title: Predictors of oedema among children hospitalized with severe acute malnutrition in Jimma University Hospital, Ethiopia: a cross sectional study.
abstract: BACKGROUND
  Severe acute malnutrition has two main clinical manifestations, i.e., oedematous and non-oedematous. However, factors associated with oedema are not well established.
  
  
  METHODS
  Children 0.5-14 years of age with SAM (MUAC < 11.0 cm or weight-for-height < 70 % of median and/or nutritional oedema) admitted to the nutrition unit were included. Information on infections before and during admission was collected together with anthropometry. Predictors of oedema was analysed separately for younger (< 60 months) and older children (≥ 60 months).
  
  
  RESULTS
  351 children were recruited (median age: 36 months (interquartile range 24 to 60); 43.3% females). Oedema was detected in 61.1%. The prevalence of oedema increased with age, peaked at 37-59 months (75%) and declined thereafter. Infection was more common in the younger group (33% vs. 8.9%, p < 0.001) and in this group children with oedema had less infections (25.2% vs. 45.1%, p = 0.001). In the older group the prevalence of infections was not different between oedematous and non-oedematous children (5.5% v. 14.3%, p = 0.17). In the younger group oedema was less common in children with TB (OR = 0.20, 95% CI: 0.06, 0.70) or diarrhea (OR = 0.40, 95% CI: 0.21, 0.73).
  
  
  CONCLUSIONS
  The proportion of oedema in SAM peaked at three to five years of age and a considerable proportion was above 5 years. Furthermore, the prevalence of infection seemed to be lower among children with oedema. Further studies are needed to better understand the role of infection-immunity interaction.
authors: Department of Pediatrics and Child Health, Jimma University Specialized Hospital, Jimma, Ethiopia. tsinuel.girma@ju.edu.et.
authors: Tsinuel
authors: T
authors: Girma
authors: Pernille
authors: P
authors: Kæstel
authors: Christian
authors: C
authors: Mølgaard
authors: Kim F
authors: KF
authors: Michaelsen
authors: Anne-Louise
authors: AL
authors: Hother
authors: Henrik
authors: H
authors: Friis
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000367:Age Factors; D000886:Anthropometry; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004487:Edema / Q000453:epidemiology* / Q000209:etiology; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007239:Infections / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000150:complications*; D015995:Prevalence; D012621:Seasons; D015983:Selection Bias