Dysglycaemia and Clinical Outcomes in Under-Five Children with Severe Acute Malnutrition in Federal Teaching Hospital, Birnin Kebbi

Abstract

Background: Severe acute malnutrition (SAM) remains a critical public health issue globally, contributing substantially to illness and death among children under five. Despite the clinical significance of glucose metabolism, data on the burden and outcomes of dysglycaemia in malnourished children, particularly in low-resource settings like Nigeria, are limited.

Objective: To determine the prevalence of dysglycaemia and its relationship with clinical outcomes in children with SAM at the Federal Teaching Hospital, Birnin Kebbi.

Methods: This was a cross-sectional study of children aged 6 months to 5years with WHO-defined SAM presenting at the EPU from 1st September to 31st August 2024. A Google Form was used to obtain relevant sociodemographic and clinical information, and random blood glucose (RBS) was measured on admission, at 24 hours, and on alternate days.

Results: The study population was 132, comprising 36 males and 96 females, with most (54.5%) aged 1 to <3 years. At 24 hours post-admission, 11.4% had dysglycaemia: 2.3% with hypoglycemia and 9.1% with hyperglycemia. The majority (80%) with dysglycaemia had delayed stabilisation time after admission, and their median length of stay (LOS) was 14 days (IQR 10-18days). The overall mortality rate in children with SAM and dysglycaemia was 4.5%. The six fatalities comprised five children with hyperglycaemia and one with hypoglycaemia.

Conclusion: The findings in the study emphasise the significant morbidity associated with dysglycaemia in children with SAM and its link to increased mortality. This highlights the critical need for routine glucose monitoring and prompt management of its disorders to improve clinical outcomes.