{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T12:17:19Z","timestamp":1773836239123,"version":"3.50.1"},"reference-count":38,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2013,5,2]],"date-time":"2013-05-02T00:00:00Z","timestamp":1367452800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1368980013001080_abs1\" sec-type=\"general\"><jats:title>Objective<\/jats:title><jats:p>To describe the burden, clinical characteristics and prognostic factors of severe malnutrition in children under the age of 5 years.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980013001080_abs2\" sec-type=\"general\"><jats:title>Design<\/jats:title><jats:p>Retrospective study of hospital-based data systematically collected from January 2001 to December 2010.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980013001080_abs3\" sec-type=\"general\"><jats:title>Setting<\/jats:title><jats:p>Rural Mozambican district hospital.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980013001080_abs4\" sec-type=\"subjects\"><jats:title>Subjects<\/jats:title><jats:p>All children aged &lt;5 years admitted with severe malnutrition.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980013001080_abs5\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>During the 10-year long study surveillance, 274 813 children belonging to Manhi\u00e7a's Demographic Surveillance System were seen at out-patient clinics, almost half of whom (47 %) presented with some indication of malnutrition and 6 % (17 188\/274 813) with severe malnutrition. Of these, only 15 % (2522\/17 188) were eventually admitted. Case fatality rate of severe malnutrition was 7 % (162\/2274). Bacteraemia, hypoglycaemia, oral candidiasis, prostration, oedema, pallor and acute diarrhoea were independently associated with an increased risk of in-hospital mortality, while malaria parasitaemia and breast-feeding were independently associated with a lower risk of a poor outcome. Overall minimum community-based incidence rate was 15 cases per 1000 child-years at risk and children aged 12\u201323 months had the highest incidence.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980013001080_abs6\" sec-type=\"conclusion\"><jats:title>Conclusions<\/jats:title><jats:p>Severe malnutrition among admitted children in this Mozambican setting was common but frequently went undetected, despite being associated with a high risk of death. Measures to improve its recognition by clinicians responsible for the first evaluation of patients at the out-patient level are urgently needed so as to improve their likelihood of survival. Together with this, the rapid management of complications such as hypoglycaemia and concomitant co-infections such as bacteraemia, acute diarrhoea, oral candidiasis and HIV\/AIDS may contribute to reverse the intolerable toll that malnutrition poses in the health of children in rural African settings.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1368980013001080","type":"journal-article","created":{"date-parts":[[2013,5,2]],"date-time":"2013-05-02T15:01:24Z","timestamp":1367506884000},"page":"1565-1574","source":"Crossref","is-referenced-by-count":48,"title":["Severe malnutrition among children under the age of 5 years admitted to a rural district hospital in southern Mozambique"],"prefix":"10.1017","volume":"16","author":[{"given":"Tacilta","family":"Nhampossa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Betuel","family":"Siga\u00faque","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00f3nia","family":"Machevo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eusebio","family":"Macete","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Alonso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quique","family":"Bassat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara","family":"Men\u00e9ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Fumad\u00f3","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2013,5,2]]},"reference":[{"key":"S1368980013001080_ref36","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/48.2.78"},{"key":"S1368980013001080_ref33","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3156.2003.01043.x"},{"key":"S1368980013001080_ref32","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/80.6.1604"},{"key":"S1368980013001080_ref29","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-11-23"},{"key":"S1368980013001080_ref27","doi-asserted-by":"publisher","DOI":"10.5402\/2012\/763591"},{"key":"S1368980013001080_ref26","first-page":"11","article-title":"Mainstreaming early and exclusive breastfeeding for improving child survival","volume":"46","author":"Dadhich","year":"2009","journal-title":"Indian Pediatr"},{"key":"S1368980013001080_ref25","first-page":"603","article-title":"Breastfeeding improves survival, but not nutritional status, of 12\u201335 months old children in rural Bangladesh","volume":"43","author":"Briend","year":"1989","journal-title":"Eur J Clin Nutr"},{"key":"S1368980013001080_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61693-6"},{"key":"S1368980013001080_ref21","doi-asserted-by":"publisher","DOI":"10.4314\/mmj.v21i3.45633"},{"key":"S1368980013001080_ref19","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e32830c6ede"},{"key":"S1368980013001080_ref18","volume-title":"Guidelines for the Inpatient Treatment of Severely Malnourished Children","year":"2003"},{"key":"S1368980013001080_ref17","volume-title":"Management of Severe Malnutrition: A Manual for Physicians and Other Senior Health Worker","year":"1999"},{"key":"S1368980013001080_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)90283-M"},{"key":"S1368980013001080_ref11","volume-title":"Normas Pediatricas","author":"Glisser","year":"1997"},{"key":"S1368980013001080_ref10","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e318187a87d"},{"key":"S1368980013001080_ref6","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2011.11-0223"},{"key":"S1368980013001080_ref5","volume-title":"Pocket Book of Hospital Care for Children: Guidelines for the Management of Common Illnesses with Limited Resources","year":"2005"},{"key":"S1368980013001080_ref4","unstructured":"UNICEF (2004). 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