The Prevalence of Refeeding Syndrome among Children with Severe Acute Malnutrition: An Observational Study in Kenyatta National Hospital, Kenya
Lilian Kerubo Okinyi
Journal Title:Medical & Clinical Research
Background: Refeeding syndrome is a complication of severe acute malnutrition occurring during initial feeding because of electrolyte changes; mostly potassium, phosphorus and magnesium. The highest mortality in sam is observed between 48-72 hours of initiating feeds, the same time that refeeding syndrome occurs. Objectives: To establish prevalence of refeeding syndrome among children with sam in kenyatta national hospital, find out its associated factors and outcomes. Design: Observational study; Setting: Kenyatta national hospital paediatric wards Study Participants: Children 6-59 months diagnosed with severe acute malnutrition interventions: potassium, phosphorus and magnesium levels were measured at admission and repeated 48 hours after feed initiation. Anthropometric measurements, oedema, dehydration, HIV status, type of feed were evaluated and patients followed for outcomes. Main outcome measures: Recovery, persistence, undetermined, death. Results: Total of 160 children with sam recruited. Prevalence of refeeding syndrome was 21% (95% ci 15.2 to 28.4). refeeding syndrome was significantly associated with HIV (p=0.032). odds of refeeding syndrome increased six-fold with HIV infection (or=5.99, 95% ci 1.23 to 29.1) after age and sex adjustment of the 34 children who developed refeeding syndrome, 65% recovered with treatment, 3% died, 12% had persistently low electrolytes despite treatment while 20% were lost to follow up. Conclusion: Prevalence of refeeding syndrome in kenyatta national hospital among children admitted with sam was 21% with HIV being significantly associated with its development (p=0.032). The outcomes of those who developed refeeding syndrome were recovery (65%), mortality (3%), lost to follow up (20%) and persistence (12%).