Skip to main content
Top
Published in: BMC Pediatrics 1/2017

Open Access 01-12-2017 | Research article

Wasting, underweight and stunting among children with congenital heart disease presenting at Mulago hospital, Uganda

Authors: Anthony Batte, Peter Lwabi, Sulaiman Lubega, Sarah Kiguli, Kennedy Otwombe, Lucy Chimoyi, Violette Nabatte, Charles Karamagi

Published in: BMC Pediatrics | Issue 1/2017

Login to get access

Abstract

Background

Children with congenital heart disease are at increased risk of malnutrition. The aim of this study was to describe the prevalence of wasting, underweight and stunting among children with congenital heart disease attending Mulago National Referral Hospital, Uganda.

Methods

A cross-sectional study among 194 children aged 0–15 years was conducted between August 2013 and March 2014. Anthropometric measurements and clinical assessments were carried out on all children. Anthropometric z-scores based on WHO 2007 reference ranges were generated for each child. Weight-for-height z-scores were generated for children 0–5 years, weight-for-age z-scores for children 0–10 years, and height-for-age and BMI-for-age z-scores for all children. Risk factors associated with malnutrition were determined by Poisson regression.

Results

One hundred and forty five (74.7%) children were aged 0–5 years; and 111 of 194 (57.2%) were female. Forty five of 145 (31.5%) children aged 0–5 years were wasted; 77 of 181 (42.5%) children aged 0–10 years were underweight; 88 of 194 (45.4%) children were stunted; and 53 of 194 (27.3%) children were thin (BMI for age z score < −2). Moderate to severe anaemia (RR 1.11, 95% CI: 1.01–1.22) and moderate to severe heart failure (RR 1.24, 95% CI: 1.13–1.36) were associated with wasting and underweight respectively. Stunting was associated with moderate to severe heart failure (RR 1.11, 95% CI: 1.01–1.21) while thinness was associated with moderate to severe heart failure (RR 1.12, 95% CI: 1.04–1.21) and moderate to severe anaemia (RR 1.15, 95% CI: 1.06–1.25).

Conclusion

Malnutrition is common in children with congenital heart disease, and is associated with anaemia and heart failure. There is need to integrate strategies to identify and manage malnutrition during the care of children with congenital heart disease.
Literature
1.
go back to reference Okoromah CA, Ekure EN, Lesi FE, Okunowo WO, Tijani BO, Okeiyi JC. Prevalence, profile and predictors of malnutrition in children with congenital heart defects: a case-control observational study. Arch Dis Child. 2011;96(4):354–60.CrossRefPubMedPubMedCentral Okoromah CA, Ekure EN, Lesi FE, Okunowo WO, Tijani BO, Okeiyi JC. Prevalence, profile and predictors of malnutrition in children with congenital heart defects: a case-control observational study. Arch Dis Child. 2011;96(4):354–60.CrossRefPubMedPubMedCentral
3.
go back to reference Varan B, Tokel K, Yilmaz G. Malnutrition and growth failure in cyanotic and acyanotic congenital heart disease with and without pulmonary hypertension. Arch Dis Child. 1999;81(1):49–52.CrossRefPubMedPubMedCentral Varan B, Tokel K, Yilmaz G. Malnutrition and growth failure in cyanotic and acyanotic congenital heart disease with and without pulmonary hypertension. Arch Dis Child. 1999;81(1):49–52.CrossRefPubMedPubMedCentral
4.
go back to reference Medoff-Cooper B, Ravishankar C. Nutrition and growth in congenital heart disease: a challenge in children. Curr Opin Cardiol. 2013;28(2):122–9.CrossRefPubMed Medoff-Cooper B, Ravishankar C. Nutrition and growth in congenital heart disease: a challenge in children. Curr Opin Cardiol. 2013;28(2):122–9.CrossRefPubMed
5.
go back to reference Grantham-McGregor S, Baker-Henningham H. Review of the evidence linking protein and energy to mental development. Public Health Nutr. 2005;8(7a):1191–201.CrossRefPubMed Grantham-McGregor S, Baker-Henningham H. Review of the evidence linking protein and energy to mental development. Public Health Nutr. 2005;8(7a):1191–201.CrossRefPubMed
6.
go back to reference De Staebel O. Malnutrition in Belgian children with congenital heart disease on admission to hospital. J Clin Nurs. 2000;9(5):784–91.CrossRef De Staebel O. Malnutrition in Belgian children with congenital heart disease on admission to hospital. J Clin Nurs. 2000;9(5):784–91.CrossRef
8.
go back to reference Vaidyanathan B, Roth SJ, Rao SG, Gauvreau K, Shivaprakasha K, Kumar RK. Outcome of ventricular septal defect repair in a developing country. J Pediatr. 2002;140(6):736–41.CrossRefPubMed Vaidyanathan B, Roth SJ, Rao SG, Gauvreau K, Shivaprakasha K, Kumar RK. Outcome of ventricular septal defect repair in a developing country. J Pediatr. 2002;140(6):736–41.CrossRefPubMed
9.
go back to reference Uganda Bureau of Statistics (UBOS) and ICF International Inc. Uganda Demographic and Health Survey 2011. Kampala: UBOS and Calverton, Maryland: ICF International Inc; 2012. Uganda Bureau of Statistics (UBOS) and ICF International Inc. Uganda Demographic and Health Survey 2011. Kampala: UBOS and Calverton, Maryland: ICF International Inc; 2012.
10.
go back to reference Batte A, Lwabi P, Lubega S, Kiguli S, Nabatte V, Karamagi C. Prevalence of arrhythmias among children below 15 years of age with congenital heart diseases attending Mulago National Referral Hospital, Uganda. BMC Cardiovasc Disord. 2016;16(1):1.CrossRef Batte A, Lwabi P, Lubega S, Kiguli S, Nabatte V, Karamagi C. Prevalence of arrhythmias among children below 15 years of age with congenital heart diseases attending Mulago National Referral Hospital, Uganda. BMC Cardiovasc Disord. 2016;16(1):1.CrossRef
12.
go back to reference Ross RD, Bollinger RO, Pinsky WW. Grading the severity of congestive heart failure in infants. Pediatr Cardiol. 1992;13(2):72–5.CrossRefPubMed Ross RD, Bollinger RO, Pinsky WW. Grading the severity of congestive heart failure in infants. Pediatr Cardiol. 1992;13(2):72–5.CrossRefPubMed
13.
go back to reference Reithmann C, Reber D, Kozlik-Feldmann R, Netz H, Pilz G, Welz A, Werdan K. A post-receptor defect of adenylyl cyclase in severely failing myocardium from children with congenital heart disease. Eur J Pharmacol. 1997;330(1):79–86.CrossRefPubMed Reithmann C, Reber D, Kozlik-Feldmann R, Netz H, Pilz G, Welz A, Werdan K. A post-receptor defect of adenylyl cyclase in severely failing myocardium from children with congenital heart disease. Eur J Pharmacol. 1997;330(1):79–86.CrossRefPubMed
14.
go back to reference World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Geneva: Vitamin and Mineral Nutrition Information System; 2011. World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Geneva: Vitamin and Mineral Nutrition Information System; 2011.
15.
go back to reference International Food Policy Research Institute. Global Nutrition Report 2016. Washington, DC: From Promise to Impact: Ending Malnutrition by 2030; 2016. International Food Policy Research Institute. Global Nutrition Report 2016. Washington, DC: From Promise to Impact: Ending Malnutrition by 2030; 2016.
16.
go back to reference Manyanga T, El-Sayed H, Doku DT, Randall JR. The prevalence of underweight, overweight, obesity and associated risk factors among school-going adolescents in seven African countries. BMC Public Health. 2014;14(1):1.CrossRef Manyanga T, El-Sayed H, Doku DT, Randall JR. The prevalence of underweight, overweight, obesity and associated risk factors among school-going adolescents in seven African countries. BMC Public Health. 2014;14(1):1.CrossRef
17.
go back to reference Lwanga F, Kirunda BE, Orach CG. Intestinal helminth infections and nutritional status of children attending primary schools in Wakiso District, Central Uganda. Int J Environ Res Public Health. 2012;9(8):2910–21.CrossRefPubMed Lwanga F, Kirunda BE, Orach CG. Intestinal helminth infections and nutritional status of children attending primary schools in Wakiso District, Central Uganda. Int J Environ Res Public Health. 2012;9(8):2910–21.CrossRefPubMed
18.
go back to reference Chen CW, Li CY, Wang JK. Growth and development of children with congenital heart disease. J Adv Nurs. 2004;47(3):260–9.CrossRefPubMed Chen CW, Li CY, Wang JK. Growth and development of children with congenital heart disease. J Adv Nurs. 2004;47(3):260–9.CrossRefPubMed
19.
go back to reference Daymont C, Neal A, Prosnitz A, Cohen MS. Growth in children with congenital heart disease. Pediatrics. 2013;131(1):e236–42.CrossRefPubMed Daymont C, Neal A, Prosnitz A, Cohen MS. Growth in children with congenital heart disease. Pediatrics. 2013;131(1):e236–42.CrossRefPubMed
20.
go back to reference Vaidyanathan B, Nair SB, Sundaram KR, Babu UK, Shivaprakasha K, Rao SG, Kumar RK. Malnutrition in children with congenital heart disease (CHD) determinants and short term impact of corrective intervention. Indian Pediatr. 2008;45(7):541–6.PubMed Vaidyanathan B, Nair SB, Sundaram KR, Babu UK, Shivaprakasha K, Rao SG, Kumar RK. Malnutrition in children with congenital heart disease (CHD) determinants and short term impact of corrective intervention. Indian Pediatr. 2008;45(7):541–6.PubMed
21.
go back to reference Hassan BA, Albanna EA, Morsy SM, Siam AG, Al Shafie MM, Elsaadany HF, Sherbiny HS, Shehab M, Grollmuss O. Nutritional status in children with un-operated congenital heart disease: an Egyptian center experience. Front Pediatr. 2015;2015:3. Hassan BA, Albanna EA, Morsy SM, Siam AG, Al Shafie MM, Elsaadany HF, Sherbiny HS, Shehab M, Grollmuss O. Nutritional status in children with un-operated congenital heart disease: an Egyptian center experience. Front Pediatr. 2015;2015:3.
22.
go back to reference Rogers EJ, Gilbertson HR, Heine RG, Henning R. Barriers to adequate nutrition in critically ill children. Nutrition. 2003;19(10):865–8.CrossRefPubMed Rogers EJ, Gilbertson HR, Heine RG, Henning R. Barriers to adequate nutrition in critically ill children. Nutrition. 2003;19(10):865–8.CrossRefPubMed
23.
go back to reference Özkale M, Sipahi T. Hematologic and bone marrow changes in children with protein-energy malnutrition. Pediatr Hematol Oncol. 2014;31(4):349–58.CrossRefPubMed Özkale M, Sipahi T. Hematologic and bone marrow changes in children with protein-energy malnutrition. Pediatr Hematol Oncol. 2014;31(4):349–58.CrossRefPubMed
24.
go back to reference Müller O, Krawinkel M. Malnutrition and health in developing countries. Can Med Assoc J. 2005;173(3):279–86.CrossRef Müller O, Krawinkel M. Malnutrition and health in developing countries. Can Med Assoc J. 2005;173(3):279–86.CrossRef
25.
go back to reference National Planning Authority. Uganda Nutrition Action Plan 2011–2016. Kampala: National Planning Authority; 2011. National Planning Authority. Uganda Nutrition Action Plan 2011–2016. Kampala: National Planning Authority; 2011.
26.
go back to reference National Planning Authority. National nutrition planning guidelines for Uganda. Kampala: National Planning Authority; 2015. National Planning Authority. National nutrition planning guidelines for Uganda. Kampala: National Planning Authority; 2015.
27.
go back to reference Knirsch W, Zingg W, Bernet V, Balmer C, Dimitropoulos A, Prêtre R, Bauersfeld U, Latal B. Determinants of body weight gain and association with neurodevelopmental outcome in infants operated for congenital heart disease. Interact Cardiovasc Thorac Surg. 2010;10(3):377–82.CrossRefPubMed Knirsch W, Zingg W, Bernet V, Balmer C, Dimitropoulos A, Prêtre R, Bauersfeld U, Latal B. Determinants of body weight gain and association with neurodevelopmental outcome in infants operated for congenital heart disease. Interact Cardiovasc Thorac Surg. 2010;10(3):377–82.CrossRefPubMed
28.
go back to reference Territo MC, Rosove MH. Cyanotic congenital heart disease: hematologic management. J Am Coll Cardiol. 1991;18(2):320–2.CrossRefPubMed Territo MC, Rosove MH. Cyanotic congenital heart disease: hematologic management. J Am Coll Cardiol. 1991;18(2):320–2.CrossRefPubMed
Metadata
Title
Wasting, underweight and stunting among children with congenital heart disease presenting at Mulago hospital, Uganda
Authors
Anthony Batte
Peter Lwabi
Sulaiman Lubega
Sarah Kiguli
Kennedy Otwombe
Lucy Chimoyi
Violette Nabatte
Charles Karamagi
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2017
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-017-0779-y

Other articles of this Issue 1/2017

BMC Pediatrics 1/2017 Go to the issue