Severe Malnutrition Characteristics and Nutritional Care Impact in Pediatric Ward of Fatmawati Hospital - Indonesia LANNY C GULTOM and

DODY FIRMANDA

Backgrounds Severe malnutrition is an important problem in worldwide including Indonesia. We implemented 10 steps of severe malnutrition treatment in children based on WHO standard treatment. Objectives To examine (1) the severe malnutrition prevalence; and (2) the nutritional care impact in severe malnutrition. The nutritional status is based on actual body weight (BW) divided by ideal body weight (IBW) according to height or actual mid upper arm circumference (MUAC) divided by MUAC according to age if there are tumor/organomegaly. Methods One group pretest and posttest study involving 678 inpatients were conducted from July 1st to Dec 31st 2010. Results Fifteen out of 678 patients detected severe malnutrition based on clinical manifestations and anthropometric measurements. Three patients refused to continue hospitalization. Seven out of 12 patients became mild-moderate malnutrition based on BW divided by IBW according to height 70% and MUAC divided by MUAC according to age 70%. The etiologies were HIV infection (5); low caloric intake (2); nasopharynx carcinoma (1); intraabdominal tumor (1); thallasemia (1); post explorated laparatomy due to abdominal perforation and illeitis complication (1); tuberculosis infection (2); hydronephrosis and urinary tract infection (1); and cerebral palsy (1). Five patients died due to HIV infection (1); malignancy (2); and aspiration (2). Conclusion Nutritional care is important as a treatment of severe malnutrition beside the definitive therapy for the underlying cause. Keywords: Severe Malnutritions, Nutritional Care