scholarly journals Performance and costing of nutrition intervention measures on admitted children in malnutrition treatment center: a case study from Jharkhand, India

2020 ◽  
Vol 7 (10) ◽  
pp. 4048
Author(s):  
Rajesh Kumar Sinha ◽  
Asha Kiran ◽  
Vivek Kashyap ◽  
Praveen Kumar
Keyword(s):  
Severe Acute Malnutrition ◽  
Average Length ◽  
Nutrition Intervention ◽  
Acute Malnutrition ◽  
Treatment Center ◽  
Medical Complication ◽  
Average Weight ◽  
Post Discharge ◽  
Target Weight ◽  
Intervention Measures

Background: Children with severe acute malnutrition (SAM) having medical complications require immediate care at malnutrition treatment centers (MTC). Thus, it becomes important to assess the effect and treatment cost of such children in these facilities. Hence, the present study was done with these aims in two MTCs in Jharkhand, India.Methods: A retrospective record review was done of the children admitted to these two MTCs between 1st April 2017 and 31st March 2018. A predesigned proforma was used to collect child related information. The data collected was entered in Microsoft excel sheet and analysed.Results: Majority of the admitted children (90.6%) were in 6-23 months age group. 358 (51.5%) children were females. Only, 194 (27.9%) children admitted were SAM had any medical complication. 690 (99.3%) children were discharged of whom 499 (72.3%) were discharged after achieving the target weight. The average weight gain during their stay was 8.1±2.4 g/kg/day and average length of stay was 16.7±3.2 days. Post discharge follow up rates were found to be low and only 130 (18.8%) children completed all three follow ups. Average cost per SAM child treated was Rs. 18,599 (US$ 272) and per SAM child cured was Rs. 25,904 (US$ 379).Conclusions: MTCs are effective in managing medically complicated SAM children. However, improvements are necessary to ensure that more such children should be treated at facility level, complimented with a community based programme for managing uncomplicated SAM children to improve coverage and ensure continuum of care.

scholarly journals Providing care for children with severe acute malnutrition in India: new evidence from Jharkhand

2012 ◽  
Vol 17 (1) ◽  
pp. 206-211 ◽  
Author(s):  
Víctor M Aguayo ◽  
Sangita Jacob ◽  
Nina Badgaiyan ◽  
Praveen Chandra ◽  
Ajit Kumar ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Average Length ◽  
Survival Rates ◽  
Acute Malnutrition ◽  
Average Weight ◽  
High Survival ◽  
Initial Weight ◽  
Average Length Of Stay ◽  
Programme Outcomes ◽  
New Evidence

AbstractObjectiveTo assess the effectiveness of facility-based care for children with severe acute malnutrition (SAM) in malnutrition treatment centres (MTC).DesignEarly detection and treatment of SAM using locally adapted protocols; assessment of programme outcomes, including survival, default, discharge and recovery rates.SettingAll forty-eight MTC in Jharkhand, India.SubjectsChildren (n 3595) with SAM admitted to MTC (1 July 2009–30 June 2011).ResultsOf children admitted, 55·0 % were girls, 77·7 % were 6–23 months old and 68·6 % belonged to scheduled tribes or castes; 34·4 % had oedema or medical complications. Of the 3418 programme exits, the proportion of children who died was 0·6 % (n 20), the proportion of children who defaulted was 18·4 % (n 628) and the proportion of children discharged was 81·0 % (n 2770). Children's average weight gain was 9·6 (sd 8·4) g/kg body weight per d and their average length of stay was 16·0 (sd 5·7) d. Among the 2770 children who were discharged from the programme, 39·4 % (n 1090) gained 15 % or more of their initial weight while 60·6 % (n 1680) gained less than 15 % of their initial weight.ConclusionsMTC provide live-saving care for children with SAM as demonstrated by high survival rates. However, the protocols and therapeutic foods currently used need to improve to ensure the recovery of all discharged children. MTC should be reserved for children with complicated SAM; children with uncomplicated SAM should be admitted to a community-based programme for the management of SAM, at a lesser risk to children and a lesser cost to families and the health system.

scholarly journals Impact of effective counselling on management of moderate acute malnutrition in a community

2020 ◽  
Vol 7 (2) ◽  
pp. 321
Author(s):  
Vikas Arya ◽  
Ajay Gaur ◽  
Neetu S. Agarwal ◽  
Harsha Chouhan
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
P Value ◽  
Case Group ◽  
Average Weight ◽  
Group Counselling ◽  
Target Weight ◽  
Dietary Counselling ◽  
Trained Counsellor ◽  
Moderate Acute Malnutrition

Background: Moderate Acute Malnutrition (MAM) is defined as Weight for Height between -2SD to -3SD, and/or Mid Upper Arm Circumference (MUAC) 11.5 cm to 12.5 cm. Effect of not treating MAM has a significant impact on Severe Acute Malnutrition (SAM) burden. Management of MAM is possible through supplementary feeding or Community centre counselling.Methods: Present study was a prospective case control study done in 2013-14 in 200 children in adjacent communities. Community in which intervention (dietary counselling) was planned, it was labelled as case group. For dietary counselling ‘structured group counselling’ method was selected in which at a time parents of six MAM children were involved. Counselling was done by a trained counsellor using all techniques proposed by IYCF. Counselling sessions were scheduled at 0, 1, 3 and 6 months.Results: 60% children of case group moved to improved or well- nourished nutritional status (p-value 0.00001). Amongst improved group, weight for height improvement is statistically significant (p-value 0.001), average weight attained is 2-3 kg in 6 months with average weight gain of 1.5-3 grams/kg/day. MUAC improvement was also found to be statistically significant (p-value 0.003), there was 47% improvement in case group with average MUAC gain is 0.6 cm to 1 cm in 6 months (0.13 cm/month). Also, there is early rise in weight for height then MUAC. Average duration to achieve target weight for height is 4.3 months in case group as compare to 5.3 months in control group.Conclusions: Structured and integrated group counselling using all counselling skills by a trained counsellor should be an integral part of managing MAM in community. Weight for height should be primary indicator in early phase of response as compare to MUAC in measuring impact of counselling.

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 Ethnic and age differences in prediction of mortality by mid-upper arm circumference in children below 3 years of age in Nepal

2018 ◽  
Vol 21 (12) ◽  
pp. 2230-2237 ◽  
Author(s):  
Avni Gupta ◽  
James M Tielsch ◽  
Subarna K Khatry ◽  
Steven C LeClerq ◽  
Luke C Mullany ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Sociodemographic Factors ◽  
Nutrition Intervention ◽  
Acute Malnutrition ◽  
Older Children ◽  
Upper Arm ◽  
Prediction Of Mortality ◽  
Arm Circumference ◽  
Increased Risk ◽  
Mid Upper Arm Circumference

AbstractObjectiveTo assess ethnicity- and age-modified associations between mid-upper arm circumference (MUAC) and mortality in Nepalese children and whether sociodemographic factors explain these associations.DesignSecondary data analysis of children followed until 3 years of age. Estimated mortality hazard ratios (HR) for MUAC<11·5cm (recommended cut-off for identifying severe acute malnutrition among children ≥6 months old) compared with ≥11·5cm in younger (<6 months) and older children (≥6 months) of Pahadi and Madhesi ethnicity, adjusting for sex, socio-economic status (SES) and mother’s education using Cox proportional hazard models.SettingSarlahi, Nepal (21 October 2001–2 February 2006).SubjectsChildren (n 48 492) enrolled in the Nepal Nutrition Intervention Project, Sarlahi-4.ResultsAmong children aged ≥6 months, MUAC<11·5 cm was associated with increased risk of mortality in both Pahadis (HR=4·01; 95 % CI 1·42, 11·76) and Madhesis (HR=5·60; 95 % CI 3·87, 8·11) compared with those with MUAC≥11·5 cm, after adjusting for sex, SES and maternal literacy. Among children <6 months old, MUAC<11·5 cm was not associated with mortality in Pahadis with (HR=1·12; 95 % CI 0·72, 1·73) or without adjusting (HR=1·17; 95 % CI 0·75, 1·18) as compared with Madeshis (adjusted HR=1·76; 95 % CI 1·35, 2·28).ConclusionsAmong older children, MUAC<11·5 cm is associated with subsequent mortality in both ethnicities regardless of other characteristics. However, among children aged <6 months, it predicted mortality only among Madhesis, while sociodemographic factors were more strongly associated with mortality than MUAC<11·5cm among Pahadis.

scholarly journals Evaluation of anthropometric indicators in malnourished children at Nutritional Rehabilitation Center, Gujarat, India

2019 ◽  
Vol 6 (4) ◽  
pp. 1410
Author(s):  
Dhara Patel ◽  
Nisha Upadhyay
Keyword(s):  
Severe Acute Malnutrition ◽  
Nutritional Intervention ◽  
Cross Sectional Study ◽  
Acute Malnutrition ◽  
Daily Weight Gain ◽  
Cross Sectional ◽  
Clinical Criteria ◽  
Anthropometric Indicators ◽  
Malnourished Children ◽  
Intervention Measures

Background: It is very difficult to recognize the cases with mild-to-moderate malnutrition because clinical criteria for their diagnosis are imprecise and are difficult to interpret accurately. The objective of the study was daily weight gain in gram/kg/day in severely malnourished children.Methods: This was a hospital based cross sectional study in which total of 114 consecutive patients of SAM less than 5 years treated for complications of severe acute malnutrition using WHO protocol. The study design included 114 children from the NRC and then followed up the period of 6 months to assess the nutritional status during the period of initial stage and the entire follow up period using available record of anthropometry indicators of the admitted children recruited in the study at the NRC.Results: Mean weight at admission was 6.4 Kg, 6.5 Kg and 6.2 Kg of overall, boys and girls respectively. Mean weight at discharge was 6.8 Kg, 6.7 Kg and 6.6 Kg of overall, boys and girls respectively. Mean MUAC at admission was 10.7 cm, 10.9 cm and 10.6 cm of overall, boys and girls respectively. Mean MUAC at discharge was 10.9 cm, 10.9 cm and 10.8 cm of overall, boys and girls respectively.Conclusions: For treatment of severe acute malnutrition, systematic guidelines required, thus this study indicates that following WHO guidelines, it has become easier to manage SAM in hospital settings, with least possible stay at hospital. The objective of the study was to know the effect of nutritional intervention measures on selected anthropometric indicators of severe acute malnourished children.

scholarly journals The Effectiveness of the Malnutrition eLearning Course for Global Capacity Building in the Management of Malnutrition: A Prospective Empirical Study (Preprint)

2018 ◽  
Author(s):  
Sunhea Choi ◽  
Ho Ming Yuen ◽  
Reginald Annan ◽  
Trevor Pickup ◽  
Andrew Pulman ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Health Professionals ◽  
Severe Acute Malnutrition ◽  
Scale Up ◽  
Health Sector ◽  
Nutrition Intervention ◽  
Acute Malnutrition ◽  
World Health ◽  
Knowledge Gain ◽  
Prospective Longitudinal

BACKGROUND Scaling-up improved management of severe acute malnutrition has been identified as the nutrition intervention with the largest potential to reduce child mortality but lack of operational capacity at all levels of the health system constrains scale-up. We therefore developed an interactive Malnutrition eLearning course that is accessible at scale to build capacity of the health sector workforce to manage severely malnourished children according to guidelines of the World Health Organization (WHO). OBJECTIVE The study aim was to test whether the Malnutrition eLearning course improves knowledge and skills of in-service and pre-service health professionals in managing children with severe acute malnutrition. METHODS This 2-year prospective, longitudinal, empirical research study took place in Ghana, Guatemala, El Salvador and Colombia between January 2015 and February 2017. A subset of 354 in-service health personnel from 12 hospitals and 2 Ministries of Health, 703 pre-service trainees from 9 academic institutions, and 204 online users participated. Knowledge gain after training and retention over time were measured through pre- and post-assessments, comprising questions pertaining to screening, diagnosis, pathophysiology, and treatment and prevention of malnutrition. Comprehension, application and integration of knowledge were tested. Changes in perception, confidence, and clinical practice were assessed through questionnaires and interviews. RESULTS Before the course, awareness of the WHO guidelines was 36.7% (389/1059) overall and 26.3% (94/358) among in-service professionals. The mean score gain in knowledge after access to the course of 606 participants who had pre-and post-assessment data was 11.8 (95% CI 10.8, 12.9 P<.001) – a relative increase of 41.5%. The proportion who achieved above the pass mark post-training was 58.7% (356/606), compared with 18.2% (110/606) pre-training. Of the in-service professionals, 86% (128/149) reported applying their knowledge by changing their clinical practice in screening, assessment, diagnosis and/or management. This group demonstrated significantly increased, retained knowledge 6-months after training (mean difference (SD) from pre-assessment:12.1 (11.8)), retaining 65.8% (12.1/18.4) of gained knowledge from the training. Changes in the management of malnutrition were reported by trained participants, and institutional operational and policy changes were also found. CONCLUSIONS The Malnutrition eLearning course improved knowledge, understanding and skills of health professionals in the diagnosis and management of children with severe acute malnutrition, and changes in clinical practice and confidence were reported following completion of the course.

scholarly journals Biomarkers of post-discharge mortality among children with complicated severe acute malnutrition

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
James M. Njunge ◽  
Agnes Gwela ◽  
Nelson K. Kibinge ◽  
Moses Ngari ◽  
Lydia Nyamako ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Post Discharge

scholarly journals Post-Discharge survival status and predictors of mortality among severely acute malnourished children <5 years of age admitted to Minia University Maternity and Children Hospital

2019 ◽  
Author(s):  
Eman Ghazawy ◽  
Gihan Bebars ◽  
Ehab Salah Eshak
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Treatment Programs ◽  
Cumulative Probability ◽  
Post Discharge ◽  
Under Five ◽  
Survival Status ◽  
Probability Of Survival ◽  
Malnourished Children ◽  
Nutrition Rehabilitation

Abstract Background: Though effective treatment programs for severely malnourished children are available, but little is known about long-term outcomes and potential predictors of post-discharge mortality. The aim of this study was to assess the post-discharge survival status and predictors for post-discharge mortality in severely malnourished children admitted to Minia University Maternity and Children Hospital Methods: A retrospective cohort study which included 135 children under five years of age who were admitted to the nutrition rehabilitation ward with severe acute malnutrition (SAM) during the period from January to December 2018. Data were collected from the inpatients hospital records and children’s parents/guardians were interviewed using a detailed structured questionnaire that inquired about demographic and socioeconomic variables. Results: A total of 135 children were enrolled into the study. Death rate during hospitalization was 9.6%. The cumulative probability of survival beyond eight weeks and at least for 24 weeks after discharge was 89.3% with a cumulative probability of post-discharge mortality of 10.7% and all deaths occurred within eight weeks after discharge. The main predictors for post-discharge mortality were illiteracy of mothers and the presence of edema at admission; the multivariable HRs (95%CIs) were 7.10 (1.58-31.93; p=0.01) and 6.96 (0.84-357.85; p=0.07), respectively. Conclusions: Mothers’ education and edema at admission are independent predictors for post-discharge mortality in under-five children with SAM. The identification of predictors for post-discharge mortality is an important preliminary step for interventions aiming to reduce morbidity and mortality following discharge.

scholarly journals Assessment of the Nutritional Status of Children on Arvs in the Prevention of Mother Transmission (PMTCT) Child Centers in the Ruashi Health Zone in Lubumbashi in Dr Congo

2021 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Nutritional Status ◽  
Severe Acute Malnutrition ◽  
Minimum Weight ◽  
Treatment Compliance ◽  
Acute Malnutrition ◽  
Average Weight ◽  
People Living With Hiv ◽  
Health Zone ◽  
Nutritional Status Of Children ◽  
Hiv Aids

Introduction: HIV infection causes and promotes enormous nutritional deficits in children. The objective of this work was to analyze the nutritional status of children infected with HIV placed on antiretrovirals in the Ruashi Health Zone in Lubumbashi. Methods: We carried out a cross-sectional descriptive study which focused on 51 children aged 3 months to 17 years selected in 8 care structures for People Living with HIV AIDS, from January to June 2016. Data was collected by documentary review and the usual descriptive statistics and anthropometric indicators were used. Result: The prevalence of overall malnutrition was 31.37% (n = 51) including 7.84% moderate malnutrition. The average weight is 19.25 kg with a minimum weight of 4.5 kg and a maximum of 49 kg. The overall prevalence of anemia (hemoglobin <11g / dl) was 9.8%. Wasting affected 3.92% of children and 7.84% were victims of chronic malnutrition. The prevalence of acute malnutrition was 25.48%, of which 3.92% was severe acute malnutrition. Immune deficiency (CD4 <350) in 5.88% of cases, undetectable viral load at 88.37% and treatment compliance at 92.16% Conclusion: HIV / AIDS affects the state of health of children in Ruashi with 31.37% overall malnutrition and 7.84% stunted growth. Good nutritional and therapeutic support for children is necessary.

scholarly journals Essai d’une farine de sevrage dans la réhabilitation nutritionnelle de la malnutrition aigüe en milieu communautaire, au Niger

2020 ◽  
Vol 151 ◽  
pp. 15573-15583
Author(s):  
Maman Mahaman Salissou ◽  
Bako Aminatou Maazou ◽  
Sabo Haoua Seini
Keyword(s):  
Weight Gain ◽  
Acute Malnutrition ◽  
Prise En Charge ◽  
Average Weight ◽  
Target Weight ◽  
The Third ◽  
Étude Prospective ◽  
Peanut Cake ◽  
Moderate Acute Malnutrition ◽  
Average Weight Gain

Objectif : l’objectif vise à évaluer l’efficacité des bouillies à base de mil, tourteaux d’arachide et la poudre de moringa, chez les enfants âgés de 6 à 59 mois admis pour malnutrition au niveau du Centre de Santé Intégré de Dan Issa. Méthodologie et Résultats : Cette étude prospective, s’est déroulée du 23 août au 04 octobre 2019. Elle a concerné 44 enfants de 06 à 59 mois, répartis en trois groupes. Le premier groupe de 20 enfants atteints de malnutrition aigüe modérée, recevant la bouillie ; le deuxième groupe constitué de 12 enfants atteints de malnutrition aigüe légère, reçoit la même bouillie et le troisième groupe constitué de 12 enfants atteints de malnutrition aigüe modérée, reçoit du CSB++. Les données ont été analysées avec le logiciel SPSS version 20. Ainsi, il ressort : pour le premier groupe, l’âge moyen est de 12,20 mois ± 4,336. La moitié des enfants (50%) a observé une amélioration de leur nutritionnel dès la première semaine de traitement avec un gain de poids moyen de 73,92g par jour ± 73,7. Pour le deuxième groupe, l’âge moyen est de 28,92 mois ± 15,163. On a constaté que 75% des enfants ont atteint le poids cible dès la première semaine de prise en charge, avec un gain de poids moyen de 85,11g/j ± 47,22. Pour le troisième groupe ayant reçu le CSB++, on a constaté que seuls 3 enfants sur 12 (25%) ont observé une amélioration de leur état nutritionnel après 14 jours de traitement. Le gain de poids moyen était de 20,53g/j ± 23,14. Cependant, il faut noter que ce dernier groupe n’a reçu le CSB++ qu’une seule fois et le CSI était en rupture jusqu’à la fin de l’étude. En effet, l’action de la bouillie sur le gain pondéral a été remarquable. Tous les enfants ont acceptés la bouillie et qu’aucun signe d’intolérance n’a été noté. Conclusion et application des résultats : la bouillie mis au point à partir du mil, tourteaux d’arachide et la poudre de moringa est une approche pour combattre ou prévenir à long terme la malnutrition chez les enfants de moins de cinq ans au Niger. Cependant, la bouillie seule ne constitue pas le traitement, mais doit être couplée avec des mesures sanitaires, d'hygiène et d’éducation nutritionnelle des mères. Mots-clés : essai, farine, malnutrition, prévention, réhabilitation nutritionnelle, Niger. Maman et al., J. Appl. Biosci. 2020 Essai d’une farine de sevrage dans la réhabilitation nutritionnelle de la malnutrition aigüe en milieu communautaire, au Niger). 15574 ABSTRACT Objective: the objective aims to assess the effectiveness of millet-based porridge, peanut cake and moringa powder, in children aged 6 to 59 months admitted for malnutrition at the Dan Issa Integrated Health Center. Methodology and Results: This prospective study took place from August 23 to October 04, 2019. It involved 44 children from 06 to 59 months, divided into three groups. The first group of 20 children with moderate acute malnutrition, receiving porridge; the second group of 12 children with mild acute malnutrition receives the same porridge and the third group of 12 children with moderate acute malnutrition receives CSB ++. Data were analyzed with SPSS software version 20. Thus, it emerges: for the first group, the average age is 12.20 months ± 4.336. Half the children (50%) observed an improvement in their nutrition from the first week of treatment with an average weight gain of 73.92 g per day ± 73.7. For the second group, the average age is 28.92 months ± 15.163. It was found that 75% of children reached the target weight within the first week of treatment, with an average weight gain of 85.11 g / d ± 47.22. For the third group who received CSB ++, it was found that only 3 out of 12 children (25%) observed an improvement in their nutritional status after 14 days of treatment. The average weight gain was 20.53 g / d ± 23.14. However, it should be noted that the latter group received CSB ++ only once and the CSI was out until the end of the study. Indeed, the action of porridge on weight gain has been remarkable. All the children accepted the porridge and no signs of intolerance were noted. Conclusion and application of the results: the porridge developed from millet, peanut cake and moringa powder is an approach to combat or prevent long-term malnutrition in children under five in Niger. However, porridge alone is not the treatment, but should be combined with sanitary, hygienic and nutritional education measures for mothers. Keywords: trial, flour, malnutrition, prevention, nutritional rehabilitation, Niger.

Sign in / Sign up

Export Citation Format

Share Document