Published in PLOS One on 2026-05-15, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Birtukan Kebede Moti, Gudina Egata, Desalegn Wirtu Tesso
Source: PLOS One • DOI 10.1371/journal.pone.0348796
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Malnutrition is common among hospitalized patients but is often overlooked in low- and middle-income countries like Ethiopia. Therefore, this study aims to determine its prevalence and identify associated factors among adult patients admitted to comprehensive specialized hospitals in Western Ethiopia.
A facility-based cross-sectional study was conducted among 1,106 randomly selected adult patients admitted to comprehensive specialized hospitals from December 16, 2023 to April 16, 2024. The sample was proportionally allocated by patient population. Data were collected using Kobo Toolbox, then exported from Microsoft Excel to Stata version 17 for analysis. Nutritional status was assessed at admission using the Subjective Global Assessment (SGA). Ordinal logistic regression was applied after verifying the proportional odds assumption, with the Brant test used for model validation. Adjusted odds ratios (AORs) alongside 95% confidence intervals (CIs) were computed, and statistical significance was set at p < 0.05.
Among all study participants, 24.5% (95% CI: 21.8%, 27.4%) were severely malnourished, while 34.4% (95% CI: 31.4%, 37.6%) were moderately malnourished. In the multivariable ordinal logistic regression analyses, factors significantly associated with both moderate and severe malnutrition included age greater or equal to 65 years [(AOR = 4.32; 95% CI: (2.02, 9.28)], age 41–64 years [(AOR = 3.36; (1.58, 7.16)], male sex [(AOR = 1.46,95% CI:(1.085,1.953)], urban residence [(AOR = 0.49; 95% CI: (0.32, 0.76)], lack of formal education [(AOR = 5.37; 95% CI: (3.32, 8.69)], comorbidities at admission [(AOR = 1.50;95%CI:(1.04,2.16)], and inadequate dietary diversity [(AOR = 1.37;95% CI:1.01,1.86)].
Malnutrition among hospitalized adult patients remains high and is strongly associated with age, sex, urban residence, educational status, comorbidities at admission, and dietary diversity. Therefore, hospital-based nutritional interventions should adopt a multidisciplinary approach, including early screening and identification, proper management of comorbidities, dietary counseling, and the development of comprehensive care plans and guidelines to improve clinical outcomes.
Introduction
The European Society for Clinical Nutrition and Metabolism (ESPEN) defines malnutrition -specifically undernutrition as “a state resulting from lack of intake or uptake of nutrition that leads to altered body composition, notably decreased fat free mass and body cell mass, resulting in diminished physical and mental function and impaired clinical outcomes from disease” [1]. In 2022, an estimated 390 million adults aged 18 years and older worldwide were underweight [[2].
Globally, an estimated 20–50% of patients are either malnourished or at high risk of malnutrition at the time of hospital admission [3]. Evidence from developed countries indicates substantial prevalence rates among hospitalized adults, including 46.3% in the United States, 29.6% in China, 24.1% in Germany, 46.5% in Ankara, Turkey, 43.0% in northern Delaware, and 51% in Canada [4–9], as well as 48.7% in Argentina [10] and 57.3% in Tehran [11]. In contrast, available evidence from Africa suggests an even higher burden. For example, the prevalence of malnutrition was reported to be 60% in Zambia [12]. In Ethiopia, studies have documented similarly high magnitudes, with 55.1% in referral hospitals of the Amhara National Regional State [13], 64.32% in southern Ethiopia [14], and 62.1% at Tikur Anbessa Specialized Hospital [15].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Birtukan Kebede Moti, Gudina Egata, Desalegn Wirtu Tesso. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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