scholarly journals Etiological factors of severe acute malnutrition and impact of nutrition rehabilitation centre: a prospective observational study from Bhavnagar

2021 ◽  
Vol 8 (4) ◽  
pp. 652
Author(s):  
Vibhuti D. Gamit ◽  
Jayendra R. Gohil ◽  
Adithya Nikhileshwar B. ◽  
Tanmay P. Vagh
Keyword(s):  
Weight Gain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Severe Acute Malnutrition ◽  
Birth Spacing ◽  
Acute Malnutrition ◽  
Rehabilitation Centre ◽  
Etiological Factors ◽  
Nutrition Rehabilitation

Background: Severe acute malnutrition (SAM) causes almost half of childhood deaths in children <5 years in developing countries. In India, as National Family Health Survey (NFHS), prevalence of SAM has increased from 6.4 in NFHS-3 (2005-2006) to 7.5% in NFHS-4 (2015-1016); [5.8 to 9.5% Gujarat]. The aim of study was to determine the etiological factors and outcome of SAM and the benefit of nutrition rehabilitation centre (NRC) among 6 months to 5 years children at the Pediatrics, NRC ward, Sir T. General Hospital.Methods: A prospective observational study of 151 SAM children over nine months. Etiological factors were determined by history and relevant investigations, exclude other systemic disorders. Therapeutic nutrition was provided for 14 days. Cases were followed up two weekly for 2 months by monitoring weight after NRC admission.Results: Association was found between Small for gestational age (64.9%), joint family (59.6%) and low birth spacing (59.6%) as etiological factors leading to SAM. 81.5% children gained weight during 14 days NRC stay. Weight gain was noted at follow-up. Defaulter rate increased from 9.9% at discharge to 28.5% at 2 months follow-up. Weight was static for 9% children. 34.4% children were from rural area and 65.6% from urban area. 23.8% children had received pre lacteal feed. Timing of complementary feeding was incorrect in 29%. There were no deaths.Conclusions: Small for gestational age, joint family, low birth spacing, and incorrect feeding practices and urban residence were etiological factors. NRC stay (defaulter rate 26%), produced weight gain in SAM children. 

scholarly journals Etiological Factors of Severe Acute Malnutrition (SAM) and Impact of Nutrition Rehabilitation Centre: a prospective observational study from Bhavnagar, Gujarat, India

2020 ◽  
Author(s):  
Vibhuti Gamit ◽  
Jayendra Ratilal Gohil
Keyword(s):  
Weight Gain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Severe Acute Malnutrition ◽  
Birth Spacing ◽  
Acute Malnutrition ◽  
Rehabilitation Centre ◽  
Etiological Factors ◽  
Nutrition Rehabilitation

Introduction Severe acute malnutrition (SAM) is a cause of almost half of childhood deaths in children &lt; 5 years in developing countries. In India, as National Family Health Survey (NFHS), prevalence of SAM has increased from 6.4 in NFHS-3 (2005-6) to 7.5% in NFHS-4 (2015-16); [5.8 to 9.5% Gujarat]. The aim of study was to determine the etiological factors and outcome of SAM and the benefit of nutrition rehabilitation centre (NRC) among 6 months to 5 years children at the Pediatrics Dept, Sir T General Hospital, Bhavnagar. Methods A prospective observational study of 151 SAM children over nine months. Etiological factors were determined by history and relevant investigations, exclude other systemic disorders. Therapeutic nutrition was provided for 14 days. Cases were followed up two weekly for 2 months by monitoring weight after NRC admission. Results Association was found between Small for gestational age (64.9%), joint family (59.6%) and low birth spacing (59.6%) as etiological factors leading to SAM. 81.5% Children gained weight during14 days NRC stay. Weight gain was noted at follow-up. Defaulter rate increased from 9.9% at discharge to 28.5% at 2 months follow-up. Weight was static for 9% children. 34.4% children were from rural area and 65.6% from urban area. 23.8% children had received pre lacteal feed. Timing of complementary feeding was incorrect in 29%. There were no deaths. Conclusion Small for gestational age, joint family, low birth spacing, incorrect feeding practices and urban residence were etiological factors. NRC stay (defaulter rate 26%), produced weight gain in SAM children.

scholarly journals Study to determine gender variation in severe acute malnutrition at nutrition rehabilitation centre

2019 ◽  
Vol 6 (2) ◽  
pp. 602
Author(s):  
Suguna S. ◽  
Vidyasagar V.
Keyword(s):  
Weight Gain ◽  
District Hospital ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Rehabilitation Centre ◽  
Gender Variation ◽  
Nutrition Rehabilitation ◽  
Time Of Admission ◽  
Discharge Criteria

Background: The objective of this study is to know the gender variation in number of admissions, severity of malnutrition at the time of admission, gaining of weight and adherence to follow up in children admitted to nutrition rehabilitation center and during follow up.Methods: This is a retrospective study involving the review of existing programme records. Children who were admitted to nutrition rehabilitation centre, district hospital, Chamarajanagar, Karnataka, India, between January 2017 to December 2017 with severe acute malnutrition were involved in the study. The programme included 2 weeks of in-patient care, and four follow-up visits to the NRC subsequently as follows; 1st visit at 7 days, 2nd at 14 days, 3rd at 1 month and 4th at 2 months after discharge.Results: Among 57 children who admitted to NRC females were 30 (52.6%) and males 27 47.4%). 25 among 57 children (43.9%) could sustain weight gain of >5grams/kg/day as per one of the discharge criteria. 13 (52%) were females and 12 (48%) were males. 32(56%) among 57 admitted children to NRC, could achieve <-1SD during entire programmed. 15(46.8%) were females and 17 (53.1%) were males.Conclusions: There was no gender variation in either number of admission or severity of malnutrition at the time of admission or weight gain during NRC programme.

scholarly journals Outcome of nutritional intervention measures at a nutrition rehabilitation centre in Krishna district, Andhra Pradesh

2018 ◽  
Vol 5 (12) ◽  
pp. 5150
Author(s):  
Deepthi Pagali ◽  
Suneetha Bollipo ◽  
Harsha B. Korrapolu ◽  
Mohammed Abdul Rahman
Keyword(s):  
Standard Deviation ◽  
Severe Acute Malnutrition ◽  
Nutritional Intervention ◽  
High Rate ◽  
Acute Malnutrition ◽  
Rehabilitation Centre ◽  
District Health ◽  
Target Weight ◽  
Significant Difference ◽  
Nutrition Rehabilitation

Background: Nutrition rehabilitation centre (NRC) is a unit in a district health facility, where children with severe acute malnutrition are admitted and provided with nutritional and therapeutic care.Methods: Analysis of nutritional data of all the children admitted to NRC at Krishna district from January 2017 to July 2018. Statistical analysis was done using SPSS.Results: A total of 200 children were included in the study. The overall mean weight at admission was found to be 8.30 kg with a standard deviation of 2.35 kg and the mean weight at the time of discharge is 9.57 kg with a standard deviation of 2.61 kg. There is a statistically significant difference in weight and mid arm circumference at admission and discharge. Mean duration of hospital stay is around 18.67±5.4 days. Target weight is achieved in 71% of the study group.Conclusions: Present study reflects that NRCs have been playing a key role to cope up with the problem of severe acute malnutrition as demonstrated by a high rate of weight gain at discharge as well as during follow ups. 

scholarly journals Comparing azithromycin to amoxicillin in the management of uncomplicated severe acute malnutrition in Burkina Faso: a pilot randomized trial

2021 ◽  
Author(s):  
Kieran S O'Brien ◽  
Ali Sié ◽  
Clarisse Dah ◽  
Millogo Ourohire ◽  
Moussa Ouédraogo ◽  
...  
Keyword(s):  
Single Dose ◽  
Weight Gain ◽  
Adverse Events ◽  
Burkina Faso ◽  
Randomized Trial ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
World Health ◽  
Promising Alternative

Introduction. Given the potential for asymptomatic infection in children with uncomplicated severe acute malnutrition (SAM), the World Health Organization recommends a broad-spectrum antibiotic like amoxicillin. Azithromycin is a promising alternative to amoxicillin as it can be administered as a single dose and has efficacy against several pathogens involved in the burden of infectious disease and mortality in this population. In this pilot study, we aimed to establish the feasibility of a larger randomized controlled trial and to provide preliminary evidence comparing the effect of azithromycin to amoxicillin on weight gain in children with uncomplicated SAM. Methods. This pilot randomized trial enrolled children 6-59 months old with uncomplicated SAM at 6 healthcare centers in Burkina Faso. Participants were randomized to a single dose of azithromycin or a 7-day course of amoxicillin. All participants received ready-to-use therapeutic food and were followed weekly until nutritional recovery and again at 8 weeks. The primary feasibility outcomes included enrollment potential, refusals, and loss to follow-up. The primary clinical outcome was weight gain (g/kg/day) over the 8-week period. Outcome assessors were masked. Results. Between June and October 2020, 312 children were screened, 301 were enrolled with 0 refusals, and 282 (93.6%) completed the 8-week visit. Average weight gain was 2.5 g/kg/day (SD 2.0) in the azithromycin group and 2.6 (SD) 1.7) in the amoxicillin group (Mean Difference -0.1, 95% CI -0.5 to 0.3, P = 0.63). Fewer adverse events were reported in the azithromycin group (Risk Ratio 0.50, 95% CI 0.31 to 0.82, P = 0.006). Conclusions. No differences were found in weight gain between groups. Given the ability to administer a single dose and the potential for fewer adverse events, azithromycin may be an alternative to amoxicillin for uncomplicated SAM. With strong enrollment and follow-up, a larger trial in this setting is feasible.

scholarly journals Changes in serum phosphorous level during inpatient treatment of children with severe acute malnutrition

2019 ◽  
Vol 6 (3) ◽  
pp. 1080
Author(s):  
Dakshayani B. ◽  
Divyashree P. ◽  
Sarala Sabapathi ◽  
Mallesh Kariyappa
Keyword(s):  
Weight Gain ◽  
Inpatient Treatment ◽  
Prospective Observational Study ◽  
Severe Acute Malnutrition ◽  
Serum Phosphate ◽  
Acute Malnutrition ◽  
Stabilization Phase ◽  
Catch Up ◽  
Therapeutic Diets ◽  
Phosphorous Level

Background: SAM children have increased requirements for phosphorus during recovery. If requirements are not met, they may develop refeeding hypophosphatemia leading to increased morbidity and mortality. However, no much studies known about the effect of current therapeutic diets (F-75 and F-100) on serum phosphate in SAM children.Methods: Prospective observational study, in which measuring serum phosphate at admission, at end of stabilization phase and at discharge in SAM children between 6-59 months.Results: Among 35 children enrolled, mean serum phosphate was 4.3 ±0.6 mg/dl at admission, 4.1± 0.8mg/dl at end of stabilization phase and 4.4±0.7mg/dl at discharge. 17% of children had hypophosphatemia at admission, 31% at end of stabilization phase and 17% at discharge. mean weight gain in hypophosphatemia and normophosphatemia groups are 1.3±1.46mg/kg/day and 2.51±2.63mg/kg/day (p=0.1) respectively. Mean duration of stay in hypophosphatemia and normophosphatemia groups are 11.6±1.26 and 10.26±1.54 days respectively (p=0.016).Conclusions: Hypophosphatemia was common among children with SAM at admission and increased at end of stabilization phase. Serum phosphate remains subnormal in about 1/5th of the children at discharge. This could be problematic for further recovery as phosphorus is needed for catch-up growth and bioavailability of phosphorus is low in local diets. Hence, authors suggest phosphorus supplementation in SAM children.

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