pharmacy

Dr Teresa Isichie Pounds

For change to occur in the narrative of hospitalised patients in developing countries—where longer hospital stays, higher medical bills, and increased mortality are common—African governments must address hospital malnutrition as an emergency, says the West African Society of Parenteral and Enteral Nutrition (WASPEN).

Founder and President of WASPEN, Dr Teresa Isichie Pounds, lamented the surge in malnutrition-related deaths over the past five years, describing it as unbearable. She urged governments to prioritise the growing concerns surrounding malnutrition in hospital settings.

Identifying the most common types of malnutrition in developing countries as protein-energy malnutrition and micronutrient deficiencies, commonly known as marasmus and kwashiorkor, Pounds asserted that an estimated 20-50 per cent of adult hospitalised patients suffer from malnutrition, either upon admission or during their stay.

Speaking with Pharmanews in an exclusive interview during Malnutrition Awareness Week, organised by WASPEN in September, Pounds stated that one in three hospitalised patients in African countries is affected by malnutrition. With nations such as South Africa, Kenya, and Ghana showing a prevalence of 61 per cent at-risk populations, she also decried the lack of malnutrition data in Nigeria, which she says requires urgent attention to prevent further mortality and morbidity.

The consultant in metabolic support, based in the diaspora, emphasised the need for government intervention to tackle clinical malnutrition in Nigeria and across Africa. She recommended the establishment of multidisciplinary nutrition support committees in all hospitals and strategies for the early detection of malnutrition as a solution.

Among her recommendations were the “development of multidisciplinary nutrition support steering committees for the management of hospital malnutrition within institutions, with responsibilities including identifying patients’ nutritional status, timely intervention, patient monitoring, and prioritising nutrition-related research.”

Citing the World Health Organisation’s definition of malnutrition, Pounds highlighted gaps in current hospital care, where many facilities lack sufficient dietitians or structured systems to evaluate patients’ nutritional status.

“There’s a system gap,” she remarked. “Most hospitals don’t have enough trained nutritionists to assess and treat malnutrition. Governments need to step up, providing the necessary resources and policy support to ensure that hospital patients undergo proper nutrition screening.”

The nutrition support committees, Pounds added, should be led by physicians and should include pharmacists, nurses, dietitians, and social workers. These committees would be responsible for educating hospital staff, assessing patients’ nutritional status, and providing appropriate nutritional interventions.

She outlined the major symptoms of patients at risk of malnutrition, including weight gain or loss of 20 per cent of ideal body weight, not eating for more than five days, high metabolic demands, trauma, sepsis, burns, and immunocompromised conditions.

Pounds further emphasised the importance of timely intervention in malnutrition, which has the potential to reverse its far-reaching impacts on patients’ health, such as weight loss, low energy, increased risk of falls, reduced independence, fractures, muscle wasting, confusion, infections, reduced mobility, low mood, and more.

Speaking on WASPEN’s Malnutrition Awareness Week, themed “Educate, Empower, and Eliminate,” Pounds revealed that the initiative had educated healthcare workers and elevated the conversation around the need for better nutritional care in hospitals.

According to her, events for the week took place concurrently in four institutions across the country, including Lagos University Teaching Hospital (LUTH), Niger Delta University Teaching Hospital (NDUTH), Anambra State Primary Health Care Development Agency, and Ahmadu Bello University Teaching Hospital (ABUTH).

Top activities during the week included nutrition screenings and interventions, awareness and education campaigns, clinical webinars on malnutrition in healthcare, strategies for early detection and comprehensive management, and panel discussions aimed at educating, empowering, and eliminating malnutrition. Additionally, the week featured two webinars with roundtable discussions on advancing nutritional care for neonatal, maternal, and adult hospitalised patients.

Some of the panellists for the week included Dr Felix Alakaloko, consultant neonatal and paediatric urology surgeon, Nutrition Steering Committee at Lagos University Teaching Hospital (LUTH); Prof. Aminu Muhammad Balarabe, consultant cardiothoracic surgeon and chairman of the medical advisory committee at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria; Pharm. (Mrs) Chisom F. Uchem, consultant social and administrative pharmacist, executive secretary/CEO, Anambra State Primary Healthcare Development Agency; Prof. Johnbull Jumbo, consultant pulmonologist and chairman of the medical advisory committee (CMAC) at Niger Delta University Teaching Hospital (NDUTH), Bayelsa; Prof. Christopher Sabo Yilgwan, chief medical director (CMD) of Plateau State Specialist Hospital, Jos; and Prof. Azuka Oparah, dean of the Faculty of Pharmacy, University of Benin, among others.