Midodrine for the early liberation from vasopressor support in the ICU (LIBERATE): A feasibility study
Authors: Kilcommons Sebastian , Hammal Fadi , Opgenorth Dawn , Fiest Kirsten , Karvellas Constantine , Lau Vincent , MacIntyre Erika , Senaratne Janek , Slemko Jocelyn , Sligl Wendy , Zampieri Fernando , Duquette D'Arcy , Guan Lily , Baig Nadia , Bagshaw Sean , Rewa Oleksa 
Published: April 2024

Abstract

Background: Malnutrition is the most common nutritional disorder in developing countries and it remains one of the most common causes of morbidity and mortality among children worldwide. Childhood malnutrition is a multi-dimensional problem. An increase in household income is not sufficient to reduce childhood malnutrition if children are deprived of food security, education, access to water, sanitation and health services. However, due to regional variations in prevalence of acute malnutrition, it is important to explore the risk factors specific to the region, for designing and implementing public health interventions.
Objective: To assess the prevalence and risk factors of malnutrition among children under five years
Methods: A descriptive study enrolled 100 children under five years in Helat Hassan Health Centre, Wad-Medani, Gezira State during the period from November 2020 - March 2021. Data regarding children and families characteristics, nutritional history, health and medical history and anthropometric measurements were collected. Malnutrition was defined according to WHO guideline as -3SD of age specific BMI
Results: Among 100 children, 59(59%) males and 41(41%) females, their mean age was 33±18 months. The frequency of malnutrition was 10% (n=10) and underweighting was 18% (n=18). Child's related risk factors associated with malnutrition were; children order above 4th (P. value= 0.000) and number of under 5 children in family above 3 children (P. value= 0.00). Family's related risk factors associated with malnutrition were; younger mother blow 30 years (P. value= 0.001), non-mother (relative) caregivers (P. value= 0.000), illiterate mothers (P. value= 0.046), employed mothers (P. value= 0.000), relative as income responsible (P. value= 0.009), lack of medical insurance (P. value= 0.047), lack of in-home source of water (P. value= 0.003), and low income blow 6,000 SDG (P. value= 0.000). Nutritional related risk factors associated with malnutrition were; lack of exclusive breastfeeding (P. value= 0.000), less than three meals per day (P. value= 0.021), lack of vegetables and fruits in daily nutrition (P. value= 0.006) and lack of milk and dietary products in daily nutrition (P. value= 0.000). Health related risk factors associated with malnutrition were; illness as cause of health care center visit (P. value= 0.018), anemia (P. value= 0.002), admission to hospital in last 2 months (P. value= 0.005), fever, cough, runny rose or chest infection in last 2 weeks (P. value= 0.032), chronic diarrhea (20.7%; P. value= 0.018) and history of malnutrition (P. value= 0.001).
Conclusion: The frequency of malnutrition is not neglectable in Helat Hassan Health Centre at Wad-Medani. Malnutrition was found to be multi-factorial and associated with child, family, nutritional and health related factors. Effective, efficient and equitable program and intervention should be designed to reduce child malnutrition