Malnutrition of patients on admission to hospitals are estimated to be as high as 60%, although the prevalence varies between countries. The impact of malnutrition on patient recovery and discharge is severe, with extensive cost implications. This study aims to assess the prevalence of at risk for malnutrition among adult patients admitted to hospital across 3 countries on the African continent.

The prevalence of malnutrition on admission to hospital varies between 15-60%. Knowing the extent of the problem and identifying at-risk patients should be a priority task since malnutrition is associated with increased hospital-related complications; longer length of stay, increased costs related to treatment and higher mortality. Post discharge, malnourished patients have also been linked to more frequent re-admissions, higher morbidity and mortality. Various screening tools are available, including the Nutrition Risk Screening-2002 recommended by European Society for Clinical Nutrition and Metabolism as the preferred screening tool for malnutrition in hospitals in Europe. ASPEN recommends a more comprehensive evaluation and diagnosis procedure. In South Africa, and the rest of Africa, nutritional screening is not routinely done and the investigators do not have any reliable national statistics indicating the extent of the problem. The aim of this study is to determine the prevalence of malnutrition on admission to hospital and to identify the impact thereof on relevant outcomes. Two different internationally recognised tools will be used and validated for the African context. In this multi-country, multi-centre descriptive cross-sectional study 3 hospitals in South Africa, 1 in Ghana and 2 in Kenya will be included. Adult patients (n=400 per hospital) will be screened on admission and at discharge and relevant outcomes (in-hospital and 3-month post-discharge) will be charted. A 50% sub-sample will be used to validate the 2 instruments.

Inclusion Criteria:

• All patients older than 18 years of age
• Males and females
• Admitted to hospital within the past 48 hours
• Conscious
• Informed consent provided

Exclusion Criteria:

• Paediatric patients younger than 18 years
• Pregnant and lactating females
• Patients admitted to ICU, burns or relevant acute care wards
• Patients admitted to psychiatry or eating disorders units
• Patients on dialysis

All adult patients admitted to the hospitals (3 in South Africa [Tygerberg Academic Hospital, Cape Town; Grootte Schuur Academic Hospital, Cape Town; Chris Hani Baragwanath Hospital, Johannesburg]; 2 in Kenya [Aga Khan University Hospital, Nairobi; Mbagathi district hospital, Nairobi] and 1 in Ghana [Korle Bu Teaching Hospital, Accra]) during the defined study periods will be eligible for inclusion in the study.