Nutritional status of patients admitted to a general acute pediatric ward in Tygerberg hospital – a prospective observational analytical study

Thesis (MMed)--Stellenbosch University, 2022.ENGLISH ABSTRACT: Children admitted to hospital are at risk of becoming undernourished regardless of their nutritional status on admission. Acute illness increases energy consumption, decreases appetite and energy intake, and increases the risk of malnutrition. Although malnutrition is very common among hospitalised children, it is often unrecognised by health care professionals. This can prolong the length of hospitalisation especially if there is no nutritional intervention in place. Malnutrition delays recovery and is an independent risk factor for nosocomial infections1,2. Malnutrition can also result in poor growth and development; hospital-related depression, poor school performance and increased cost of medical services. These unwanted effects can be avoided by a nutritional intervention which in turn can be achieved if the nutritional status of hospitalised children can be rapidly assessed and documented. Identification and treatment of malnutrition in hospitalised patients are important in improving health outcomes. Determination of nutritional status is complex and requires several methods of assessment such as dietary history, anthropometry and biochemical data. There is however, no single best assessment method to determine the nutritional status of hospitalised patients."Geen opsomming biskikbaar."Master

Clinical experience with severe acute respiratory syndrome Coronavirus 2-related illness in children : hospital experience in Cape Town, South Africa

CITATION: van der Zalm, M. M. et al. 2021. Clinical Experience With Severe Acute Respiratory Syndrome Coronavirus 2-Related Illness in Children: Hospital Experience in Cape Town, South Africa. Clinical infectious diseases, 72(12):e938–e944. doi:10.1093/cid/ciaa1666The original publication is available at https://academic.oup.com/cid/Background: Children seem relatively protected from serious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related disease, but little is known about children living in settings with high tuberculosis and human immunodeficiency virus (HIV) burden. This study reflects clinical data on South African children with SARS-CoV-2. Methods: We collected clinical data of children aged <13 years with laboratory-confirmed SARS-CoV-2 presenting to Tygerberg Hospital, Cape Town, between 17 April and 24 July 2020. Results: One hundred fifty-nine children (median age, 48.0 months [interquartile range {IQR}, 12.0-106.0 months]) were included. Hospitalized children (n = 62), with a median age of 13.5 months (IQR, 1.8-43.5 months) were younger than children not admitted (n = 97; median age, 81.0 months [IQR, 34.5-120.5 months]; P < .01.). Thirty-three of 159 (20.8%) children had preexisting medical conditions. Fifty-one of 62 (82.3%) hospitalized children were symptomatic; lower respiratory tract infection was diagnosed in 21 of 51 (41.2%) children, and in 11 of 16 (68.8%) children <3 months of age. Respiratory support was required in 25 of 51 (49.0%) children; 13 of these (52.0%) were <3 months of age. One child was HIV infected and 11 of 51 (21.2%) were HIV exposed but uninfected, and 7 of 51 (13.7%) children had a recent or new diagnosis of tuberculosis. Conclusions: Children <1 year of age hospitalized with SARS-CoV-2 in Cape Town frequently required respiratory support. Access to oxygen may be limited in some low- and middle-income countries, which could potentially drive morbidity and mortality. HIV infection was uncommon but a relationship between HIV exposure, tuberculosis, and SARS-CoV-2 should be explored.https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciac266/6591403Publishers versio