Abstract:

Background: Undernutrition is common among children with congenital heart diseases (CHD) and has been associated with significant morbidity and mortality. Assessment of nutrition status is very important among children with CHD however is rarely done, this study therefore aimed at determining the magnitude, patterns and factors associated with undernutrition among children with CHD.

Methods: This was a hospital based cross-sectional study with a minimum sample size of 169 participants with CHD aged 6 months to 15 years who attended at Bugando Medical Centre in Mwanza Tanzania from November 2021 to April 2022. Data from enrolled participants were obtained through structured questionnaire, nutritional assessment was done as per WHO Z Score and BMI for age-z-score for children from 5 years and above, blood sample was taken for assessment of anemia and assessment of heart failure was done using modified ROSS classification of heart failure in children. Data analysis was done using STATA version 15.

Results: A total of 203 children with CHD were enrolled into the study, their mean age was 38.9±37.9SD. Prevalence of wasting, underweight and stunting was 53.2%, 66.9% and 66% respectively with 36.5% presenting with concurrent wasting, underweight and stunting. Multivariate logistic regression showed family size >5 people, (OR 2.4; [95% CI: 1.3 – 4.6], p-value 0.008), parental revenue < 1 dollar per day (OR 2.9; [95% CI: 3.4 – 6.0], p-value 0.005), inadequate dietary intake (OR 8.8; [95% CI: 2.3 – 29.6], p-value <0.001), living in rural residence (OR 2.9; [95% CI: 1.5 – 5.5] p-value 0.001) and heart failure (OR 2.1; [95% CI; 1.2 – 3.8] p-value 0.027) were associated with wasting. Inadequate dietary intake (OR 22.1; [95% CI: 5.9 – 82.6], p-value <0.001), cardiac surgery not being done, (OR 4.3; [95% CI: 1.3 – 14.8] p-value <0.001) and heart failure (OR 2.4; [95% CI 1.1 – 5.4] p-value 0.023) were associated with underweight. Inadequate dietary intake (OR 4.; [95% CI: 1.6 – 11.2], p-value 0.003) and delayed cardiac surgery (OR 5.6; [95% CI: 1.8 – 16.9] p-value 0.002) were associated with stunting among children with CHD.

Conclusion and recommendation: This study highlighted a high prevalence of undernutrition among children with congenital heart disease who attended Bugando Medical Centre warranting thorough nutritional assessment, management and counselling during routine clinic visits.