ASSESSMENT OF HOSPITAL-ACQUIRED MALNUTRITION AMONG UNDER-FIVE CHILDREN AND THE ROLE OF NUTRITIONAL STATUS AT ADMISSION IN A TERTIARY CARE HOSPITAL, BENGALURU

Abstract

Background Hospital-acquired malnutrition (HAM) among under-five children is a significant public health concern, especially in developing countries such as INDIA. Children admitted to hospitals are at increased risk of nutritional deterioration due to illness-related factors, inadequate dietary intake, prolonged hospitalization, feeding difficulties, and hospital care practices. Poor nutritional status during hospitalization may negatively affect recovery, increase complications, prolong hospital stay, and worsen clinical outcomes. Assessment of nutritional status at the time of admission plays an important role in identifying children at risk and preventing further nutritional decline during hospitalization. Therefore, the present study was conducted to assess hospital-acquired malnutrition among under-five children and the role of nutritional status at the time of admission in selected tertiary care hospitals. Objectives 1.To determine the nutritional status of under-five children at the time of hospital admission. 2.To estimate the prevalence of hospital-acquired malnutrition among under-five children. 3.To estimate the relationship between baseline nutritional status and hospital-acquired malnutrition 4.To identify contributing factors associated with hospital-acquired malnutrition Methods A quantitative research approach with a longitudinal observational study design was adopted. The study was conducted among under-five children admitted to selected tertiary care hospitals. A total of 80 children were selected using a convenient sampling technique. Data were collected using a structured socio-demographic questionnaire, nutritional assessment parameters, and anthropometric measurements, including weight-for-age and height/length-for-age. Nutritional status was assessed at both admission and discharge. Contributing factors related to illness, feeding practices, and hospital care processes were assessed throughout the hospital stay through observation, review of medical and nursing records, and caregiver interviews. The average Length of stay among the under-five children was 5 days. The collected data were analyzed using SPSS version 20. Descriptive statistics, including frequency and percentage, were used to describe socio-demographic variables and nutritional factors. The Chi-square test was used to examine the relationship between baseline nutritional status and hospital-acquired malnutrition. Logistic regression analysis was performed to assess the association between contributing factors and hospital-acquired malnutrition. Results The prevalence of hospital-acquired malnutrition among under-five children was 37.5%. No significant association was found between baseline nutritional status at admission and hospital-acquired malnutrition. Among the contributing factors, feeding practices showed a statistically significant association with hospital-acquired malnutrition, whereas illness severity and length of hospital stay showed no significant relationship. These findings highlight the importance of appropriate feeding practices and nutritional monitoring during hospitalization. Conclusion The study concluded that hospital-acquired malnutrition is a common problem among hospitalized under-five children. Although nutritional status at admission was not significantly associated with the development of hospital-acquired malnutrition, feeding practices during hospitalization were significantly related to nutritional outcomes. Early nutritional assessment, regular monitoring, and timely nutritional interventions are essential to prevent deterioration in nutritional status during hospitalization. The findings emphasize the need for standardized nutritional screening and nutrition-focused care practices in pediatric hospital settings.