Serum electrolyte imbalance in severely malnourished children at hospitals in North-central Ethiopia

Abstract

Abstract Background – Severe acute malnutrition (SAM) raises the risk of death and disability associated with diarrhea owing to electrolyte depletion. Children with SAM have severely disrupted physiology and metabolism, and if vigorous refeeding begins before metabolic and electrolyte imbalances have been resolved, fatality rates are significant. No study has been conducted in Ethiopia on this topic, so this study was aimed at assessing electrolyte imbalance and its associated factors in under-5 children with severe acute malnutrition. Methods – Hospital-based case control study was conducted at south Gondar Hospitals from October to December, 2021. Children under-went physical examination and had blood drawn for serum glucose, hemoglobin and electrolytes investigation. A semi-structured questionnaire consisting socio-demographic, clinical and personal variable as well as associated factors for electrolyte imbalance was applied. Both bi-variable and multivariable binary logistic regression analyses was performed. Both bi-variable and multivariable logistic regression were done. We performed crude odds ratio and adjusted odds ratio at 95% CI. In the final model, variables with a p-value < 0.05 was declared as statistically significant. Result – We enrolled 232 children (116 cases and 116 controls). The mean age was 38.0 (SD±12.8) for cases and 37.1 (SD±13.1) for controls respectively. Sixty-one (52.6%) cases and 66 (56.9%) controls were female participants respectively. Hypokalemia [26.7%,16.4%]) and hyponatremia [25%, 14.7%] were frequently seen among cases and controls respectively. Death was recorded in 11 (9.5%) of cases. Edema (AOR=2.3; 1.4-4.7), not-vaccinated (AOR=1.2; 0.3-2.4) and diarrhea (AOR: 3.02; 1.09–8.63) were significantly associated with electrolyte derangement. Conclusion: Electrolyte derangements, specifically hypokalemia and hyponatremia, were common in malnourished children. Having edema, not being fully vaccinated, and diarrhea were independent determinants of electrolyte derangement in malnourished children. Electrolyte levels should be measured in all severely malnourished cases to detect asymptomatic electrolyte imbalance.