The value of erythrocyte sedimentation rate in the diagnosis of infection in children with protein energy malnutrition

In this study, a total of 207 children with severe protein energy malnutrition hospitalised into the general paediatric wards of muhimbili medical center between 1st December 3lst December 1989 had erythrocyte sedimentation rates done and also investigated !or infection. The find if there was any correlation between erythrocyte sedimentation rate and the presence of infection. Severely malnourished children often present with infection which require antibiotic therapy. The initiation of antibiotic therapy usually follows the identification of the organism and its sensitivity pattern by culture of body fluids or its discharges. These laboratory procedures take time and the facilities may not be available in the smaller health centres. However estimation of the erythrocyte sedimentation rate is a simple and inexpensive procedure that can be done even in the smaller health units and used to initiate antibiotic therapy. Of the 207 children in the study, 106 had marasmus, 47 had marasmic kwashiorkor and 54 had kwashiorkor. Infection was present in 84 children with marasmus, 32 with marasmic kwashiorkor and 40 with kwashiorkor Overall 156 (75%) of the children studied had one or more infections. There was a statistically significant association between an elevated erythrocyte sedimentation rate and presence of infection (p=0.000). This association was highly significant for chest infection (p=0.000) but did not exist with bacteremia and urinary tract infection. It is concluded that the erythrocyte sedimentation rate may be useful as a simple screening test for chest infections in children with severe protein energy malnutrition. It is probably of limited value in bacteremia and urinary infection