scholarly journals Clinical spectrum of severe acute malnutrition among children admitted to nutritional rehabilitation centre of a tertiary care hospital with special reference to incidence of bilateral pitting pedal oedema in children with severe acute malnutrition

2018 ◽  
Vol 5 (5) ◽  
pp. 1928
Author(s):  
M. R. Prashanth ◽  
M. R. Savitha ◽  
H. N. Yashwanth Raju ◽  
M. Shanthi
Keyword(s):  
Severe Acute Malnutrition ◽  
Tertiary Care ◽  
Clinical Spectrum ◽  
Acute Malnutrition ◽  
Care Hospital ◽  
Nutritional Rehabilitation ◽  
Rehabilitation Centre ◽  
Under Five ◽  
Under Five Children ◽  
Pedal Oedema

Background: Malnutrition is a major cause of morbidity and mortality in under five children globally, according to global nutrition report 2016, forty five percent of deaths in under five children are linked to malnutrition. The objective of this study was to study the clinical spectrum in children with Severe Acute Malnutrition (SAM) admitted to nutritional rehabilitation center of a tertiary care hospital.Methods: Children between the age group of 6 months to 5 years admitted in the nutritional rehabilitation centre during the period of 1 year (from April 2016 to March 2017) meeting our inclusion criteria were included in the study. We retrospectively reviewed the medical records of these children. Clinical spectrum of SAM was compared with comparison group.Results: A total of 100 cases were included in the study. Ninety five percent of children met the criteria of weight for height less than 3SD, 45% of children met the criteria of Mid Upper arm Circumference (MUAC) less than 11.5 cms and 5% of children met the criteria of bilateral pitting pedal oedema. Mean age of presentation of children in the present study was 15.8 months among which 45% were males and 55% were females. Major symptoms of the study group were fever, cough, hurried breathing, loss of appetite and loose stools with 79%, 45%, 27%, 26% and 23% as respective frequencies. Pneumonia (43%) was the major comorbidity among children admitted with severe acute malnutrition. Diarrhoea (21%), meningitis (8%), urinary tract infection (6%) were the other co-morbidities present in the study group.Conclusions: Pneumonia and diarrhoea are the major co-morbidities present in children with SAM. Majority of children fulfil the criteria of weight for height ≤3SD for diagnosis of SAM. There is a low incidence of oedematous malnutrition in the present study.

scholarly journals Determinants of severe acute malnutrition in children between six months to five year of age enrolled in nutritional rehabilitation centre at a tertiary care level

2019 ◽  
Vol 6 (6) ◽  
pp. 2489
Author(s):  
Gargi H. Pathak ◽  
Anuya V. Chauhan ◽  
Sunita O. Beniwal
Keyword(s):  
Nutritional Status ◽  
Severe Acute Malnutrition ◽  
Tertiary Care ◽  
Feeding Practices ◽  
Well Being ◽  
Acute Malnutrition ◽  
Nutritional Rehabilitation ◽  
Rehabilitation Centre ◽  
Under Five ◽  
History Of

Background: Indicators showing levels of nutritional status in children are often regarded as representative of the health and general well-being of a society at large. Malnutrition stands as a consequence of several key social and economic factors such as lack of education, inadequate health care services and ill-informed cultural behaviors.  In order to holistically address the issues surrounding malnutrition, a comprehensive understanding of the multi-dimensional complexities at play in society is crucial. Objective was to identify determinants of severe acute malnutrition among children with severe acute malnutrition under 5 years (between 6 months to 60 months) of age. Methods: A cross sectional study design involving 64 patients with severe acute malnutrition between 6 to 60 month of age was employed to identify the risk factors of severe acute malnutrition among children admitted in pediatric wards and nutritional rehabilitation centers, Civil hospital Ahmedabad, from April 2018 to march 2019. A detailed history of all the patients were taken and data collected using structured interviewer-administered questionnaire.Results: Thus, from the above study, it is clear  that age of the child <2 years, female gender, bigger family size, poverty, illiteracy in mother, poor feeding practices, improper complementary feed introduction, poor nutritional status of mother whose child were breastfed, acute or chronic illness in child and narrow birth spacing were the chief determinants of SAM in under five children.Conclusions: Socio demographic characters, nutrition and child caring practices, infection and other childhood illness as well as obstetric history of mother are important determinants of severe acute malnutrition in children under five years of age. As a result, collaborative efforts should be organized to improve promotion of better child caring practices through appropriate age specific child and maternal feeding practices, prevention and early treatment of acute childhood illnesses and promotion of family planning.

scholarly journals Demographic and clinical profile of children with severe acute malnutrition admitted in a tertiary care hospital in Mahbubnagar, India

2020 ◽  
Vol 7 (2) ◽  
pp. 300
Author(s):  
Archana Reddy D. ◽  
Lakshmi Aparnadevi V. V.
Keyword(s):  
Risk Factors ◽  
Tertiary Care Hospital ◽  
Severe Acute Malnutrition ◽  
Tertiary Care ◽  
Acute Malnutrition ◽  
Care Hospital ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Under Five ◽  
Under Five Children

Background: All possible efforts are being made by the governments, and other agencies to reduce the burden of these problems of malnutrition and deaths associated with it but still it remains a challenge. Severe acute malnutrition continues to constitute an important risk for mortality and morbidity among the under five children. Objective of the study was to study the profile and risk factors of severe acute malnutrition of the under five children in a tertiary care hospital setting.Methods: Hospital based cross sectional study was carried out among 60 under five children with severe acute malnutrition who were admitted for difference causes in the Pediatric wards of SVS Medical College and Hospital, Mahabubnagar. A detailed history and physical examination were done. Anthropometric indices like weight, length/height, MUAC and weight for height were recorded and analysed using WHO growth charts.Results: Majority of the children with severe acute malnutrition were found in the age group of 1-2 years i.e. 48.3%. Males were more (69%) compared to females (31%) and this can be attributed to the hospital based cross sectional nature of the present study. Only 21.6% of the children were completely immunized for age. Majority of the children were found to have grade IV type of malnutrition i.e. 38.3%. Majority of the children presented with fever in 71.6% of the cases. Majority of the children had gastrointestinal related comorbidity in 54.6% of the cases.Conclusions: Incomplete immunization, low social class, inappropriate feeding practices in young age of <1 year are important risk factors of severe acute malnutrition.

scholarly journals Evaluation of the performance of a nutrition rehabilitation centre in a tertiary care hospital in Eastern India

2019 ◽  
Vol 6 (4) ◽  
pp. 1728
Author(s):  
Mayadhar Panda ◽  
Sikata Nanda ◽  
Mangala Charan Murmu ◽  
Rama Chandra Giri ◽  
Lila Lalantika Debi
Keyword(s):  
Health Care Providers ◽  
Rural Areas ◽  
Severe Acute Malnutrition ◽  
Tertiary Care ◽  
Acute Malnutrition ◽  
Care Hospital ◽  
Care Providers ◽  
Rehabilitation Centre ◽  
Nutrition Rehabilitation ◽  
The Mean

Background: Severe acute malnutrition (SAM) places extraordinary challenges in the way of survival, growth and development of the child under five years of age. Our aim was to evaluate the functioning and performance of facility based management of SAM children admitted in the nutrition rehabilitation centre (NRC) and to identify the existing bottlenecks in the NRC.Methods: Children above 1 month and less than 5 years of age with severe acute malnutrition were included during the study period. Demographic details of the SAM children, clinical features during admission were recorded. Anthropometric measurements like MUAC, weight, height/length and WHZ scores were taken at admission and compared with the findings at discharge. Statistical analysis: the data after collection, compilation was analysed by SPSS.Results: Majority 277 (78.47%) of them belonged to rural areas. 300 (85%) SAM children were referred by medical officers. Bilateral oedema was recorded in 12 (17.9%) admitted children during 2014-2015, 22 (17.9%) children in 2015-2016 and in 37 (22.7%) children during 2016-2017. There was significant improvement in the mean weight (kg) and mean MUAC (cm) at discharge was in comparison to the weight and MUAC of the children at admission and this difference in increase in the mean weight and MUAC were found to be statistically significant.Conclusions: Implementation of WHO feeding guidelines resulted in adequate weight gain of inpatient malnourished children, however the frontline workers in the community and health care providers of PHCs should be trained and given hands on training for early identification and referral of SAM cases.

scholarly journals Demographic Profile, Clinical Profile and Outcome of Severe Acute Malnutrition among Children Aged 6 to 59 Months at a Tertiary Care Hospital, North East India

2021 ◽  
Vol 8 (18) ◽  
pp. 1276-1280
Author(s):  
Rajkumari Rupabati Devi ◽  
Chingshubam Imobi Singh
Keyword(s):  
Tertiary Care Hospital ◽  
Severe Acute Malnutrition ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Acute Malnutrition ◽  
Care Hospital ◽  
Rehabilitation Centre ◽  
North East India ◽  
North East ◽  
Nutrition Rehabilitation

BACKGROUND Malnutrition is one of the leading causes of morbidity and mortality in children under 5 years of age. Children with severe acute malnutrition have nine times higher mortality than those in well-nourished children. The purpose of this study was to describe the demography, clinical profile, and outcome of children with severe acute malnutrition aged between 6 months to 59 months admitted in nutrition rehabilitation centre at a tertiary care hospital in North East India. METHODS A cross sectional-observational hospital-based study was conducted between May 2019 and April 2020 on 140 children. Severe acute malnutrition was diagnosed as per WHO criteria by using standard techniques. Variables recorded were demographic factors, anthropometry, clinical profile, laboratory tests, and medical complications. The outcome indicators including hospital course were studied. RESULTS In the present study 63.6 % were males and the mean age of presentation was 20.0 ± 1.54 months. 57.1 % children were found to be having both weight for height z-score below – 3 SD and mid upper arm circumference less than 115 mm together. Acute gastroenteritis (45.2 %) was the most common co-morbid condition followed by respiratory tract infection (26.2 %). Iron deficiency anaemia was found in 70.7 % of study children. Recovery rate from severe acute malnutrition was 86.4 % with average weight gain of 6.4 g / kg / day. CONCLUSIONS Children with severe acute malnutrition tend to suffer from serious co-morbid conditions. Early identification and treatment in nutrition rehabilitation centre with facility for critical care support should become a key component of continuum of care for children with severe acute malnutrition. KEYWORDS Children, Clinical Profile, Facility-Based Care, Severe Acute Malnutrition, Outcome

scholarly journals Clinicoepidemiological and laboratory profile of children with severe acute malnutrition admitted to a tertiary care centre

2020 ◽  
Vol 7 (5) ◽  
pp. 966
Author(s):  
Abdus Sami Bhat ◽  
Umer Amin Qureshi ◽  
Waseeqa Nigeen ◽  
Iram Bashir ◽  
Shagufta Khursheed
Keyword(s):  
Birth Order ◽  
Maternal Education ◽  
Family Income ◽  
Severe Acute Malnutrition ◽  
Tertiary Care ◽  
Acute Malnutrition ◽  
Nutritional Rehabilitation ◽  
Rehabilitation Centre ◽  
Rural Background ◽  
Laboratory Profile

Background: Severe Acute Malnutrituon (SAM) is a form of malnutrition where there is an imminent threat of death to the child. The chances of complications are very high and in most case child requires hospitalization for stabilization and rehabiliatation. Objective of study the clinicoepidemiological and laboratory profile of children with severe acute malnutrition (SAM) admitted to a Nutritional Rehabilitation Centre (NRC) of our hospital.Methods: A retrospective chart review of admitted patients. Nutritional Rehabilitation centre (NRC) at GB Pant Hospital Government Medical College Srinagar over a one year period between June 2017 and June 2018.Results: Total of 187 patients of SAM was admitted in NRC during the study period. One hundred and eight (57.7%) were males and 79(42.3%) were females .Patients were equally among various districts. Infants (<12months) constituted the majority of admissions (54.5%). Marasmus was by far the commonest phenotype presenting as SAM (85.5%).Respiratory comorbidity was the commonest present in about  41 (26.3%) followed by daiarrhea in  32(20.5%). Delayed initiation of complimentary feeding was found in 75(40.1%) while early weaning was found in another 55 children (29.4%). Birth order more than three was present in 92 children (49%). Mother’s literacy status had a direct bearing on the prevalence of SAM. Most of the children were from rural background (75%).Most belonged to low economic and income class as around 65.2% had a very meager  family income.Conclusions: SAM is more common in Infants and in children from rural background. It is highly associated with faulty feeding practices including lack of breast feeding and presence of mixed and faulty feeding. It is also associated with increasing birth order, low maternal education and low family income Pneumonia and diarrhea are leading comorbidities. Hypoglycemia and hypothermia are leading complications.  Marasmus is the commonest phenotype.

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