Prevalence of malnutrition and associated factors among epileptic children having follow up at neurology clinic of St Paul Hospital Millennium Medical College, Ethiopia,2023

Abstract

Abstract Background: The presence of malnutrition on top of seizure load in children with epilepsy results in poor control and untoward neurologic outcome. There are different factors that affect the interaction between the presence of epilepsy and malnutrition. Objective: To determine the prevalence of malnutrition and its associated factors among children with epilepsy who have follow up at SPHMMC neurology clinic from August 01/2023 to October 30/2023. Method: Hospital based cross sectional study was conducted. Data was collected prospectively by using a pretested and structured questionnaire containing sociodemographic, clinical and anthropometry parameters. Each epileptic child was taken until the final sample size is reached during follow up dates. The collected data was coded and checked for completeness and entered to epi-info version 7.0 and exported to SPSS version 26.0 for analysis. Descriptive statistics, Bi-variate and multivariate binary logistic regression was performed. Result: From 422 children screened for malnutrition, the overall prevalence of malnutrition was 38.6%. From all children included in the study, 56 (13.3%), 71 (16.8%) and 41 (9.7%) had severe wasting, underweight and stunting, respectively. While 60 (14.2%), 62 (14.7%) and 57 (13.5%) had moderate wasting, underweight and stunting, respectively. About 45 (10.7%) children had microcephaly(<-3 SD). Children for whom vitamin D level determined during their routine follow up (n= 268), 49 (18.3%) were deficient for vitamin D, 97 (36.2%) children had vitamin D insufficiency. From the revised available CBC results (n= 401), 40 (10.0%) had anemia with low MCV for age. The risk of malnutrition in children with out neurologic comorbidities other than epilepsy was lower than those with comorbidities (AOR= 0.517(95% CI: 0.296-0.902, p-value= 0.02). Feeding difficulties (AOR= 2.033 (95% CI: 1.612-10.567, p-value= 0.000) and poor adherence to followup (AOR= 2.033 (95% CI: 1.612-10.567, p-value= 0.008) were significantly associated with malnutrition. Conclusion: Nutritional screening and intervention should be part of routine epileptic care. Children with epilepsy and associated severe neurologic impairment like cerebral palsy may need the greatest nutritional support. Key words: Malnutrition, Epilepsy, Children, Ethiopia