Seasonal effect and long-term nutritional status following exit from a Community-Based Management of Severe Acute Malnutrition program in Bihar, India

Background: Nutrition rehabilitation centers (NRCs) were started to control severe malnutrition and follow-up of children with severe acute malnutrition is essential because mortality rate of 10-30% has been reported after discharge from hospital.Methods: A community based cross sectional study with the objectives to assess the current health status of the children discharged from the NRC and to assess the healthy practices learned by mothers during their stay at NRC. We included children those discharged from May to October 2013. The children were approached house to house visit and assessed for their health status with a pretested semi structured questionnaire. Mothers of the children were also interviewed for the knowledge and practices of the dietary and child care.Results: Among 67 children, 8 (11.9%) children could not be traced and 7 (10.4%) were reported dead, 52 were included 27 were boys and 25 were girls with a mean age of 35 months. The current nutritional status was 71.2% were not in very low weight, 17.3% were moderately underweight, and 11.5% were still severely underweight. Children who had more number of follow-ups had a better nutritional status which was significant (p<0.0001). 94% of the mothers had knowledge about correct feeding practices and food preparations; 86.5% were aware of good hygiene; 75% aware of the danger signs. Only 59.5% of the mothers could recollect the structured play therapy.Conclusions: Community based followup of the children following discharge from NRC and appropriate feedback to the mothers is very much essential for sustained results.

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Long-term mortality and nutritional status following severe acute malnutrition: a longitudinal cohort study

Archives of Disease in Childhood ◽

10.1136/adc.2010.186338.9 ◽

2010 ◽

Vol 95 (Suppl 1) ◽

pp. A4.2-A4 ◽

Cited By ~ 3

Author(s):

M Kerac ◽

G Chagaluka ◽

S Collins ◽

P Bahwere ◽

A Seal ◽

...

Keyword(s):

Cohort Study ◽

Nutritional Status ◽

Severe Acute Malnutrition ◽

Acute Malnutrition ◽

Longitudinal Cohort Study ◽

Longitudinal Cohort ◽

Long Term Mortality

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Community-based Clinical Trial With Microbiota Directed Complementary Foods (MDCFs) Made of Locally Available Food Ingredients for the Management of Children With Post-severe Acute Malnutrition Moderate Acute Malnutrition (Post-SAM MAM)

Case Medical Research ◽

10.31525/ct1-nct04015986 ◽

2019 ◽

Author(s):

Keyword(s):

Clinical Trial ◽

Severe Acute Malnutrition ◽

Acute Malnutrition ◽

Complementary Foods ◽

Community Based ◽

Food Ingredients ◽

Moderate Acute Malnutrition

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Coverage Assessment For Community-Based Management Of Acute Malnutrition In Rural And Urban Ghana: A Comparative Cross-Sectional Study.

10.21203/rs.3.rs-43723/v2 ◽

2021 ◽

Author(s):

Joana Apenkwa ◽

Sam K Newton ◽

Samuel Kofi Amponsah ◽

Reuben Osei-Antwi ◽

Emmanuel Nakua ◽

...

Keyword(s):

Severe Acute Malnutrition ◽

Qualitative Approach ◽

Rural District ◽

Urban Setting ◽

Acute Malnutrition ◽

Rural Setting ◽

Community Based ◽

Cross Sectional ◽

Study District ◽

Point Coverage

Abstract Background: Ghana for years has implemented the Community-based Management of Acute Malnutrition (CMAM) among children in order to reduce malnutrition prevalence. However, the prevalence of malnutrition remains high. This study aimed to determine CMAM coverage levels in the Ahafo Ano South (AAS), a rural district, and Kumasi Subin sub-metropolis (KSSM), an urban district. Methods: The study was a cross-sectional comparative study with a mixed-methods approach. In all, 497 mother/caregiver and child under-five pairs were surveyed using a quantitative approach while qualitative methods were used to study 25 service providers and 40 mother/ caregivers who did not participate in the quantitative survey. Four types of coverage indicators were assessed: point coverage (defined as the number of Severe Acute Malnutrition cases [SAM] in treatment divided by total number of Severe Acute Malnutrition cases in the study district), geographical coverage (defined as total number of health facilities delivering treatment for SAM divided by total number of healthcare facilities in the study district), and treatment coverage (defined as children with SAM receiving therapeutic care divided by total number of SAM children in the study district) and program coverage (defined as number of SAM cases in the CMAM programme ÷ Number of SAM cases that should be in the programme). The qualitative approach was used to support the assessment of the coverage indicators. Data were analyzed using STATA version 14, and Atlas.ti, version 7.5 for the quantitative and qualitative data respectivelyResults: Geographically, only 6% of the facilities in the urban communities were participating in the CMAM programme as against 29% of rural district facilities. The districts had point coverage of 41% and 10% for the urban and rural districts respectively. The urban setting recorded a SAM prevalence of 52% as against 36% in the rural setting. The proportion of SAM children enrolled in CMAM was higher in KSSM when compared with AAS; 41% and 33% respectively. In both districts, the most likely factors to attract mothers/caregivers to utilize the CMAM services were: ‘free services’ and ‘a cured child.’ The qualitative approach showed that coverage improvement in both districts is hampered by barriers such: distance, transportation cost, lack of trained personnel in the communities for community mobilization and home visits, and insufficient feeds. Conclusion: To improve CMAM coverage, there is the need to train health workers to embark on aggressive health education strategies to encourage mothers/caregivers of malnourished children to utilize CMAM while ensuring that services reach those who need them. Trial registration: This study is approved and registered with The Kwame Nkrumah University of Science and Technology Committee on Human Research, Ethics and Publications (CHRPE/AP/314/15)

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Improving the outcome of severe acute malnutrition by community-based management

Journal of Health Research and Reviews ◽

10.4103/2394-2010.177492 ◽

2016 ◽

Vol 3 (1) ◽

pp. 20 ◽

Cited By ~ 1

Author(s):

ZubaidaLadan Farouk ◽

GarbaDayyabu Gwarzo ◽

Aisha Zango ◽

Halima Abdu

Keyword(s):

Severe Acute Malnutrition ◽

Acute Malnutrition ◽

Community Based

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Determinants of severe acute malnutrition among children under 5 years of age in Nepal: a community-based case–control study

BMJ Open ◽

10.1136/bmjopen-2017-017084 ◽

2017 ◽

Vol 7 (8) ◽

pp. e017084 ◽

Cited By ~ 16

Author(s):

Nilesh Kumar Pravana ◽

Suneel Piryani ◽

Surendra Prasad Chaurasiya ◽

Rasmila Kawan ◽

Ram Krishna Thapa ◽

...

Keyword(s):

Educational Level ◽

Case Control Study ◽

Complementary Feeding ◽

Severe Acute Malnutrition ◽

Case Control ◽

Acute Malnutrition ◽

Community Based ◽

Mother’S Age ◽

Age At Birth ◽

Control Study

BackgroundMalnutrition is one of the leading causes of morbidity and mortality among children under the age of 5 years in low and middle income countries like Nepal. Children with severe acute malnutrition (SAM) are nine times more likely to die than children without malnutrition. The prevalence of SAM has increased in Nepal over the past 15 years; however, the determinants of SAM have not been clearly assessed in the country.ObjectiveTo assess the determinants of SAM among children aged 6–59 months in the Bara district of Nepal.SettingA community-based case–control study was conducted in 12 randomly selected Village Development Committees (VDCs) of the Bara district of Nepal.ParticipantsA random sample of 292 children aged 6–59 months (146 as cases and 146 as controls) from 12 VDCs were included in this study.ResultsThe prevalence of SAM among children under the age of 5 years was 4.14%. The following factors were significantly associated with SAM: low socioeconomic status (adjusted odds ratio (AOR) 17.13, 95% CI 5.85 to 50.13); mother’s age at birth <20 or >35 years (AOR 3.21, 95% CI 1.30 to 7.94); birth interval <24 months (AOR 4.09, 95% CI 1.87 to 8.97); illiterate father (AOR 3.65, 95% CI 1.62 to 8.20); bottle feeding (AOR 2.19, 95% CI 1.73 to 12.03); and not initiating complementary feeding at the age of 6 months (AOR 2.91, 95% CI 1.73 to 12.03). Mother’s educational level, initiation of breastfeeding, colostrum feeding, and exclusive breastfeeding were not significantly associated with SAM.ConclusionThe mother's age at birth, birth interval, socioeconomic status, father’s educational level and initiation of complementary feeding at the age of 6 months were important determinants of SAM among children. A multi-sector approach is essential to address SAM. There is a need for further studies not only focusing on SAM but also moderate acute malnutrition.

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Assessment of the Nutritional Status of Under-Five Years (6–59 Months) Children Attending Dalhatu Araf Specialist Hospital Lafia, Nasarawa State, Nigeria

Current Developments in Nutrition ◽

10.1093/cdn/nzaa043_034 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 183-183

Author(s):

Emmanuel Kigbu Francis ◽

Titilayo Bamidele ◽

Micheal Enemali

Keyword(s):

Nutritional Status ◽

Severe Acute Malnutrition ◽

Well Being ◽

Acute Malnutrition ◽

Nutritional Knowledge ◽

Normal Range ◽

Child Feeding ◽

Under Five ◽

Under Five Children ◽

Nutritional Status Of Children

Abstract Objectives Malnutrition is a major public health challenge in developing countries and as such the nutritional status of children serve as an indicator to rate the overall well-being of a society. In this study, we assessed the nutritional status of under-five children attending Dalhatu Araf Specialist Hospital, Lafia, Nigeria. Methods After ethical clearance, 165 under five children were randomly recruited into the study. The socio-demographic and nutritional information of the children and mother were obtained using structured questionnaires. Anthropometric assessment was done on each child and blood samples analyzed using standard biochemical techniques. The data obtained were statistically analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Results Out of the 165 children recruited for this study, 51.5% were males. 41.2% of the children showed prevalence of Global Malnutrition, 15.8% and 25.5% indicated moderate acute malnutrition (MAM) and Severe Acute Malnutrition (SAM) respectively. 66.1% of the children had Mid-upper arm circumference (MUAC) measures in the normal range of 12.5–14.6 cm. There is a significant relationship between nutritional knowledge of the mother, socioeconomic status, child feeding practices, and the nutritional status of their children (P < 0.05). The biochemical parameters studied reported that average PCV (33.32 ± 4.49) and total protein (34.53 ± 13.26 g/L) were lower than the normal range, glucose (4.52 ± 0.97 mmol/L) and Calcium (2.14 ± 0.25 mmol/L) were within the normal range and Albumin (64.16 ± 16.87 g/L) was above the normal range. Conclusions This study has successfully revealed the nutritional status of under five years children in Nasarawa State, Nigeria. Our findings have critical implications for intervention initiatives among children in Nigeria. Funding Sources Self funded.

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