Abstract:
BACKGROUND
Diarrhea leads to malnutrition while malnutrition aggravates the course of diarrhoea.
In addition, it has been observed that children with moderate severe diarrhoea cases are
more likely to be malnourished compared to those with mild cases, and the bidirectional
relationship of the conditions occurs in situations where either malnutrition or diarrhoea has
become chronic. However, there is scanty information on the risks of bidirectional diarrhoea
malnutrition among under fives from high burden areas in the informal settlements of
Western Kenya.
MATERIALS AND METHODS
A
cross sectional design using a quantitative approach to collect primary and
secondary data was applied to determine the occurrence of malnutrition, diarrhoea, and
bidirectional diarrho ea malnutrition and further investigated the risk of bidirectional
diarrhoea malnutrition among 105 under fives admitted in two referral hospitals of Western
Kenya between August 2020 to April 2021. The under five children who met the inclusion
criteria co mprised those experiencing either acute or chronic malnutrition, as well as severe
diarrhoea with dehydration or those at risk of dehydration due to malnutrition and
diarrhoea, respectively. Primary and secondary data were collected using a semi structured
questionnaire and a data abstraction tool respectively.
RESULTS
Out of 105 patients aged 0
59 months admitted to the hospital, 52 had malnutrition,
and 53 had diarrhoea. The high occurrence of malnutrition and diarrhoea ranged between
71.7% and 78.85% in the age groups of 6 23 months whereas other age groups had 13.46
18.87% < 6 and 7.69 9.43% in 24 59 months. Of the 33 cases with bidirectional diarrhoea
malnutrition, n=28 (84.85%) cases were observed in the age group of 6 23 months, and the
majority, 21 (63.64 %) had diarrhoea and then developed malnutrition. The findings showed
that the risk for bidirectional diarrhoea malnutrition among under fives was untrimmed
fingernails AOR= 2.73, 95% CI=0. 1.04 7.17 , P value=0.041 and having more than 3 under
fives in a household (AOR=3.44, 95% CI= 1.15 24.65, P value=0.032)
CONCLUSION
The study findings show a high occurrence of malnutrition, diarrhoea, and
bidirectional diarrhoea malnutrition among children aged 6 23 months. Untrimmed
fingernails and th e number of under fives in a household were associated with bidirectional
diarrhoea malnutrition. The study suggests that the occurrence of bidirectional diarrhoea
malnutrition can be reduced with the best household health practices.
