Pattern of ocular morbidity in children admitted with Severe acute malnutrition at jimma university medical Center departement of pediatrics, south west Ethiopia

Abstract

Background: The World Health Organization defined malnutrition as a cellular imbalance between the supply of nutrients and energy and the body's demand for them to ensure growth maintenance and specific functions. Ocular involvement is relatively common in malnourished children, and the consequences of malnutrition on the eye are frequently more severe during the formative years of life. This is a significant cause of avoidable blindness that has to be addressed with affordable methods. The World Health Organization (estimates that vitamin A deficiency alone is responsible for 250,000 to 500,000 children becoming blind every year, with half of these children dying within 12 months of losing their sight. The prevalence of ocular morbidities among severely malnourished children varies across regions. In sub-Saharan Africa and South Asia, where the burden of malnutrition is highest, ocular complications are more prevalent due to inadequate intake of micronutrients, limited access to healthcare, and high rates of infectious diseases. Studies have shown that up to 50% of children with severe acute malnutrition may develop some form of ocular pathology, with xerophthalmia being the most common. Aim: To determine the pattern of ocular morbidity in children admitted with severe acute malnutrition at Jimma Medical Center, Department of Pediatrics. Methods: A hospital-based cross-sectional study was conducted from November 1, 2024, to January 30, 2025, at JUMC. A total of 91 children aged 6 months to 5 years with SAM were enrolled. Data were collected using a pretested, structured questionnaire administered to parents or caregivers. A complete ocular examination was carried out by trained ophthalmology residents, using tools such as a portable slit lamp, torch, and indirect ophthalmoscope. Data were recorded using Epi-data version 3.1 and analyzed using SPSS version 27. Descriptive statistics were used to characterize the data, and bivariate and multivariate logistic regression were used to identify factors that were associated with ocular morbidity. Statistical significance was defined by a p-value of <0.05. Results: The prevalence of ocular morbidity among children with SAM was 33%. The most commonly identified ocular morbidities were blepharitis (43.3%), and conjunctivitis (26.7%). 20% of the patients were having sign of vitamin A deficiency. Abnormalities of the posterior segment were rare and were observed in only 2cases (6.6%), which is papilledema and retinal hemorrhages. Sociodemographic factors that were significantly associated with ocular morbidity were younger age less than two years is 6 times more likely to have ocular morbidities. p = .026, and those children who have 3 or more siblings had more likely to have ocular morbidities. AOR= 15.087, 95%CI (3.243, 70.199) 0.001