On discharge summaries completed by the hospital staff, we determined whether information was appropriately completed/ recorded in the following fields: (i) patient identifiers (first name, surname, gender, hospital number, and dates of birth, admission, and discharge or death); (ii) outcome of hospitalisation; (iii) details of doctor completing the summary (name, signature and date of completion of summary); (iv) HIV status (HIV exposure, and CD4+ and viral load results for infected children); (v) anthropometric status (admission weight and length/height, presence of nutritional oedema, and discharge weight); (vi) ICD-10 codes for children diagnosed with any form of lower respiratory tract infection (LRTI) (e.g.
Proportions of parameters that were complete and accurate in paediatric discharge summaries (N=1 148) Domain n (%) Patient identifiers Name 1 050 (91.5) Surname 1 042 (90.8) Gender 1 071 (93.3) Hospital number 962 (83.8) Date of birth 920 (80.1) Date of admission 963 (83.9) Date of discharge 933 (81.3) Discharge outcome 1 049 (91.4) Doctor details Name 1 124 (97.9) Doctor's date 1 085 (94.5) HIV exposure 972 (84.7) Anthropometric parameters Admission weight 1 049 (91.4) Admission length/height 814 (70.9) * Discharge weight 575 (50.0) ([dagger]) Nutritional oedema 1 032 (89.9) LRTI 503 (43.8) Correct ICD-10 for LRTI 338 (67.2) LRTI = lower respiratory tract infection; ICD-10 = International Statistical Classification of Diseases and Related Health Problems, 10th revision.
Severe Acute Malnutrition is defined by very low weight-for-height/length (Z-score below -3 SD of the median WHO child growth standards), and/or a upper arm circumference (MUAC) <115 mm and/or by the presence of nutritional oedema
. SAM increases significantly the risk of death in children under five years of age.
Golden et al (13) in a study examined the association between plasma albumin and nutritional oedema by observing the changes in albumin during loss of oedema in patients on a restricted diet.
Anti-diuretic factor in the urine of children with nutritional oedema: Nutritional oedema is associated with an increased secretion of an anti-diuretic substance (probably anti-diuretic hormone) which prevents the normal excretory response to water administration.
With a view to reveal the precise role of ferritin in the pathogenesis of nutritional oedema, Gopalan and Srikantia (17) investigated the sequence of changes occurring in induced protein and calorie under-nutrition with focus on oedema formation in monkeys.
Treatment of nutritional oedema syndrome (kwashiorkor) with vegetable protein diets.
Severe Acute Malnutrition (SAM) is defined by very low weight for height/length (Z score below -3 SD of the median WHO child growth standards), a mid-upper arm circumference <115 mm, or by the presence of nutritional oedema. 
They should also be able to recognise nutritional oedema of the feet, which is another sign of this condition.