Evaluation of the Integrated Management Program for Acute Malnutrition in the Douentza Health District, Mopti Region, Mali

Introduction: Malnutrition is a major public health problem in Mali, despite the efforts of the government, its technical and financial partners. The aim of this study was to evaluate the integrated management program for acute malnutrition (IMPAM). Methodology: This was a descriptive cross-sectional study that took place from January to December 2020 in the Douentza health district. The study included anyone with at least one malnourished child aged 6 to 59 months in their care who agreed to take part in the study, community health center staff who had given their consent, and the URENI manager at the Douentza reference health center. Data collected via questionnaires were entered into Excel and then analyzed using Epi-Info version 7 software. Results: A total of 138 acutely malnourished children aged 6 - 59 months, including 71 girls (51.45%), 138 accompanying mothers and 11 health workers, were included in our case study. Among the malnourished, 54.34% were in the 12 - 23 months age group and 69.57% had the severe form. 93% of the mothers interviewed were satisfied with the care provided, and all the health staff interviewed stated that community conflicts had an impact on IMPAM’s activities. Cure rates were 81% in Moderate Outpatient Nutritional Recovery and Education Unit (URENAM), 84% in Severe Ambulatory Nutritional Recovery and Education Unit (URENAS) and 92% in Recovery and Intensive Nutritional Education Unit (URENI). Drop-out rates were 19% in URENAM, 16% in URENAS and 0% in URENI. The death rate was 8% in URENI and 0% in URENAM and URENAS. Conclusion: This study confirms the high prevalence of malnutrition in the district (10.54%). It also reveals that factors such as inter-community conflict and insecurity have seriously affected the IMPAM program.

Prevalence of Malnutrition and Anaemia in Children ≤ 5 Years of Age in Some Conflict Hit Areas of Meme Division of the South West Region of Cameroon

Malnutrition refers to the deficiency, imbalances, or excesses in a person’s intake of energy or nutrients [1]. Khan defines anaemia as below level of Haemoglobin in red blood shown by a lower number of functioning red blood cells [2]. The crisis in the North West and South West Regions of Cameroon has led to several negative effects on children’s living conditions. There has been an increase in malnutrition and anaemia in the South West Region and Kumba in particular. The main objective of this study was “to examine the prevalence of malnutrition and anaemia in children ≤ 5 years of age in some conflict-hit areas of Meme Division”. A descriptive cross-sectional study was conducted in 2023 from March to June. We recruited 200 children ≤ 5 years into the study from three hospitals. The regional hospital annex in Kumba, Presbyterian General Hospital Kumba and the Ntam Hospital in Kumba. Socio-demographic factors were assessed using questionnaire, nutritional status was assessed by the use anthropometric measurements and an auto haematology analyser was used to determine anaemia. The overall prevalence of malnutrition in the study area was 40.5%. The prevalence of malnutrition varied significantly (P < 0.001) with the study sites. The overall prevalence of anaemia in the study area was 70.5%. The prevalence of anaemia was not significantly associated with the study sites. The prevalence of Malnutrition and Anaemia in children ≤ 5 years of age is very high in the Kumba municipalities. This could be attributed to the ongoing crisis which has caused a lot of social migrations from rural areas to Urban areas which are safer.

Prevalence of Malnutrition among Hospitalized Pediatric Patients in a Tertiary Hospital in Jordan: Pilot Study

Introduction: Failure to thrive (FTT) occurs when a child’s growth falls below expected standards, typically due to inadequate nutrient intake. Factors include insufficient oral intake, poor nutrient absorption, and increased metabolic demands. Previous studies have shown high malnutrition rates in hospitalized children due to illness-related metabolic demands, decreased appetite, and inadequate intake. Our objective was to assess the growth and nutritional status of children admitted to King Abdullah University Hospital (KAUH) and identify the prevalence of undernutrition and associated factors. Methods: This prospective, cross-sectional cohort study was conducted at KAUH from July to December 2022. We included children aged 2 months to 16 years, excluding those with conditions altering growth parameters. Data were collected through pediatric data sheets, physical examinations, and laboratory tests. Anthropometric measurements were taken, and growth was assessed using CDC growth charts. Nutritional anemia was defined as hemoglobin 16. Results: A total of 111 patients were included (56.8% male, median age 65 months). Most patients had normal height (82%) and weight (86.5%) upon admission. However, 14.4% were stunted, 11.7% were underweight, 14.4% were overweight, and 3.6% were obese. Growth impairment correlated with higher anemia rates (p = 0.042). Nutritional anemia was present in 12% of patients. No significant relation was found between breastfeeding history and growth retardation, but maternal perception of malnutrition correlated well with actual malnutrition. Conclusion: Our study found a malnutrition prevalence of 19.8%, highlighting the need for systematic nutritional screening in hospitalized children. The study’s limitations include its small sample size and specific patient population, suggesting the need for larger, multicenter studies for more generalizable results.

Malnutrition and Its Association with the Mortality of Patients with Femoral Intertrochanteric Fractures: A Retrospective Analysis of Japanese Patients

Background: The incidence of femoral intertrochanteric fractures in older adults is higher than that of femoral neck fractures;however, both conditions are often analyzed together as proximal femoral fractures. Considering the difference in treatment, postoperative complication, and mortality risk, these two fractures should be analyzed separately. This study aimed to analyze 1-year mortality and its risk factors in patients with surgically treated femoral intertrochanteric fractures. Methods: Consecutive patients with intertrochanteric fractures who underwent surgical interventions at our institution between January 2017 and December 2021 were retrospectively reviewed. A total of 238 patients were eligible for inclusion in this study. Patients’ demographic and clinical information were retrospectively collected. Patients were divided into the 1-year mortality (n = 16) and survival (n = 222) groups. The incidence of 1-year mortality and its independent risk factors were investigated using univariate and multivariate logistic regression analyses. Results: The mean age of patients was 85.6 ± 8.5 years. The 1-year mortality rate was 6.7% (16/238). Preoperative albumin level, the Geriatric Nutritional Risk Index (GNRI), and malnutrition status (GNRI p = 0.02, p = 0.02, and p = 0.0011, respectively). Multivariate analysis showed that malnutrition status (GNRI p = 0.035) was an independent risk factor for 1-year mortality. Conclusion: Malnutrition status assessed using GNRI (GNRI < 92) was an independent risk factor for 1-year mortality. Our findings suggest that GNRI may be an effective screening tool for predicting postoperative 1-year mortality of patients with surgically treated femoral intertrochanteric fractures.

Management of Acute Malnutrition in Children Aged 0 to 24 Months Boulbinet Health Center

Introduction: Malnutrition is a pathological state resulting from the relative deficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biochemical, anthropometric or physiological analyses. The overall objective was to assess the quality of management of acute malnutrition in children aged 0 - 24 months at the Boulbinet health center. Methodology: This was a prospective descriptive study lasting six (06) months from May 5 to October 5, 2018. The study included all children aged 0 to 24 months. Results: Acute malnutrition in children aged 0 - 24 months accounted for 2.11% of cases. The sex ratio was 1.41 in favor of males. The mean age of our patients was 5 months 7 days, with extremes of 1 month and 6 months. The majority came from Ra toma (40.24%). Exclusive breastfeeding was most common (54.02%). The main clinical signs were: pallor 49.42%, diarrhea 46.67, oral lesions37.96%. SAM represented 89.66% and MAM 10.34%. Most associated pathologies: anemia 49.42% and oral candidiasis 37.93%. In terms of outcome, we recorded 56.32% cures, 20.69% deaths, 18.39% dropouts and 4.60% cures. Conclusion: Improving the quality of care for malnourished children aged 0 - 24 months requires raising awareness among mothers and the general public of the consequences of malnutrition.

Malnutrition Assessed Using the Geriatric Nutritional Risk Index Is Associated with Preoperative Incidence of Deep Vein Thrombosis in Japanese Patients Undergoing Total Knee Arthroplasty

Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate the prevalence of preoperative DVT in Japanese patients undergoing total knee arthroplasty (TKA) and the importance of malnutrition in the risk of preoperative DVT. Methods: We retrospectively analyzed 394 patients admitted for primary TKA at our institution between January 2019 and December 2023. All patients scheduled for TKA at our institution had serum D-dimer levels measured preoperatively. Lower-limb ultrasonography was examined to confirm the presence of DVT in patients with D-dimer levels ≥ 1.0 µg/mL or who were considered to be at high risk of DVT by the treating physician. Based on the results of lower-limb ultrasonography, all patients were divided into the non-DVT and DVT groups. The incidence of and risk factors for preoperative DVT were investigated, as well as the correlation of DVT with the patient’s nutritional parameters. We used two representative tools for nutritional assessment: the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status Score. Results: The mean age was 77.8 ± 6.9 years. Preoperative DVT was diagnosed in 57 of the 394 (14.5%) patients. Multivariate logistic regression analysis showed that advanced age and malnutrition status, assessed using the GNRI, were independent risk factors for preoperative DVT. Conclusion: A high incidence of preoperative DVT was observed in patients who underwent TKA. Malnutrition status, as assessed using the GNRI, increased the risk of preoperative DVT. Our findings suggest that clinicians should consider these factors when tailoring preventive strategies to mitigate DVT risk in patients undergoing TKA.

Superior Mesenteric Artery Syndrome, a Rare Complication of Severe Malnutrition: Two Cases from a Subsaharian Endocrinology Department

Introduction: Superior mesenteric artery syndrome (SMAS), a rare diagnosis due to compression of the third duodenum between the superior mesenteric artery (SMA) and the aorta resulting in bowel obstruction, may lead to severe malnutrition. We report two cases of patients hospitalised in the Internal Medicine, Endocrinology, Diabetology, and Nutrition Department of the National Hospital Center (NHC) of Pikine. Observations: Patient 1: A 35-year-old female was referred for an aetiological diagnosis due to a rapid weight loss of 15 kilograms in one month, accompanied by persistent vomiting, following an appendectomy performed a month before admission. Upon clinical examination, she presented severe malnutrition (Buzby index of 76%), early post-prandial chronic vomiting, and a poor general condition. An abdominal CT scan revealed aortomesenteric clamp syndrome (AMCS) with an angulation between the aorta and the SMA of 13˚. The underlying cause in this patient was severe malnutrition. Fortunately, her condition improved with medical treatment. Patient 2: We report the case of a 30-year-old female hospitalized due to unusual weight-bearing post-prandial epigastric pain and intermittent vomiting over the past six months. Upon physical examination at admission, she exhibited severe malnutrition with a body mass index (BMI) of 14 kg/m2, a Buzby index of 71%, trophic disorders, and a stage IV general condition assessment according to the World Health Organization (WHO). An abdominal CT scan revealed AMCS with an angle between the aorta and the SMA of 22˚ and an aortomesenteric space of 4 mm. The outcome was poor with medical treatment failure and, unfortunately, the patient died before surgery. Conclusion: SMAS is rarely evoked in clinical practice despite the presence of contributing factors and suggestive clinical signs. The prognosis depends on management time.

Clinical and Evolutive Aspects of Severe Acute Malnutrition in Children Aged 0 - 59 Months at Maroua Regional Hospital in Cameroon’s Far North Region

Introduction: Severe acute malnutrition remains one of the most important causes of under-five mortality. In Cameroon, the northern regions have the highest prevalence, with 1.4% in the Far North in 2021. These children are managed at the Internal therapeutic and Nutrional Centre, one of which is located at Maroua Regional Hospital, the third level referral Hospital. We therefore proposed to carry out a study on the clinical and evolutive aspects of these children. Materials and Methods: it was a descriptive, cross-sectional study from January 2020 to December 2022, at the ITNC (CNTI) of Maroua Regional Hospital. The sample size was obtained from the Lorentz formula. Patient records were used for data collection. We excluded all incomplete records and patients with less than 24 hours of admission. Results: Out of the 873 patients we recruited, the prevalence of severe malnutrition was estimated at 18 %. The average age was 14 months, with a male predominance. The main reasons for consultation were fever (42%) and diarrhoea (35%). Marasmus was the predominant clinical form. The major medical complications were sepsis (32.9%) and malaria (16.8%). HIV prevalence was 2.5% and tuberculosis was 4.9%. Most patients had haemoglobin levels between 7 and 10g/dl. 79.3% were cured and 6.5% died. The main causes of death were sepsis and malaria. Conclusion: Severe acute malnutrition remains a major problem in the Far North region. Several joint actions are needed to break this cycle.

Analysis of Influencing Factors of Moderate to Severe Malnutrition in Elderly Patients with Lung Cancer during Chemotherapy

Objective:This study aims to identify the factors influencing moderate to severe malnutrition in elderly lung cancer patients undergoing chemotherapy and to provide a basis for developing clinical prevention and intervention strategies.Methods:The clinical data of 150 elderly lung cancer patients who received chemotherapy were retrospectively analyzed.Demographic data,clinical characteristics,laboratory indicators,treatment plans,and other relevant information were collected.Independent risk factors for moderate to severe malnutrition during chemotherapy were identified.Results:During chemotherapy,50 patients(33.33%)developed moderate to severe malnutrition.The BMI of patients with moderate to severe malnutrition was significantly lower than that of patients with no or mild malnutrition(21.20±1.60 vs.26.14±2.31,P<0.001),and the proportion of patients with stage IV tumors was significantly higher(60.00%vs.27.00%,P<0.001).Serum pre-albumin(pre-ALB)and hemoglobin(Hb)levels in patients with moderate to severe malnutrition were significantly lower than those in patients with no or mild malnutrition(152.67±30.41 g/L vs.252.47±51.24 g/L and 102.44±10.09 g/L vs.154.21±15.18 g/L,respectively,P<0.001 for all).Conclusion:Low BMI,decreased serum pre-ALB levels,and decreased serum Hb levels before chemotherapy are independent risk factors for moderate to severe malnutrition in elderly lung cancer patients during chemotherapy.Close clinical attention should be given to these patients,with early intervention measures such as nutritional support to reduce the incidence of malnutrition and improve patients’quality of life and prognosis.

Preliminary validation of Global Leadership Initiative on Malnutrition criteria in cancer patients:A cross-sectional study

Background:The Global Leadership Initiative on Malnutrition(GLIM)has been used in China since 2019.This study aimed to test the use of the GLIM criteria in Chinese cancer patients and to compare the diagnostic performance of the GLIM criteria with the Patient-Generated Subjective Global Assessment(PG-SGA)and modified PG-SGA(mPG-SGA). Methods:A total of 2,000 cancer patients were consecutively screened using the Nutritional Risk Screening 2002 instrument on ad-mission.Patients at nutritional risk(Nutritional Risk Screening 2002 score≥3)were enrolled to obtain the complete GLIM,PG-SGA,and mPG-SGA criteria.To evaluate the convergent validity,Spearman correlation analysis was used to compare the test-retest reliability of the GLIM criteria and its results with the scores of various nutritional tools and objective parameters.Kruskal-Wallis tests and χ2 tests were used to test the discriminant validity among groups with different nutritional status.We calculated the sensitivity,specificity,positive predictive value,and negative predictive value for the various tools. Results:There were 562 patients found to be at nutritional risk,accounting for 28.1%of all patients.One hundred seventy-four patients(8.7%)were diagnosed as moderately malnourished,and 333 patients(16.6%)were severely malnourished based on the PG-SGA.When assessed using the GLIM criteria,185 patients(9.3%)were diagnosed as moderately malnourished and 311 patients(15.5%)were severely malnourished.The content validity of the GLIM criteria was 95%,evaluated by 60 medical staff members.The test-retest reliability was good.For the diagnosis of malnutrition versus the PG-SGA,the sensitivity of the GLIM was"good"(90.5%;95%confidence interval[95%CI]=88.0%-93.1%),with a positive predictive value of 92.5%(95%CI=90.2%-94.9%),but the spec-ificity and negative predictive value were"poor."Similar results were obtained when the mPG-SGA was used as the criterion. Conclusions:Overall,this cross-sectional study suggests that the GLIM criteria comprise a valid and reliable tool to assess the nutri-tional status of Chinese cancer patients.

Diagnosis of malnutrition in cancer patients

Malnutrition is a common complication in patients with malignant tumors and adversely affects treatment and prognosis1.It has been reported that the global prevalence of malnutrition in hospitalized patients with malignant tumors is approximately 70%2.Moreover,approximately 20%of cancer patient deaths are directly attributable to malnutrition3.According to the Investigation on Nutrition Status and its Clinical Outcome of Common Cancers(INSCOC)project4,the overall prevalence of malnutrition in Chinese inpatients with common malignant tumors is 80.4%.Of the 58.

Evaluation of Malnutrition in Infants Aged 0 - 59 Months in the Suburbs of Dakar

Introduction: Child malnutrition is a major public health concern worldwide, particularly in low- and middle-income countries. The latest report from Senegal’s Continuous Demographic and Health Survey revealed that 18% of children in Senegal were stunted (chronic malnutrition), 8% were wasted (acute malnutrition) and 14% were underweight. Thus, this study aimed to assess the characteristics associated with malnutrition in children according to their nutritional status. Methods: This descriptive transverse study was conducted at the Pediatric Social Institute of Pikine/Guediawaye and the National Hospital Center of Pikine, in Senegal between October and December 2019. A total of 94 children were recruited, with the consent of their legal tutors. Descriptive and multivariate analyses of the factors associated with malnutrition were performed. The z-scores for the indices of nutrition were determined with WHO Anthro® software version 3.2.2. All the data analyses were performed using R software version 4.2.2. Result: From the 94 children recruited, 51.06% were female, with a sex ratio (male/female) of 0.96. Acute malnutrition was recorded in 62.77% of cases, chronic malnutrition in41.49%, and underweight in 71.27%. Linear regression analysis showed that many factors, such as the female gender [OR = 1.82 CI (1.02 - 3.3), P-value = 0.04], consanguinity [OR = 2.84 CI (1.14 - 7.65), P-value = 0.03], low birth weight [OR = 4.83 CI (2.15 - 12.89), P-value = 0.0004], were associated with acute malnutrition. Low birth weight (<2.5 kg) [OR = 10.66 CI (3.82 - 44.39) P-value < 0.0001], non-exclusive breastfeeding [OR = 3 CI (1.40 - 7.13)] P-value = 0.007], dietary diversification before six months [OR = 2.04 CI (1.23 - 3.51), P-value = 0.007] and others factors were associated with underweight. The most frequently recorded clinical signs are weight loss (30.85%), fever (23.40%), diarrhea (34.04%), and anemia (70.21%). Conclusion: Problems associated with malnutrition are multifactorial. Dietary diversification, consanguinity, and low birth weight are factors associated with malnutrition in children in Senegal. Thus, special attention must be paid to this problem because of its impact on child survival. .

A bibliometric analysis and visualization of research on heart failure complicated with malnutrition

Objective:This study aimed to have a good knowledge of heart failure complicated with malnutrition research status,hotspots,and forecast research trends using bibliometric analysis and visualization of studies of hear t failure complicated with malnutrition in the past 10 years.Methods:Ar ticles related to malnutrition-induced hear t failure were obtained from the Web of Science Core Collection(Wo SCC)series from January 2012 to January 2022.Two software(Java Cite Space 5.8R3 and Microsoft Excel 2019)were used to perform bibliometric and knowledge-map analysis,including analyzing the annual publication and trend of ar ticles,authors and co-cited authors,institutions/countries,co-cited journals,co-occurrence,clusters,and burst of keywords,co-cited references,and reference burst.Results:A total of 672 articles appeared in 180 scientific journals by 4249 authors from 1453 institutions in 71 countries.Over the past 10 years,the number of related studies released has shown an upward trend,and the range of increases has been larger over the past 5 years.Takatoshi Kasai released the most papers,while Anker S D had the most co-quotes.Simultaneously,active cooperation existed in complicated hear t failure with researchers on malnutrition.Circulation,Journal of The American College of Cardiology,and Clinical Nutrition were the top 3 co-cited journals.The USA,Japan,and China were the most productive countries,while Johns Hopkins University was the most active institution.In addition,the reference published by Ponikowski P had the most co-citations,relating to as a knowledge base.The latest hotspots of hear t failure complicated with malnutrition mainly included research on:(1)assessment of nutrition status,the impact/risk factor of nutrition,and the prevalence and outcome of the patients;(2)hear t failure complicated with malnutrition when complicated with other diseases,for example,chronic kidney disease and diabetes mellitus;(3)the nutrition of child patients with heart failure complicated with malnutrition;and(4)the treatment of heart failure complicated with malnutrition,including assist devices,organ transplantation,and drug therapy.While the frontier topics included research on:(1)the index of hear t failure complicated with malnutrition;(2)the effect of sarcopenia to hear t failure complicated with malnutrition patients and the use of geriatric nutritional risk index to assess the nutritional statue;and(3)find the nutritional risk index.Conclusions:This study conducted a full overview of the present research situation,hotspots,and frontiers by using bibliometric and visualization analysis methods in hear t failure complicated with malnutrition,which would provide a helpful reference for future research.

Prevalence and Predictors of Double Burden of Malnutrition within Households in Africa: A Systematic Review

In recent years, there has been growing interest in the emergence of double burden of malnutrition (DBM) in Africa. In this study, we reviewed the literature on double burden of malnutrition in households, reviewing previous studies investigating the prevalence of DBM in Africa and the factors associated with it. To identify relevant studies, we consulted the PubMed and Cochrane electronic databases, using specific search terms. A total of seventeen articles met the eligibility criteria. These articles were published between 2012 and 2022, and their data were collected between 2000 and 2019. Twelve of these studies used secondary data, including demographic and health surveys. The age of children and adults varied from study to study. All studies used Body Mass Index as a nutritional indicator for adults. For children, the height-for-age Z-score was most commonly used, while weight-for-age, weight-for-height and Body Mass Index-for-age were less commonly used. The national prevalence of double nutritional burden in households ranged from 1.71% to 38.7%, depending on the country and the year. However, direct comparisons between studies were limited due to differences in combinations of undernutrition, overweight or obesity. Among the factors associated with double nutritional burden within households, the most frequently cited in the selected articles were urban/rural residence, income or socioeconomic status, age of child and mother, household size and mother’s level of education. However, no study assessed physical activity, and very few examined the diet of household members. It is essential to take these different parameters into account when designing and implementing interventions to prevent the DBM in Africa. Community and societal factors will also need to be studied and taken into account in these interventions.

Effectiveness of Enriched Flour in the Recovery of Children Aged 6 to 59 Months with Moderate Acute Malnutrition

Introduction: In Chad, malnutrition is a silent emergency. Yet the use of local products in the fight against malnutrition is essential. The purpose of this study was to compare the efficacy of locally sourced enriched flour in the recovery of children 6 to 59 months of moderate acute malnourishment compared to Ready-to-Use Therapeutic Foods (Plumpy’ Sup) in the city of Abéché-Chad. Methodology: This study took place from 1 October 2021 to 31 January 2022 in the city of Abéché, capital of the province of Ouaddaï. It was conducted in eight (8) urban health centers in the city of Abéché and concerned eighty (80) children with moderate acute malnutrition. It was based on a consumption assessment of two complementary foods by two groups of children. The assessment of nutritional status was made through anthropometric data such as weight, height and brachial perimeter. Results: All 80 children were tested for moderate acute malnutrition. Two complementary foods have been used which are locally produced flour and the Ready-to-Use Therapeutic Food. The study showed that the group 1 who consumed the locally produced flour had an average weight gain of 1100 g and the group 2 who consumed the Plumpy sup had an average weight gain of 400 g. Conclusion: The present study carried out in Abéché allowed us to compare the effectiveness of locally produced weaning flours with Ready-to-Use Therapeutic Foods on moderate malnourished child weight growth in the nutritional units of the town of Abéché.

Ocular Manifestations in Severe Acute Malnutrition in Children under 60 Months in a Secondary Health Center

Introduction: Severe acute malnutrition (SAM) is one of the main public health problems in the world. It is responsible in addition to the general symptoms, vitamin A deficiency which can cause serious eye damage including keratomalacia. This work aims to study possible ophthalmological lesions in severely acutely malnourished children from 0 to 60 months. Patients and Method: This study was carried out in a secondary ophthalmology center. It concerned all severely acute malnourished patients admitted for consultation in the pediatric department. Results: A total of 174 eyes of 87 children aged 0 to 60 months were examined. Two-thirds of the patients were aged between 6 and 18 months. Palpebral lesions are rare, however, we observed 12.64% blepharitis and palpebral dermatitis. Ocular involvement due to vitamin A deficiency was 6.9%, including one case of BITOT SPOT, 4 cases of conjunctival xerosis and one case of keratomalacia. Conclusion: Xerophthalmia is an ocular lesion due to a dietary intake deficient in vitamin A that occurs during severe acute malnutrition. Its occurrence is increasingly rare even in developing countries. However, some cases are observed in practice and may be responsible for profound visual impairments.

Outcome after Discharge from Hospital of Children with Complicated Severe Acute Malnutrition and Predictors Factors of Non-Response during Outpatient Treatment, in Senegal

Introduction: Malnutrition is a public health problem. It is responsible for high morbidity and mortality in children aged 6 - 59 months. The aim of this study was to determine the outcome of children with complicated severe acute malnutrition after hospital discharge. Methods: This is a descriptive and analytical cross-sectional study conducted from March 1 to November 31, 2021 at the Albert Royer Children’s Hospital. Children discharged from hospital for complicated severe acute malnutrition were included. Results: A total of 103 children were included. The mean age of children at hospitalization was 16.41 ± 10.11 months and mean duration of follow-up after hospital discharge was 29.63 ± 8.59 months. Three children (2.91%) died after hospital discharge. The mean z-score of the weight-for-current height was -1.34 ± 1.08. Almost a quarter (24.27%) of the children remain acute malnourished with 3.88% of severe acute malnutrition (SAM). The predictors’ factors associated with non-response were weaning before 2 years of age (ORaj: 12.21;95% CI [6.82 - 18.44];p = 0.04) and tuberculosis (ORaj: 21.06;95% CI [12.54 - 41.09];p = 0.03). Conclusion: The rate of recovery of nutritional status in children with complicated severe acute malnutrition is satisfactory. Ablactation before the age of two and the existence of tuberculosis are significantly associated with non-recovery of nutritional status.

Ocular Manifestations in Severe Acute Malnutrition in Children under 60 Months in a Secondary Health Center

Introduction: Severe acute malnutrition (SAM) is one of the main public health problems in the world. It is responsible in addition to the general symptoms, vitamin A deficiency which can cause serious eye damage including keratomalacia. This work aims to study possible ophthalmological lesions in severely acutely malnourished children from 0 to 60 months. Patients and Method: This study was carried out in a secondary ophthalmology center. It concerned all severely acute malnourished patients admitted for consultation in the pediatric department. Results: A total of 174 eyes of 87 children aged 0 to 60 months were examined. Two-thirds of the patients were aged between 6 and 18 months. Palpebral lesions are rare, however, we observed 12.64% blepharitis and palpebral dermatitis. Ocular involvement due to vitamin A deficiency was 6.9%, including one case of BITOT SPOT, 4 cases of conjunctival xerosis and one case of keratomalacia. Conclusion: Xerophthalmia is an ocular lesion due to a dietary intake deficient in vitamin A that occurs during severe acute malnutrition. Its occurrence is increasingly rare even in developing countries. However, some cases are observed in practice and may be responsible for profound visual impairments.

Correlation of dietary mineral intake and malnutrition in cancer patients:A multicenter cross-sectional study

Background:To examine the correlation between the dietary mineral intake and the nutritional status of patients suffering from malignan-cies.Methods:This multi-center cross-sectional study included a total of 866 patients with malignant tumors recruited from seven hospitals throughout China.The information of socio-demographic characteristics and biochemical indicators were obtained from electronic medical records of inpatients.Dietary data were collected using a 3-day 24-hour dietary recall questionnaire.The intake of energy,dietary calcium(Ca),phosphorus(P),potassium(K),sodium(Na),magnesium(Mg),iron(Fe),zinc(Zn),selenium(Se),copper(Cu)and manganese(Mn)were estimated according to the Chinese Food Composition Tables standard edition.The weight and height of patients were measured,and the body mass index(BMI)was calculated.Nutritional risk and malnutrition were assessed by the Nutritional Screening 2002(NRS 2002)and Global Leadership Initiative on Malnutrition(GLIM)diagnostic criteria.We used a multivariable logistic regression model to estimate the asso-ciations between dietary minerals and malnutrition.Results:The patients had an average age of 61.98(±15.49)years,and 40.6%(n=352)were female.Slightly less than half(44.5%)of the patients were at nutritional risk(NRS 2002≥3),and 32.7%were diagnosed with malnutrition(using the GUM criteria).Univariate analy-ses revealed that there was a statistically significant relationship between dietary mineral intake and the occurrence of nutritional risk(P<0.001).After adjusting the collinearity,we found that higher levels of P,Mn and Se intake were negatively associated with nutritional risk as-sessed by the NRS 2002 score.Moderate intake of Ca and high intake of Zn might also decrease the nutritional risk(Ca:OR,0.53,95%CI,0.32-0.88;Zn:OR,0.36,95%CI,0.19-0.68).However,no significant relationships were observed between any dietary mineral intake and malnutrition identified by the GUM criteria.Conclusions:Dietary minerals,especially P,Se,and Mn,may have a protective effect on the occurrence of nutritional risk in patients with malignant tumors.In addition,patients should maintain appropriate levels of Ca and Zn.

Rehabilitation interventions for malnutrition in head and neck cancer patients: Current state and future directions

Head and neck cancer and the approaches used to treat it can cause symptoms such as mucositis,alteration or loss of taste,dysphagia,and xerostomia,whichmakes the incidence of malnutrition in head and neck cancer patients higher than in the general population of cancer patients.Malnutrition in patients with head and neck cancer is associated with the occurrence of treatment-related adverse events,an increase in overall economic cost,a decline in quality of life,and a poor prognosis.Therefore,rehabilitation interventions for malnutrition are necessary throughout the course of the disease.However,the importance of rehabilitation interventions for malnutrition in patients with head and neck cancer has not been fully recognized,and the optimal methods and timing of interventions are unclear.This article provides an overview of rehabilitation interventions for malnutrition,including nutritional supplementation,exercise-based interventions,nutritional counseling and cognitive improvement,and drug therapy,and discusses their advantages and disadvantages as well as potential future directions.