Abstract Introduction Severe acute malnutrition (SAM) is a disease of global public health concern, worse in developing countries, contributing to illnesses and deaths among under-five children. Diphtheria is a deadly disease with its burden alongside SAM, poorly known. This gap could impact negatively on policy formulation and interventions. In-hospital burden of under-five SAM and diphtheria with their outcome and associated factors were assessed in North-east Nigeria. Methods A retrospective hospital-based cross-sectional study of children admitted for various illnesses at the Paediatric Emergency Unit, Paediatric Medical Ward and the Paediatric Infectious Diseases Unit of the Federal Medical Centre Nguru from 01/01/24–30/09/24. Data was analyzed using SPSS version 23. Univariate and multi-variates analyses were presented in tables and graphs, significant p was < 0.05. Results There were 194 (12.7%) deaths from the total 1,530 under five admissions. Males accounted for 123 (63.4%) of these deaths. SAM contributed 854 (55.8%) to the total morbidities, while acute diarrhea disease and malaria were the other lead contributors to under-five morbidities with 207 (13.5%) and 130 (8.5%) cases respectively. SAM was the highest 139 (71.6%) contributor to mortalities, followed by Diphtheria 16 (8.2%), Acute Diarrhea diseases (ADDx) 13 (6.7%) and malaria 11 (5.7%). Diphtheria and SAM have the highest case fatality rates of 22.2% and 17.0% respectively. Age, admission duration and diagnosis were major determinants of outcome of care with aOR and CI of 4.24 (2.094–5.125), 6.92 (3.54–8.10) and 2.24 (1.18–3.67) respectively. Conclusions We found high mortality rate, more males and children with SAM in this study. Most of the SAM patients were infants. SAM, ADDx and Malaria were the reasons for most admissions while SAM, Diphtheria, ADDx and Malaria were the major causes of deaths. Age, duration on admission and diagnosis were the main determinants of outcome of care. Underscoring the needs for early infant feeding and optimal complimentary feeding practices. Clinical trial number Not applicable.
Bello et al. (Mon,) studied this question.