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Journal of Tropical Pediatrics Advance Access published online on June 2, 2009
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmp038
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© The Author [2009]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Hypothermia in Children with Severe Malnutrition: Low Prevalence on the Tropical Coast of Kenya

Alison Talberta, Sarah Atkinsonb, Japhet Karisaa, James Ignasa, Charles Chesaroa and Kathryn Maitlanda,c

a Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, PO Box 230, Kilifi, Kenya
b Department of Paediatrics, University of Oxford, Oxford OX3 9DU, UK
c Wellcome Trust Centre for Clinical Tropical Medicine, Faculty of Medicine, Imperial College, Norfolk Place, London, W2 1PG, UK

Correspondence: Alison Talbert, Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, PO Box 230, Kilifi, Kenya. Tel.: 00254 4175 22063; Fax.: 00254 4175 22390. Email: <atalbert{at}kilifi.kemri-wellcome.org>.


  Abstract

Hypothermia is stated as a common complication of severe malnutrition although there are little primary data to support this. We performed a prospective study of children with severe acute malnutrition (SAM) admitted to a district hospital in Kenya. We documented the prevalence of hypothermia and examined its association with outcome and ambient temperature. During a 2-year period 667 children were recruited. Hypothermia was recorded in only 12 out of 15 191 (0.08%) temperature observations and as a single event in 12 children (2% of cases). There was no correlation with ambient temperature. Although mortality rates were higher in children with hypothermia (4/12, 33%) than those without (121/655, 18%), the timing of hypothermia did not coincide with clinical deterioration. Hypothermia was a rare marker of severity in our setting. We recommend that other observations be highlighted to identify high risk groups and that routine temperature observations be reduced wherever staff are few.

Key Words: malnutrition • kwashiorkor • children • hypothermia • outcome • weather • Kenya


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