scholarly journals An experience of facility based management at one of the malnutrition treatment centre in district Baran of Rajasthan, India

2017 ◽  
Vol 4 (6) ◽  
pp. 2162
Author(s):  
Shakila Mulla ◽  
Pankaj Kumar Gupta
Keyword(s):  
Weight Gain ◽  
Length Of Stay ◽  
Performance Indicators ◽  
Death Rate ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Age Group ◽  
Treatment Centre

Background: To assess performance of one of the Malnutrition Treatment Centre (MTC) in district Baran of Rajasthan. India. Methods: An observational prospective study was conducted at MTC where 132 Severe Acute Malnutrition (SAM) children were recruited. Their socio-demographic details and anthropometric measurements were recorded. These SAM children were followed till the period of 4 follow-up visits to measure their weight. MTC performance indicators were assessed. Results: Majority of SAM children belong to age group less than 2 years, gender female, caste OBC (Other Backward Class), SC (Scheduled Caste) and ST (Scheduled Tribe). ASHAs (Accredited Social Health Activists) are playing key role in referring them to MTC. Death rate was 0%, cure (recovery) rate 42.4%, defaulter rate 25.8%, mean length of stay (days) at MTC was 8.04 and mean weight gain was 5.926 g/kg/day. Performance indicators are significantly affected by length of stay at MTC. Follow-up rate was poor with no significant weight gain observed after discharge. Conclusions: MTCs are effective in saving lives of SAM children but not in maintaining long term control on malnutrition. 

scholarly journals Response to gluten free diet in sero-positive celiac disease children suffering from severe acute malnutrition in age group 1-5 years

2019 ◽  
Vol 6 (3) ◽  
pp. 1090
Author(s):  
Mahendra Meena ◽  
Pradeep Meena ◽  
R. L. Suman ◽  
Suresh Goyal
Keyword(s):  
Celiac Disease ◽  
Weight Gain ◽  
Severe Acute Malnutrition ◽  
Gluten Free Diet ◽  
Acute Malnutrition ◽  
P Value ◽  
Age Group ◽  
Gluten Free ◽  
Group 1

Background: Diagnosis of celiac disease in children suffering from severe acute malnutrition without duodenal biopsy or HLA typing is a dilemma. The objective of this study was to study the response to gluten free diet in sero-positive Celiac Disease children suffering from severe acute malnutrition in age group 1-5 years.Methods: This prospective, observational, hospital-based study was conducted at MTC of tertiary care medical college hospital of southern Rajasthan from Dec. 2017 to Nov. 2018. Total 110 children with SAM were enrolled and screened for celiac disease on the basis of tissue tTg-IgA/IgG serology. Seropositive cases were kept on gluten free diet for short period of time and observed for the resolution of symptoms and improvement in growth, monitored by anthropometry on discharge and follow up visit.Results: Mean weight gain (gm/kg/day) on follow up was 3.87±3.49 in seropositive and 1.88±3.79 in seronegative cases (P-value<0.05). Mean weight gain was 6.43±3.28gm/kg/day in only tTg-IgA positive and 3.04±2.95 gm/kg/day in only tTg-IgG positive cases (P-value-<0.05). The mean weight gain in strictly gluten free adherent sero-positive cases was 4.89±2.97 gm/kg/day while in gluten free non-adherent patients it was -0.49±1.70 (P-value <0.001). Mean weight gain in probable (tTg-Ig-A <10 times ULN) and presumptive (tTg-IgA >10 times ULN) Celiac disease were 3.44±3.73 and 5.44±3.78, respectively without statically significant difference (P-value >0.05).Conclusions: In situations where facility of duodenal biopsy and or HLA DQ2/DQ8 typing is not available, resolution of symptoms and improvement in growth on gluten free diet confirms the diagnosis of celiac disease.

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 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 Long-term outcomes for children with disability and severe acute malnutrition in Malawi

2020 ◽  
Vol 5 (10) ◽  
pp. e002613
Author(s):  
Natasha Lelijveld ◽  
Nora Groce ◽  
Seema Patel ◽  
Theresa Nnensa ◽  
Emmanuel Chimwezi ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
School Achievement ◽  
Acute Malnutrition ◽  
Health Issues ◽  
Physical Strength ◽  
Children With Disability ◽  
Increased Risk ◽  
Outcomes For Children

IntroductionSevere acute malnutrition (SAM) and disability are major global health issues. Although they can cause and influence each other, data on their co-existence are sparse. We aimed to describe the prevalence and patterns of disability among a cohort of children with SAM.MethodsA longitudinal cohort study in Malawi followed SAM survivors up to 7 years postdischarge. Clinical and anthropometric profiles were compared with sibling and community controls. Disability at original admission was identified clinically; at 7-year follow-up a standardised screening tool called ‘the Washington Group Questionnaire’ was used.Results60/938 (6.4%) of admissions to SAM treatment had clinically obvious disability at admission. Post-treatment mortality was high, with only 11/60 (18%) surviving till 7-year follow-up. SAM children with a disability at admission had 6.99 (95% CI 3.49 to 14.02; p<0.001) greater risk of dying compared with children without disability. They were also older, less likely to be HIV positive or have oedema and more severely malnourished. Long-term survivors were more stunted, had less catch-up growth, smaller head circumference, weaker hand grip strength and poorer school achievement than non-disabled survivors.The Washington Group Questionnaire confirmed disability in all who had been identified clinically, and identified many who had not been previously flagged.ConclusionDisability is common among children affected by SAM. Those with disability-associated SAM have greatly increased risk of dying even if they survive the initial episode of malnutrition. Survivors have poorer growth, physical strength and school achievement. To enable all children to survive and thrive post-SAM, it is vital to focus more on those with disabilities. SAM treatment programmes should consider using not just clinical assessment but structured assessments to better identify at-risk individuals as well as understand the population of children for which they are developing services.

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 Complimentary feeding practices in severe acute malnutrition children admitted in malnutrition treatment centre of RNT medical college

2017 ◽  
Vol 4 (3) ◽  
pp. 972
Author(s):  
Rupali Jain ◽  
Vivek Arora ◽  
Sandip Gediya
Keyword(s):  
Breast Feeding ◽  
Severe Acute Malnutrition ◽  
Goat Milk ◽  
Acute Malnutrition ◽  
Cow Milk ◽  
Feeding Practice ◽  
Nutritional Requirement ◽  
Age Group ◽  
Treatment Centre ◽  
Anthropometric Assessment

Background: To assess the complimentary feeding practice in Severe Acute Malnutrition (SAM) children aged between 6months to 5years.Methods: 110 SAM children admitted in Malnutrition Treatment Centre (MTC) of MBGH Hospital, Udaipur over a period of 3 months were taken in the study. Structured questionnaire including child’s personal data, socioeconomic status of the family, breast feeding and complementary feeding status were used. Clinical and anthropometric assessment of children was done.Results: Out of the 110 children included in the study, 58 (52.7%) were males and 52 (47.2%) were females. Mean age of children included was 16.8 ± 10.73 months. Maximum children were in the age group of 6-12months 60 (54.5%), followed by 13-24 months of age 38 (34.5%), followed by >2-5years of age 12 (10.9%). Thirty-four (30.9%) children were on exclusive breast feeding, with 30 (27.3%) in age group of 6-12 months and 4 (3.6%) in 12- 24 months. Breast feeding with complimentary feeding was practiced in 30 (27.3%) children of 6-12 months of age and 22 (20%) children of 13-24 months. Out of the 76 children on additional feed with or without breast feeds, 70 (92.1%) consumed milk- either goat milk, cow milk or buffalo milk.Conclusions: Anthropometric assessment revealed that maximum number of SAM children also had chronic malnutrition. Diet of SAM children mainly included milk and cereals. They did not obtain a balanced diet to meet their nutritional requirement. 

scholarly journals Clinical features and treatment outcomes of visceral leishmaniasis patients admitted to three centers in Oromia, Ethiopia

2020 ◽  
Vol 14 (06.1) ◽  
pp. 42S-47S
Author(s):  
Samson Tekalign ◽  
Cherinet Adera ◽  
Margriet Den Boer ◽  
Hirpha Miecha ◽  
Ashenafi Zewde ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Outcome Data ◽  
Health Care Facilities ◽  
Acute Malnutrition ◽  
Response To Treatment ◽  
Aggregated Data ◽  
Hiv Coinfection ◽  
Long Term Follow Up

Introduction: In three health care facilities in the Oromia region, the aim of this study is to report on 1) the number of VL cases registered over time (2013-2018) and 2) the clinical profile, type of treatment used and response to treatment. Methodology: A retrospective cohort study was conducted among all VL cases admitted with a diagnosis of VL. Results: A total of 434 VL cases were registered at the three health facilities, but patient files were available for only 188. Most (51.6%) were children and only three presented with VL relapse. 78 (41.5%) of the 188 patients presented within one month of symptom onset. Concurrent severe acute malnutrition (27.1%), tuberculosis (6.4%) and malaria (6.4%) were common. There were only two cases with HIV coinfection. Fourty-three percent were treated with antimonials, 34% with antimonials combined with paromomycin and 23% with AmBisome. Amongst the 188 patients with patient files there were no deaths and one treatment failure. Six months outcome data were however missing for all. Aggregated data from the 434 VL cases reported three deaths, two treatment failures and one relapse. Conclusions: Children were most commonly affected, suggesting long-term endemicity. While short-term outcomes are encouraging, long-term follow-up data are required.

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 Comparing Azithromycin to Amoxicillin in the Management of Uncomplicated Severe Acute Malnutrition in Burkina Faso: A Pilot Randomized Trial

2022 ◽  
Author(s):  
Kieran O’Brien ◽  
Ali Sié ◽  
Clarisse Dah ◽  
Millogo Ourohiré ◽  
Moussa Ouedraogo ◽  
...  
Keyword(s):  
Single Dose ◽  
Weight Gain ◽  
Burkina Faso ◽  
Severe Acute Malnutrition ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Acute Malnutrition ◽  
Average Weight ◽  
Promising Alternative

Azithromycin is a promising alternative to amoxicillin in the management of uncomplicated severe acute malnutrition (SAM) as it can be administered as a single dose and has efficacy against several pathogens causing infectious disease and mortality in children under 5. In this pilot trial, we aimed to establish the feasibility of a larger randomized controlled trial and provide preliminary evidence comparing the effect of azithromycin to amoxicillin on weight gain in children with uncomplicated SAM. We enrolled children 6–59 months old with uncomplicated SAM at six healthcare centers in Burkina Faso. Participants were randomized to a single dose of azithromycin or a 7-day course of amoxicillin and followed weekly until nutritional recovery and again at 8 weeks. Apart from antibiotics, participants received standard of care, which includes ready-to-use therapeutic food. Primary feasibility outcomes included enrollment potential, refusals, and loss to follow-up. The primary clinical outcome was weight gain (g/kg/day) over 8 weeks. Outcome assessors were masked. Between June and October 2020, 312 children were screened, 301 were enrolled with zero refusals, and 282 (93.6%) completed the 8-week visit. Average weight gain was 2.5 g/kg/day (standard deviation [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 0.31–0.82, P = 0.006). With strong enrollment and follow-up, a fully powered trial in this setting is feasible.

scholarly journals Point-of-use water treatment improves recovery rates among children with severe acute malnutrition in Pakistan: results from a site-randomized trial

2018 ◽  
Vol 21 (16) ◽  
pp. 3080-3090 ◽  
Author(s):  
Shannon Doocy ◽  
Hannah Tappis ◽  
Nicolas Villeminot ◽  
Ann Suk ◽  
Deepak Kumar ◽  
...  
Keyword(s):  
Weight Gain ◽  
Water Treatment ◽  
Length Of Stay ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Control Group ◽  
Recovery Rates ◽  
Water Filter ◽  
Point Of Use ◽  
Receiving Water

AbstractObjectiveTo evaluate effectiveness of point-of-use water treatment in improving treatment of children affected by severe acute malnutrition (SAM).DesignProgramme sites were randomized to one of four intervention arms: (i) standard SAM treatment; (ii) SAM treatment plus flocculent/disinfectant water treatment; (iii) SAM treatment plus chlorine disinfectant; or (iv) SAM treatment plus ceramic water filter. Outcome measures were calculated based on participant status upon exit or after 120d of enrolment, whichever came first. Child anthropometric data were collected during weekly monitoring at programme sites. Child caregivers were interviewed at enrolment and exit. Use of water treatment products was assessed in a home visit 4–6 weeks after enrolment.SettingDadu District, Sindh Province, Pakistan.SubjectsChildren (n 901) aged 6–59 months with SAM and no medical complications.ResultsRecovery rates were 16·7–22·2 % higher among children receiving water treatment compared with the control group. The adjusted odds of recovery were approximately twice as high for those receiving water treatment compared with controls. Mean length of stay until recovery was 73 (sd 24·6) d and mean rate of weight gain was 4·7 (sd 3·0) g/kg per d. Differences in recovery rate, length of stay and rate of weight gain between intervention groups were not statistically significant.ConclusionsIncorporating point-of-use water treatment into outpatient treatment programmes for children with SAM increased nutritional recovery rates. No significant differences in recovery rates were observed between the different intervention groups, indicating that different water treatment approaches were equally effective in improving recovery.

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