Screening for fecal occult blood loss in severely malnourished children

Introduction: PEM is the most important and basic hurdle in the triple-M complex of malnutrition,morbidity, and mortality. Very high mortality has been reported in severe PEM. PEM is found toaccount for about 4 million deaths in children. The study aimed to perform a fecal occult blood testin patients in the age group of six months to five years and also to identify the conditions associatedwith fecal occult blood loss in pem patients. Materials and Methods: A total of 100 indoor patientsof PEM admitted in our pediatric ward were taken as subjects in this study. According to WHO andIAP classification of PEM, severe malnutrition (marasmus, kwashiorkor, and marasmic kwashiorkor)were taken as study group; and mild grades of PEM (grade I and grade II) were taken as a controlgroup. Results: In severe PEM, marasmus (83%) was more common followed by kwashiorkor(14%) and marasmic kwashiorkor (3%); however in mild grades of PEM, grade I PEM was found in58% and grade II PEM was found in 42%. In severe PEM, pallor (64%), hair changes (38%), andtachypnoea(31%) were major clinical signs; while tachypnoea(36%), dehydration (26%), and pallor(20%} were major clinical signs in patients with mild grades of PEM. Conclusion: A positive fecaloccult blood test (FOBT) is strongly associated with moderate to severe anemia in severe PEMpatients. So all patients having a positive FOBT should have a hemogram profile done and thenappropriately treated for anemia.