scholarly journals A study of effectiveness of nutritional interventions on children with severe acute malnutrition admitted in nutrition rehabilitation centers of Bhopal, Madhya Pradesh

2018 ◽  
Vol 5 (6) ◽  
pp. 2590
Author(s):  
D. M. Saxena ◽  
Akshat Pathak ◽  
Ganga Ram Mahor ◽  
Ramniwas Mahor ◽  
Anil Agarwal
Keyword(s):  
Severe Acute Malnutrition ◽  
Madhya Pradesh ◽  
Acute Malnutrition ◽  
Severe Malnutrition ◽  
Average Weight ◽  
Full Potential ◽  
Health Issues ◽  
Significant Difference ◽  
Nutrition Rehabilitation

Background: The prevalence of under-nutrition among under-five children is high and varies widely. Children with severe acute malnutrition require immediate attention along with proper nutritional rehabilitation not only to decrease mortality but also to achieve full potential after recovery. Nutrition rehabilitation centres (NRCs) were started to control severe malnutrition and decrease the prevalence of severe malnourished children to less than 1% among children aged 1–5 years.Methods: The present study was conducted from July 2016 to June 2017; 500 children admitted to five different NRCs in Bhopal district of Madhya Pradesh were observed during their stay at NRCs and children were followed up during a period of 6 months after discharge from NRCs. Mothers of the children were interviewed on various health issues of children and feeding practices at the NRCs using a predesigned and pretested interview schedule.Results: The study group consisted of 252 boys and 248 girls; 51.20% were between 13 and 36 months of age. All 500 children were analysed for anthropometric indicators. A statistically significant difference was obtained between the weight of children at admission, discharge and follow up (ANOVA=106.2, p<0.001); difference of mid upper arm circumference (MUAC) at admission, discharge and follow up was also statistically significant (ANOVA=24.02, p<0.001). The average weight gain during the stay at the centers was 8.95±3.59 g/kg/day. The mothers of the children lacked adequate information on health issues and composition and preparation of nutrient rich diets for their children.Conclusions: The NRCs were effective in improving the condition of admitted children, but the effects were not well sustained following discharge due to lack of adequate parental awareness and action. 

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 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 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 Comparison study on efficacy of UNICEF specified therapeutic food (F-75/F-100) with traditionally used home based food in management of severe acute malnutrition

2018 ◽  
Vol 5 (4) ◽  
pp. 1674
Author(s):  
Anand Shukla ◽  
Y. K. Rao
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Severe Malnutrition ◽  
Comparison Study ◽  
Medical College ◽  
Home Based ◽  
Appropriate Therapy ◽  
Moderate Malnutrition ◽  
Therapeutic Food

Background: The management of malnutrition depends on its severity. While mild to moderate malnutrition can be managed on ambulatory basis, severe malnutrition is preferably managed in hospital settings. This study was undertaken to find the magnitude of SAM in children (6 months to 60 months) and to compare the UNICEF specified therapeutic food (F-75/F-100) with traditionally used home based food in treatment of severe acute malnutrition.Methods: This prospective and observational study was conducted in the Department of Pediatrics of G.S.V.M. Medical College, L.L.R. and Associated Hospitals, Kanpur. Logarithmic transformation was achieved by SPSS 20.Results: The prevalence of SAM in children between 6 months to 60 months of age to be 18%. Clinical spectrum of SAM showed 95.24% of marasmus 3.57% of Kwashiorkor and 1.19% of marasmic kwashiorkor.    There was significant increase in weight of hospitalized patient receiving F75/F100 at 28 days of follow up. Weight gain was not statistically significant in patients treated at home.Conclusions: SAM should preferably be treated in hospital with appropriate therapy rather than home based management.

scholarly journals Treatment Outcome of Severe Acute Malnutrition Cases at the Tamale Teaching Hospital

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Mahama Saaka ◽  
Shaibu Mohammed Osman ◽  
Anthony Amponsem ◽  
Juventus B. Ziem ◽  
Alhassan Abdul-Mumin ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Treatment Plan ◽  
Retrospective Chart Review ◽  
Acute Malnutrition ◽  
Severe Malnutrition ◽  
Average Weight ◽  
Cure Rate ◽  
Default Rate ◽  
Average Weight Gain ◽  
Tamale Teaching Hospital

Objective.This study investigated the treatment outcomes and determinant factors likely to be associated with recovery rate.Methods.A retrospective chart review (RCR) was performed on 348 patients who were enrolled in the outpatient care (OPC) during the study period.Results.Of the 348 cases, 33.6% recovered (having MUAC≥125 mm), 49.1% defaulted, and 11.5% transferred to other OPC units to continue with treatment. There were 187 (53.7%) males and 161 (46.3%) females with severe malnutrition. The average weight gain rate was 28 g/kg/day. Controlling for other factors, patients who completed the treatment plan had 3.2 times higher probability of recovery from severe acute malnutrition (SAM) as compared to patients who defaulted (adjusted odds ratio (AOR) = 3.2, 95% CI = 1.9, 5.3, andp<0.001). The children aged 24–59 months had 5.8 times higher probability of recovery from SAM as compared to children aged 6–11 months (AOR = 5.8, 95% CI = 2.5, 10.6, andp<0.001).Conclusions.Cure rate was low and the default rate was quite high. Children who were diagnosed as having marasmus on admission stayed longer before recovery than their kwashiorkor counterparts. Younger children were of greater risk of nonrecovery.

scholarly journals Changes in whole-blood PUFA and their predictors during recovery from severe acute malnutrition

2016 ◽  
Vol 115 (10) ◽  
pp. 1730-1739 ◽  
Author(s):  
Esther Babirekere-Iriso ◽  
Charlotte G. Mortensen ◽  
Ezekiel Mupere ◽  
Maren J. H. Rytter ◽  
Hanifa Namusoke ◽  
...  
Keyword(s):  
Fatty Acid ◽  
Whole Blood ◽  
Severe Acute Malnutrition ◽  
Tube Feeding ◽  
Acute Malnutrition ◽  
Blood Levels ◽  
Pufa Composition ◽  
Nutrition Rehabilitation ◽  
Predictors Of Change

AbstractChildren with severe acute malnutrition (SAM) with complications require in-patient management including therapeutic feeding. Little attention has been given to the effects of these feeds on the essential fatty acid status of children with SAM. The objective of this study was to describe changes in the PUFA composition in whole blood in children with SAM during treatment and to determine predictors of change. This prospective study took place in a paediatric nutrition rehabilitation unit in Kampala, Uganda, and assessed whole-blood fatty acid composition of children with SAM at admission, transition, discharge and follow-up (8 and 16 weeks). ANCOVA was used to identify predictors of change in whole-blood PUFA. The study included 120 children with SAM and twenty-nine healthy control children of similar age and sex. Among the SAM children, 38 % were female and 64 % had oedema. Whole-blood n-6 PUFA proportions increased from admission to follow-up, except for arachidonic acid, which decreased by 0·79 (95 % CI 0·46, 1·12) fatty acid percentage (FA%) from admission to transition and 0·10 (95 % CI 0·23, 0·44) FA% at discharge. n-3 Long-chain (LC) PUFA decreased by 0·21 (95 % CI 0·03, 0·40) FA% at discharge and 0·22 (95 % CI 0·01, 0·42) FA% at 8 weeks of follow-up. This decrease was greater in children from families with recent fish intake and those with nasogastric tube feeding. Current therapeutic feeds do not correct whole-blood levels of LCPUFA, particularly n-3 LCPUFA, in children with SAM. Increased attention is needed to the contents of n-3 LCPUFA in therapeutic feeds.

scholarly journals Linear growth following complicated severe malnutrition: 1-year follow-up cohort of Kenyan children

2018 ◽  
Vol 104 (3) ◽  
pp. 229-235 ◽  
Author(s):  
Moses M Ngari ◽  
Per Ole Iversen ◽  
Johnstone Thitiri ◽  
Laura Mwalekwa ◽  
Molline Timbwa ◽  
...  
Keyword(s):  
Linear Growth ◽  
Severe Acute Malnutrition ◽  
Clinical Trial Data ◽  
Severe Pneumonia ◽  
Acute Malnutrition ◽  
Dietary Quality ◽  
Severe Malnutrition ◽  
Regression To The Mean ◽  
Change In Mean

BackgroundStunting is the most common manifestation of childhood undernutrition worldwide. Children presenting with severe acute malnutrition (SAM) are often also severely stunted. We evaluated linear growth and its determinants after medically complicated SAM.MethodsWe performed secondary analysis of clinical trial data (NCT00934492) from HIV-uninfected Kenyan children aged 2–59 months hospitalised with SAM. Outcome was change in height/length-for-age z-score (HAZ) between enrolment and 12 months later. Exposures were demographic, clinical, anthropometric characteristics and illness episodes during follow-up.ResultsAmong 1169 children with HAZ values at month 12 (66% of those in original trial), median (IQR) age 11 (7–17) months and mean (SD) HAZ −2.87 (1.6) at enrolment, there was no change in mean HAZ between enrolment and month 12: −0.006Z (95% CI −0.07 to 0.05Z). While 262 (23%) children experienced minimal HAZ change (within ±0.25 HAZ), 472 (40%) lost >0.25 and 435 (37%) gained >0.25 HAZ. After adjusting for regression to the mean, inpatient or outpatient episodes of diarrhoea and inpatient severe pneumonia during follow-up were associated with HAZ loss. Premature birth and not being cared by the biological parent were associated with HAZ gain. Increases in mid-upper arm circumference and weight-for-age were associated with HAZ gain and protected against HAZ loss. Increase in weight-for-height was not associated with HAZ gain but protected against HAZ loss. No threshold of weight gain preceding linear catch-up growth was observed.ConclusionsInterventions to improve dietary quality and prevent illness over a longer period may provide opportunities to improve linear growth.

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.

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