Diagnostic performance of visible severe wasting for identifying severe acute malnutrition in children admitted to hospital in Kenya
Polycarp Mogeni, Hemed Twahir, Victor Bandika, Laura Mwalekwa, Johnstone Thitiri, Moses Ngari, Christopher Toromo, Kathryn Maitland & James A Berkley
Volume 89, Number 12, December 2011, 900-906
Table 3. Demographic and clinical characteristics of children aged 6 to 59.9 months with anthropometrically diagnosed severe acute malnutritiona, with and without visible severe wasting (VSW), admitted to two public hospitals in Kenya, 2007–2010
| Characteristic | CPGH |
P | KDH |
P | KDH |
P | |||
|---|---|---|---|---|---|---|---|---|---|
| MUAC < 11.5 cm |
WHZ below −3 |
WHZ below −3 |
|||||||
| Without VSW (n = 285) | With VSW (n = 319) | Without VSW (n = 331) | With VSW (n = 471) | Without VSW (n = 534) | With VSW (n = 432) | ||||
| Age, median (IQR) | 9.0 (7.0 to 13) | 12 (9.0 to 17) | < 0.001 | 11 (8.0 to 16) | 18 (11 to 25) | < 0.001 | 15 (9.8 to 25) | 18 (12 to 25) | 0.002 |
| Male, No. (%) | 149 (47) | 140 (49) | 0.58 | 179 (54) | 232 (50) | 0.18 | 345 (65) | 235 (54) | 0.001 |
| Duration of illness (days), median (IQR) | 3 (3 to 7) | 4.5 (3 to 10) | 0.003 | 3 (2 to 7) | 4 (3 to 7) | < 0.001 | 3 (2 to 4) | 4 (3 to 7) | < 0.001 |
| History of fever, No. (%) | 285 (89) | 226 (79) | 0.001 | 262 (79) | 341 (72) | 0.03 | 410 (77) | 327 (76) | 0.69 |
| History of cough or difficulty breathing, No. (%) | 243 (76) | 210 (74) | 0.48 | 206 (62) | 329 (70) | 0.02 | 302 (57) | 287 (66) | 0.002 |
| History of diarrhoea, No. (%) | 172 (54) | 170 (60) | 0.16 | 164 (50) | 233 (50) | 0.98 | 267 (50) | 222 (51) | 0.69 |
| Deep acidotic breathing, No. (%) | 17 (5.3) | 11 (3.9) | 0.39 | 47 (14) | 45 (9.6) | 0.04 | 75 (14) | 38 (8.8) | 0.01 |
| Lower chest wall indrawing, No. (%) | 136 (42) | 105 (37) | 0.16 | 103 (31) | 135 (29) | 0.54 | 138 (26) | 111 (26) | 0.96 |
| Sunken eyes, No. (%) | 118 (37) | 147 (52) | < 0.001 | 94 (29) | 115 (25) | 0.20 | 165 (31) | 115 (27) | 0.14 |
| Skin pinch > 2 seconds, No. (%) | 42 (13) | 96 (34) | < 0.001 | 68 (21) | 113 (24) | 0.24 | 111 (21) | 102 (24) | 0.30 |
| Weak pulse, No. (%) | 39 (13) | 58 (21) | 0.006 | 17 (5.2) | 38 (8.2) | 0.11 | 26 (4.9) | 30 (7.0) | 0.17 |
| MUAC, mean (95% CI) | 10.6 (10.5 to 10.7) | 9.9 (9.7 to 10.0) | < 0.001 | 10.5 (10.4 to 10.6) | 10.0 (9.9 to 10.1) | < 0.001 | 10.6 (10.5 to 10.7) | 10.0 (9.9 to 10.1) | < 0.001 |
| WHZ, mean (95% CI) | – | – | – | −3.2 (−3.3 to −3.0) | −4.2 (−4.3 to −4.0) | < 0.001 | −3.8 (−3.9 to −3.7) | −4.4 (−4.5 to −4.3) | < 0.001 |
| Kwashiorkor, No. (%) | 24 (7.5) | 54 (19) | < 0.001 | 25 (7.6) | 129 (27) | < 0.001 | 25 (4.7) | 95 (22) | < 0.001 |
| Positive to HIV antibodies, No. (%) | 14/142 (9.9) | 29/146 (20) | 0.02 | 41 (13) | 128 (29) | < 0.001 | 44 (8.7) | 116 (28) | < 0.001 |
| Died in hospital (%) | 37 (13) | 70 (22) | 0.002 | 36 (11) | 80 (17) | 0.007 | 36 (6.4) | 65 (15) | < 0.001 |
CI, confidence interval; CPGH, Coast Provincial General Hospital; HIV, human immunodeficiency virus; IQR, interquartile range; KDH, Kilifi District Hospital; MUAC, mid-upper arm circumference; WHZ, weight-for-height z-score.
a Defined as a MUAC < 11.5 cm or a WHZ below −3.