashiorkor, respectively. The cause of death remained obscure in 16 children, however. In marasmus a poor prognosis was significantly associated with the finding on admission of a temperature < 36.5.degree. C (P < 0.05), apathy (P < 0.01) and a depigmented skin (P < 0.05), while in marasmic kwashiorkor only the finding of the latter was significantly (P < 0.05) associated with death. In non-survivors with kwashiorkor the following characteristics were observed significantly more often: complaints of diarrhoea and/or vomiting on admission (P < 0.05), the finding of apathy, pallor, skin defects and hepatomegaly on admission (P < 0.01), and the finding of a low serum albumen, Na+ and K+ in the first days (P < 0.05). Irratibility was significantly (P < 0.05) more common in survivors with Kwashiorkor. Xerophthalmia was observed only once. Infections were diagnosed in 86% of all and giardiasis in 28% of 146 children. Twenty-eight children contracted measles of whom 5 died. Severe PEM still carries a high mortality despite hospitalisation. The findings confirm the need for intensive management of severe PEM.