Malnutrition in children

The appropriate assessment of nutrition and ongoing review of growth are important aspects of monitoring children. Overall, hospitalised children have higher rates of under-nutrition: this altered nutritional status may impact adversely upon morbidity during hospitalisation and length of hospital stay. The overall hypothesis of this project was that the optimal use of Nutritional Risk Screening (NRS) tools in children will lead to earlier detection of children at risk of malnutrition, both in developed and developing countries. Recently, three NRS tools (STRONGkids, PYMS and STAMP) have been developed in Europe for the evaluation of hospitalised children but have not been evaluated elsewhere. Therefore, these three tools were applied to 119 and 162 paediatric hospitalised patients (in Iran and NZ) respectively. The STRONGkids tool was shown to be the most reliable and feasible tool in both settings. This tool was able to recognise 83% to 100% of under-nourished patients in its at risk groups. In both studies, the nutritional state of the children (hospitalised and the comparison groups) was assessed. 9.9% of NZ hospitalised children were under-nourished, contrasting to just 3.7% of a healthy community-based group (p=0.04). An even higher rate of under-nutrition was seen in a group of children admitted to an Iranian hospital, whilst under-nutrition was again seen infrequently in the community comparison group (25.2% versus 3%; p