scholarly journals Are ready to use therapeutic foods a solution for management of child undernutrition in India

2021 ◽  
Vol 8 (6) ◽  
pp. 3191
Author(s):  
Shalli . ◽  
Anuradha .
Keyword(s):  
Severe Acute Malnutrition ◽  
Incidental Finding ◽  
Acute Malnutrition ◽  
Care Giver ◽  
Nutritional Rehabilitation ◽  
Indian Children ◽  
Crucial Step ◽  
Child Undernutrition ◽  
Low Weight ◽  
Weight For Age

Childhood undernutrition is a very common problem in India. India contributes to one-fifth of global underlnutrition. Thirty- eight % of Indian children have stunting and 35.7% have low weight for age. Out of these 7.4% of under-5 children suffer from severe acute malnutrition (SAM). Government of India and many other Non- governmental organisations (NGOs) are working towards eliminating malnutrition. This is being done by establishment of various nutritional rehabilitation centres and malnutrition treatment centres. However, in order to achieve the goals and lead to widespread coverage, community participation is a crucial step. Malnutrition is usually an incidental finding when any care giver seeks medical care for the child due to some illness.

Child Undernutrition in the States of India: An Analysis Based on Change in Composite Index of Anthropometric Failure from 2006 to 2016

2021 ◽  
pp. 097226612110103
Author(s):  
J. R. Jith ◽  
Rajshree Bedamatta
Keyword(s):  
Child Nutrition ◽  
Composite Index ◽  
Family Health ◽  
Wealth Index ◽  
Household Wealth ◽  
Population Projections ◽  
Indian Children ◽  
Indian States ◽  
Child Undernutrition ◽  
Low Weight

Stunting, wasting and underweight—the three traditional indicators of undernourishment among children—provide mutually non-exclusive categories of anthropometric failures: low height for age, low weight for height and low weight for age. Although these indicators are essential for designing specific clinical and child nutrition policy interventions, they fall short of estimating the prevalence of overall anthropometric failure, which provides a sense of the scale of the nutrition problem. This article estimates the alternative, more comprehensive measure Composite Index of Anthropometric Failure (CIAF) for Indian states, based on data from the National Family Health surveys of 2006 and 2016, for children under five years (Ch–U5). The CIAF-based undernutrition estimates show significantly high anthropometric failure levels among Indian children compared to only stunting, wasting and underweight. Based on population projections for Ch–U5, we also show that a sizeable number of states may have seen an increase in child undernutrition between 2006 and 2016. We also correlated CIAF with household wealth index scores and found a positive relationship with children facing no anthropometric failure.

scholarly journals An Experience at a Tertiary Level Hospital NRC in Management of Severe Acute Malnutrition in Children Aged between 6-59 Months Adopting World Health Organization Recommendations

2016 ◽  
Vol 1 (1) ◽  
pp. 41 ◽  
Author(s):  
S. Bharathi ◽  
K. Anuradha ◽  
J. Venkateshwar Rao
Keyword(s):  
World Health Organization ◽  
Severe Acute Malnutrition ◽  
Case Fatality ◽  
Acute Malnutrition ◽  
World Health ◽  
Severe Malnutrition ◽  
Rehabilitation Center ◽  
Nutritional Rehabilitation ◽  
Retrospective Case ◽  
Health Organization

<p><em>Objectives:<strong> </strong></em><em>To study the outcome indicators of a nutritional rehabilitation center and to assess its performance.</em></p><p><em>Design: </em><em>Retrospective case study.</em></p><p><em>Period:</em><em> One year period from Jan 2014 to Dec 2014.</em></p><p><em>Methods:<strong> </strong></em><em>Data of 254 children aged between 6-59</em><em> </em><em>months with severe acute malnutrition admitted in nutritional rehabilitation center at department of pediatrics, Gandhi hospital, was</em><em> </em><em>analyzed retrospectively. Identification and treatment of severe acute malnutrition was done according to world health organization recommendations.</em></p><p><em>Results:<strong> </strong></em><em>The recovery rate, death rate, defaulter rate, mean (SD) weight gain &amp; mean (SD) duration of stay in the nutritional rehabilitation center were 51.42%, 3.54%, 28.57%, 8g/kg/day, 14.2 days respectively.</em></p><p><em>Conclusions:<strong> </strong></em><em>Nutritional rehabilitation centers are effective in management of severe malnutrition and also in decreasing the case fatality rates.</em></p>

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.

Urinary Organic Acids Increase After Clinical Stabilization of Hospitalized Children With Severe Acute Malnutrition

2019 ◽  
Vol 40 (4) ◽  
pp. 532-543
Author(s):  
Allison I. Daniel ◽  
Matilda E. Arvidsson Kvissberg ◽  
Edward Senga ◽  
Christian J. Versloot ◽  
Philliness Prisca Harawa ◽  
...  
Keyword(s):  
Organic Acids ◽  
Low Income ◽  
Severe Acute Malnutrition ◽  
Urinary Metabolites ◽  
Acute Malnutrition ◽  
Partial Recovery ◽  
Nutritional Rehabilitation ◽  
Risk Of Death ◽  
Urinary Organic Acids ◽  
Clinical Stabilization

Background: Despite a reduction of child mortality in low-income countries, acutely ill undernourished children still have an elevated risk of death. Those at highest risk are children with severe acute malnutrition (SAM) who often show metabolic dysregulation that remains poorly understood. Objective: We performed a pilot study to examine changes in urinary organic acids during nutritional rehabilitation of children with SAM, and to identify metabolites associated with the presence of edema or with mortality. Methods: This study included 76 children aged between 6 and 60 months, hospitalized for SAM at the Moyo Nutritional Rehabilitation and Research Unit in Blantyre, Malawi. Urine was collected at admission and 3 days after clinical stabilization and metabolomics were performed using gas chromatography–mass spectrometry. Metabolite concentrations were evaluated with both uni- and multivariate approaches. Results: Most metabolites increased 3 days after clinical stabilization, and total urinary concentration changed from 1.2 mM (interquartile range [IQR], 0.78-1.7) at admission to 3.8 mM (IQR, 2.1-6.6) after stabilization ( P < .0001). In particular, 6 metabolites showed increases: 3-hydroxybutyric, 4-hydroxyhippuric, p-hydroxyphenylacetic, oxoglutaric, succinic, and lactic acids. Urinary creatinine was low at both time points, but levels did increase from 0.63 mM (IQR, 0.2-1.2) to 2.6 mM (IQR,1.6-4.4; P < .0001). No differences in urinary profiles were found between children who died versus those who survived, nor between children with severe wasting or edematous SAM. Conclusions: Total urinary metabolites and creatinine increase after stabilization and may reflect partial recovery of overall metabolism linked to refeeding. The use of urinary metabolites for risk assessment should be furthered explored. Trial registration: TranSAM study (ISRCTN13916953).

scholarly journals Effect of topical applications of sunflower seed oil on systemic fatty acid levels in under-two children under rehabilitation for severe acute malnutrition in Bangladesh: a randomized controlled trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
K. M. Shahunja ◽  
Daniel C. Sévin ◽  
Lindsay Kendall ◽  
Tahmeed Ahmed ◽  
Md. Iqbal Hossain ◽  
...  
Keyword(s):  
Enteral Feeding ◽  
Sunflower Seed ◽  
Seed Oil ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Whole Body ◽  
Nutritional Rehabilitation ◽  
Randomized Controlled ◽  
Link Type ◽  
Sunflower Seed Oil

Abstract Background Children with severe acute malnutrition (SAM) have inadequate levels of fatty acids (FAs) and limited capacity for enteral nutritional rehabilitation. We hypothesized that topical high-linoleate sunflower seed oil (SSO) would be effective adjunctive treatment for children with SAM. Methods This study tested a prespecified secondary endpoint of a randomized, controlled, unblinded clinical trial with 212 children with SAM aged 2 to 24 months in two strata (2 to < 6 months, 6 to 24 months in a 1:2 ratio) at Dhaka Hospital of icddr,b, Bangladesh between January 2016 and December 2017. All children received standard-of-care management of SAM. Children randomized to the emollient group also received whole-body applications of 3 g/kg SSO three times daily for 10 days. We applied difference-in-difference analysis and unsupervised clustering analysis using t-distributed stochastic neighbor embedding (t-SNE) to visualize changes in FA levels in blood from day 0 to day 10 of children with SAM treated with emollient compared to no-emollient. Results Emollient therapy led to systematically higher increases in 26 of 29 FAs over time compared to the control. These effects were driven primarily by changes in younger subjects (27 of 29 FAs). Several FAs, especially those most abundant in SSO showed high-magnitude but non-significant incremental increases from day 0 to day 10 in the emollient group vs. the no-emollient group; for linoleic acid, a 237 μg/mL increase was attributable to enteral feeding and an incremental 98 μg/mL increase (41%) was due to emollient therapy. Behenic acid (22:0), gamma-linolenic acid (18:3n6), and eicosapentaenoic acid (20:5n3) were significantly increased in the younger age stratum; minimal changes were seen in the older children. Conclusions SSO therapy for SAM augmented the impact of enteral feeding in increasing levels of several FAs in young children. Further research is warranted into optimizing this novel approach for nutritional rehabilitation of children with SAM, especially those < 6 months. Trial registration ClinicalTrials.gov: NCT02616289.

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 Evaluation of Malnutrition in Children Admitted in Nutritional Rehabilitation Home of Pokhara Academy of Health Sciences- A Retrospective Cross-sectional Hospital Based Study

2020 ◽  
Vol 3 (2) ◽  
pp. 281-287
Author(s):  
Amrita Ghimire Paudel ◽  
Gita Ghimire ◽  
Shreekrishna Shrestha ◽  
Ramchandra Bastola ◽  
Yagyaraj Sigdel ◽  
...  
Keyword(s):  
Weight Gain ◽  
Nutritional Status ◽  
Severe Acute Malnutrition ◽  
Nutritional Intervention ◽  
Health Sciences ◽  
Acute Malnutrition ◽  
Nutritional Rehabilitation ◽  
Management Protocol ◽  
Significant Difference ◽  
Moderate Acute Malnutrition

Introduction: The burden of malnutrition is of significant concern in Nepal. The objectives of this study are to classify the nutritional status in children admitted in nutritional rehabilitation home of Pokhara Academy of Health Sciences and to relate the demographic characteristics and the effectiveness of the nutritional intervention measures on status of malnutrition which can help in the policy formulation to tackle the burden of malnutrition. Materials and Methods: This is a hospital based retrospective study in which total of 238 children with malnutrition admitted in nutritional rehabilitation home of Pokhara Academy of Health Sciences during July 2014 to July 2018 were followed. The socio-demographic factors and nutritional status were analyzed at admission and at discharge using the available record. Data was analyzed using SPSS 16. Results: Out of 238 malnourished children, 167(70.2%) were cases of moderate acute malnutrition and 76(29.8%) were cases of severe acute malnutrition. The mean weight at admission was 7.18±1.73 kg, mean weight at discharge was 7.82±1.82 kg and mean weight increased after nutritional intervention was 0.62 kg±0.40. The average weight gain in severe acute malnutrition was 4.7gm/kg/day. A statistically significant difference was obtained between mean weight (p=0.00, t= - 24.62) of children at admission and discharge. There was significant statistical difference between mean weight gain (p<0.05, t= -3.1) in severe acute malnutrition (0.76±0.49 kg) and in moderate acute malnutrition (0.59±0.34 kg). Conclusion: Nutritional rehabilitation homes are effective in improving the nutritional status of undernourished children, more effective in severe acute malnutrition. However it is important to reassess the management protocol to meet the intake targets so that the rate of weight gain is improved.

scholarly journals Clinical profile of patients with infantile tremor syndrome in a tertiary care center

2020 ◽  
Vol 7 (11) ◽  
pp. 2172
Author(s):  
Gargi H. Pathak ◽  
Anuya V. Chauhan ◽  
Dhruti Pandya
Keyword(s):  
Vitamin B12 ◽  
Complementary Feeding ◽  
Severe Acute Malnutrition ◽  
Vitamin B12 Deficiency ◽  
Clinical Profile ◽  
Acute Malnutrition ◽  
Severe Anemia ◽  
Age Group ◽  
Nutritional Rehabilitation ◽  
B12 Deficiency

Background: Infantile tremor syndrome (ITS) is a condition reported from many areas of Indian subcontinent due to lack of proper nutrition, improper weaning or delayed introduction of complementary feeding. There is no proven macro or micro nutrient deficiency responsible for it but relation with vitamin B12 deficiency has been identified in some studies. The aim of this study was to study the clinical profile of patients with ITS.Methods: It is a prospective observational study including total 30 patients, from 6 months to 3-year age group, admitted to pediatric wards and nutritional rehabilitation centre, civil hospital, Ahmedabad, from June 2018 to December 2019.Results: Out of 30 patients studied, 69% had pre-ITS and rest had ITS, 61.5% were males and 38.4% were females, 69.2% had severe acute malnutrition, 84.6% had severe anemia and 23% of them presented with CCF, 15.4% patients had microcephaly and 23% had hypotonia. 23% had motor and speech delay. 61.5% belonged to lower socio-economic group. There was delayed introduction of complementary feeding in 63% of patients. 69% patients had severe vitamin B12 deficiency and 21% had moderate vitamin B12 deficiency.Conclusion: ITS, is commonly seen among male children belonging to lower socio-economic group among age group of 6 months to 24 months, presents with coarse tremors with moderate to severe anemia with moderate to severe acute malnutrition and is associated with deficiency of vitamin B12. Early diagnosis and treatment including nutritional rehabilitation grossly improved the outcome.

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