In Burkina Faso, according to the final report of the SMART 2020 survey, the prevalence of acute malnutrition, chronic malnutrition and severe wasting at the national level were respectively 9.1% (including 1.0% in severe form), 24.9% and 17.6% [2] .

Severe physio-pathological disorders (hydroelectrolytic disorders) are associated with emaciation. They are the subject of a medical emergency and require rapid and effective treatment. In Burkina Faso, these troubles are poorly studied. Thus, through this study, we propose to evaluate the factors associated with ionic disorders occurring in wasting in infants aged 6 to 24 months hospitalized at the Yalgado Ouedraogo Teaching Hospital (YO-TH) and at the Charles De Gaulle Pediatric Teaching Hospital (CDG PTH). These centers have a Center for Recovery and Nutritional Education (CRNE).

The aim of the present study was to investigate disturbances in blood ionograms in infants 6 to 24 months with severe wasting at YO-TH and CDG-PTH. The

main limit in this study was the retrospective data collection with high risk of missing data. Despite this, we were able to include 271 emaciated infants.

The mean age of the infants was 14.48 ± 5.44 months and the 12 - 18-month age group was most affected by severe acute undernutrition (42.07%). This age group is also found in Mali with 49.4% [3] and in Burkina with 51.8% [4] . This high frequency of severe emanciation in this group could be explained by the fact that it is the weaning period for infants therefore food can be insufficient (quantitatively and qualitatively) to cover the growth needs, thus causing nutriments deficiencies and immunodeficiency with a high risk of infections which, in turn, aggravate undernutrition.

The major ionic disorders were hyponatremia (65.68%), hypobicarbonataemia (55.35%), hypoprotidemia (41.33%) and hypokalaemia (32.47%) in infants aged 6 to 24 months. The high frequency of hyponatremia, hypobicarbonatemia, hypoprotidemia and hypokalaemia is reported by several authors in Guinea [5] , India [6] [7] [8] [9] and in Pakistan [10] . Emaciated infants have profound physiological disturbances, particularly electrolyte imbalances and poor fluid distribution. This modification of the distribution of fluids influences the concentrations of several ions hence hyponatremia, hypokalemia, hypobicarbonatemia, hypoprotidemia [11] . Sodium, chloride and bicarbonate are the main ions contributing to the osmolality of extracellular fluid. Bicarbonate is the major ion that regulates the pH of extracellular fluid. The concentrations of individual ions influence the properties and behavior of excitable membranes such as nerve cells and the performance of many intracellular enzymes.

In undernutrition conditions, serum electrolytes do not reflect body content but only circulating concentration. Thus, high serum potassium leads to intracellular potassium deficiency while low serum sodium masks sodium overload, but correction of these disorders is important in the immediate treatment of life-threatening situations [12] . A reduction in bicarbonate levels occurred more often in infants with prolonged deterioration and undernutrition.

A significant association was found between hypokalemia and diarrhea. In severe acute malnutrition with diarrhea, there is a significant risk of fluid and electrolyte disturbances, especially with hyponatremia, hypokalemia and metabolic acidosis [13] . In infants, diarrhea continues to be a serious problem that can be fatal when added to undernutrition.

Place of residence was statistically associated with hypochloremia. Infants in the rural area were the most susceptible to hypochloremia. This could be explained by a deficit in chloride intake that could be observed in infants receiving chloride-deficient breastmilk substitutes or linked to excessive gastrointestinal and renal losses [14] .

This study demonstrated the extent of major fluid electrolyte disturbances in emaciated infants aged 6 to 24 months. Also, it showed the association of two factors, namely diarrhea and residence which were respectively associated with hypokalemia and hypochloremia. It is concluded that ionic disorders in emaciated infants become evident in the presence of diarrhea and vomiting.

Prospective cohort follow-up studies will shed more light on the factors associated with metabolic disorders in this 6-to-24-month age group.

This study did not receive any specific funding from public, commercial, or nonprofit funding agencies.

Realization of this work benefited from the invaluable support of several people, including of our elders by their accompaniments (Dr. F. Soudre, Dr. C. Yonaba, Dr. A. Kiba, Dr. R. Karfo, Dr. O. Da) and that our masters with their precious advice (Prof. Elie Kabre and Prof. Jean Sakande). May these people find here the expression of my greatest gratitude.

The authors declare no conflicts of interest regarding the publication of this paper.

Kouraogo, A., Soudre, F., Okengo, C.Y., Yagui, F., Kalmogho, A., Yameogo, G., Kiba, A., Karfo, R., Da, O., Zongo, E., Thiombiano, C., Tall, F.G., Ouédraogo, A.S., Bamba, S., Ouédraogo, G.A., Kabré, E., Koueta, F. and Sakande, J. (2023) Ionic Disorders Observed in Infants with Severe Wasting at the Yalgado Ouedraogo Teaching Hospital and the Charles de Gaulle Pediatric Teaching Hospital in Ouagadougou, Burkina Faso. Advances in Biological Chemistry, 13, 247-255. https://doi.org/10.4236/abc.2023.136018