scholarly journals Outcome of Severe Acute Malnutrition Management at a Tertiary Care Nutrition Rehabilitation Centre

Author(s):  
Prakash Chandra Panda ◽  
Author(s):  
Mayadhar Panda ◽  
Sikata Nanda ◽  
Mangala Charan Murmu ◽  
Rama Chandra Giri ◽  
Lila Lalantika Debi

Background: Severe acute malnutrition (SAM) places extraordinary challenges in the way of survival, growth and development of the child under five years of age. Our aim was to evaluate the functioning and performance of facility based management of SAM children admitted in the nutrition rehabilitation centre (NRC) and to identify the existing bottlenecks in the NRC.Methods: Children above 1 month and less than 5 years of age with severe acute malnutrition were included during the study period. Demographic details of the SAM children, clinical features during admission were recorded. Anthropometric measurements like MUAC, weight, height/length and WHZ scores were taken at admission and compared with the findings at discharge. Statistical analysis: the data after collection, compilation was analysed by SPSS.Results: Majority 277 (78.47%) of them belonged to rural areas. 300 (85%) SAM children were referred by medical officers. Bilateral oedema was recorded in 12 (17.9%) admitted children during 2014-2015, 22 (17.9%) children in 2015-2016 and in 37 (22.7%) children during 2016-2017. There was significant improvement in the mean weight (kg) and mean MUAC (cm) at discharge was in comparison to the weight and MUAC of the children at admission and this difference in increase in the mean weight and MUAC were found to be statistically significant.Conclusions: Implementation of WHO feeding guidelines resulted in adequate weight gain of inpatient malnourished children, however the frontline workers in the community and health care providers of PHCs should be trained and given hands on training for early identification and referral of SAM cases.


2021 ◽  
Vol 8 (18) ◽  
pp. 1276-1280
Author(s):  
Rajkumari Rupabati Devi ◽  
Chingshubam Imobi Singh

BACKGROUND Malnutrition is one of the leading causes of morbidity and mortality in children under 5 years of age. Children with severe acute malnutrition have nine times higher mortality than those in well-nourished children. The purpose of this study was to describe the demography, clinical profile, and outcome of children with severe acute malnutrition aged between 6 months to 59 months admitted in nutrition rehabilitation centre at a tertiary care hospital in North East India. METHODS A cross sectional-observational hospital-based study was conducted between May 2019 and April 2020 on 140 children. Severe acute malnutrition was diagnosed as per WHO criteria by using standard techniques. Variables recorded were demographic factors, anthropometry, clinical profile, laboratory tests, and medical complications. The outcome indicators including hospital course were studied. RESULTS In the present study 63.6 % were males and the mean age of presentation was 20.0 ± 1.54 months. 57.1 % children were found to be having both weight for height z-score below – 3 SD and mid upper arm circumference less than 115 mm together. Acute gastroenteritis (45.2 %) was the most common co-morbid condition followed by respiratory tract infection (26.2 %). Iron deficiency anaemia was found in 70.7 % of study children. Recovery rate from severe acute malnutrition was 86.4 % with average weight gain of 6.4 g / kg / day. CONCLUSIONS Children with severe acute malnutrition tend to suffer from serious co-morbid conditions. Early identification and treatment in nutrition rehabilitation centre with facility for critical care support should become a key component of continuum of care for children with severe acute malnutrition. KEYWORDS Children, Clinical Profile, Facility-Based Care, Severe Acute Malnutrition, Outcome


Author(s):  
Deepthi Pagali ◽  
Suneetha Bollipo ◽  
Harsha B. Korrapolu ◽  
Mohammed Abdul Rahman

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. 


2019 ◽  
Vol 6 (2) ◽  
pp. 602
Author(s):  
Suguna S. ◽  
Vidyasagar V.

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.


2018 ◽  
Vol 5 (5) ◽  
pp. 1928
Author(s):  
M. R. Prashanth ◽  
M. R. Savitha ◽  
H. N. Yashwanth Raju ◽  
M. Shanthi

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.


2019 ◽  
Vol 6 (6) ◽  
pp. 2489
Author(s):  
Gargi H. Pathak ◽  
Anuya V. Chauhan ◽  
Sunita O. Beniwal

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.


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