Magnitude of undernutrition and associated factors among children with cardiac disease at University of Gondar hospital, Ethiopia

Abstract

Background: Undernutrition and cardiac disease are interconnected in a vicious cycle. Little is known about the effect of undernutrition on cardiac disease among children in low- and middle-income countries (LMICs). This study aimed to assess magnitude of undernutrition and associated factors among children with cardiac disease at University of Gondar hospital, northwest Ethiopia. Method: This hospital-based cross-sectional study included children with cardiac disease presenting to the pediatric outpatient clinic at University of Gondar Hospital, Ethiopia. A self-administered questionnaire was administered to participating families, and medical records were reviewed. All participants who fulfill the inclusion criteria were included. Anthropometric measurements were made and the presence of malnutrition was diagnosed according to the WHO criteria. Associated factors of undernutrition analyzed by using binary logistic regression model. Variables with p-value ≤0.2 in bivariate analysis were fitted to the final multivariable analysis and those variables with p-value ≤0.05 were considered as having statistically significant association to the outcome variable. AOR and 95% confidence interval was calculated to assess the strength of association between the variables. Result: A total of 269 patients participated in the study. 177 (65.7%) were undernourished, of whom 96 (54.5%) were underweight, 70 (39.7%) were stunted, and 95 (53.9%) were wasted. Pulmonary hypertension (adjusted odds ratio [AOR] = 3.82, 95%CI 1.80–8.10), NYHA/modified Ross class III and IV heart failure (AOR = 4.64, 1.69–12.72) and cardiac chamber enlargement (AOR = 2.91, 1.45–5.66) were associated with undernutrition. Conclusion: Undernutrition is common among children with cardiac disease in northern Ethiopia. Children with pulmonary hypertension, high-grade heart failure, and cardiac chamber enlargement may warrant close follow-up for malnutrition.