scholarly journals Nutritional status of children in a remote village of desert region Tharparkar Sindh, Pakistan

2017 ◽  
Vol 1 (1) ◽  
pp. 9
Author(s):  
Fayza Rani
Keyword(s):  
Severe Acute Malnutrition ◽  
Living Conditions ◽  
Health Facilities ◽  
Acute Malnutrition ◽  
Severe Malnutrition ◽  
Cross Sectional Survey ◽  
Related Factors ◽  
Cross Sectional ◽  
Basic Health ◽  
Desert Region

Background and Introduction: An increasing number of deaths have accused at Tharparkar desert region of Sindh. Hence, a nutrition relief camp was set up at two remote villages named Haryar and Bhorilo. Visiting team consisted of nutritionists, dietitians, pediatricians and logistic support providers. Objective: To determine the prevalence of malnutrition among children (0-10 yrs) and its association with their living conditions. Methods: A cross sectional survey was conducted. Mothers with children aged 1 month to 10 years were invited to visit the camp.200 children were screened for malnutrition using anthropometric measurements including height, weight and Mid Upper Arm Circumference (MUAC). Dietary intake data was    collected from mother including information about feeding practices, vaccination, disease history, and living conditions. Data was analyzed through SPSS 17. Inc using descriptive statistics. Results: Out of 200 children, 191 questionnaires were     completed. Mean age was 3.6 ± 2.8 SD years. There were 101(52.9%) males and 90(47%) females. Results showed that 42.4 % (n=81) were affected by severe    malnutrition (lower than 3rd percentile). Children less than 5 years were severely wasted as per WHO diagnostic criteria for Severe Acute Malnutrition (SAM) as   indicated by 79(51%) children had a z score of -4 SD (for height & weight). Further analysis of children under 5 years into the mild acute (≤13.5 cm), moderate Acute (11.5-12.5 cm) and severe acute malnutrition (<11.5 cm) was carried out. The data demonstrated that 33.7 % (n=32) children had mild malnutrition, 37.7 % (n=58)  suffered from moderate malnutrition and 15 % (n=23) had severe malnutrition. Food intake includes roti (Pakistani bread) and chatni (green chilies paste). There was no consumption of fruit, vegetable and milk due to no availability. Infants were breast fed and vaccinated but inappropriate and delayed weaning practices were reported by the mothers. Nearest medical facility/hospital was located at a distance of 15-30 miles. Conclusion: Major non nutrition related factors found to be contributing towards malnutrition were lack of education, water scarcity, non-availability of food, drinking water and lack of basic health facilities. There should be a provision of basic health facilities at community level. Health education and nutrition counseling should be included in their basic health initiatives.

scholarly journals A study on assessment of nutrition and health status of the children one year after discharge from the Nutritional Rehabilitation Centre in South India

2018 ◽  
Vol 5 (8) ◽  
pp. 3492
Author(s):  
C. Chandra Sekhar ◽  
D. Surendra Babu ◽  
C. Sravana Deepthi ◽  
Shakeer Kahn Patan ◽  
Khadervali N. ◽  
...  
Keyword(s):  
Health Status ◽  
Nutritional Status ◽  
Severe Acute Malnutrition ◽  
Cross Sectional Study ◽  
Acute Malnutrition ◽  
Severe Malnutrition ◽  
Rehabilitation Centre ◽  
Community Based ◽  
Cross Sectional ◽  
Danger Signs

Background: Nutrition rehabilitation centers (NRCs) were started to control severe malnutrition and follow-up of children with severe acute malnutrition is essential because mortality rate of 10-30% has been reported after discharge from hospital.Methods: A community based cross sectional study with the objectives to assess the current health status of the children discharged from the NRC and to assess the healthy practices learned by mothers during their stay at NRC. We included children those discharged from May to October 2013. The children were approached house to house visit and assessed for their health status with a pretested semi structured questionnaire. Mothers of the children were also interviewed for the knowledge and practices of the dietary and child care.Results: Among 67 children, 8 (11.9%) children could not be traced and 7 (10.4%) were reported dead, 52 were included 27 were boys and 25 were girls with a mean age of 35 months. The current nutritional status was 71.2% were not in very low weight, 17.3% were moderately underweight, and 11.5% were still severely underweight. Children who had more number of follow-ups had a better nutritional status which was significant (p<0.0001). 94% of the mothers had knowledge about correct feeding practices and food preparations; 86.5% were aware of good hygiene; 75% aware of the danger signs. Only 59.5% of the mothers could recollect the structured play therapy.Conclusions: Community based followup of the children following discharge from NRC and appropriate feedback to the mothers is very much essential for sustained results.

scholarly journals Impact of Socioeconomic Inequalities on Child Malnutrition

2020 ◽  
pp. 114-119
Author(s):  
Zamir Ahmed Qambrani ◽  
Asif Nadeem Jamali ◽  
Habibullah Siyal ◽  
Sarah Azhar ◽  
Hafiz Syed Imran-ul Haque ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Tertiary Care Hospital ◽  
Severe Acute Malnutrition ◽  
Tertiary Care ◽  
Acute Malnutrition ◽  
Severe Malnutrition ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Chi Square Analysis

Socioeconomic status and the education of mother plays important role in providing better health care and nutrition to children. To the best of our knowledge the major population of Pakistan belongs to middle class and identification of malnutrition in our setups may help the policy makers to develop certain parameters to provide better nutrition to children under 5 years of age. The aims of current study were to analyze the prevalence of malnutrition and their association with different socioeconomic status in tertiary care hospital of Hyderabad. Study Design: Cross sectional. Place and Duration of Study: Study was performed at nutritional stabilization center of pediatric department of tertiary care hospital Hyderabad during the month of July 2019 to January 2020. Methodology: Preformed proforma was designed to record the data of participants. Hospital protocols using WHO guidelines (17) i.e. 10 steps for in-patient care of severe malnutrition were started & followed with feeding F-75 & F-100. Data was analyzed on SPSS-20. Results: The minimum age recorded was 8 months and maximum was found to be 45 months (3 years 9 months). 72% were females and 70% of participants had Weight to height ratio below normal. Prevalence of severe acute malnutrition was found to be 35.2%. After admission and management protocols 91.6% were recovered however, mortality was observed in 8.9% participants. Chi square analysis of all socioeconomic groups showed highly significant results with severe acute malnutrition (p-value= 0.001). Conclusion: Current study concluded a high prevalence of SAM in Pakistani population that is about 35.2%, out of which majority was from lower socioeconomic class.

scholarly journals Mid-upper arm circumference in detection of weight-for-height Z-score below −3 in children aged 6–59 months

2018 ◽  
Vol 21 (10) ◽  
pp. 1794-1799 ◽  
Author(s):  
Umesh Kapil ◽  
RM Pandey ◽  
Rahul Bansal ◽  
Bhavana Pant ◽  
Amit Mohan Varshney ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Characteristic Curve ◽  
Predictive Ability ◽  
Acute Malnutrition ◽  
Test Accuracy ◽  
Cross Sectional Survey ◽  
Upper Arm ◽  
Cross Sectional ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference

AbstractObjectiveTo evaluate the predictive ability of mid-upper arm circumference (MUAC) for detecting severe wasting (weight-for-height Z-score (WHZ) <−3) among children aged 6–59 months.DesignCross-sectional survey.SettingRural Uttar Pradesh, India.SubjectsChildren (n 18 456) for whom both WHZ (n 18 463) and MUAC were available.ResultsThe diagnostic test accuracy of MUAC for severe wasting was excellent (area under receiver-operating characteristic curve = 0·933). Across the lower range of MUAC cut-offs (110–120 mm), specificity was excellent (99·1–99·9 %) but sensitivity was poor (13·4–37·2 %); with higher cut-offs (140–150 mm), sensitivity increased substantially (94·9–98·8 %) but at the expense of specificity (37·6–71·9 %). The optimal MUAC cut-off to detect severe wasting was 135 mm. Although the prevalence of severe wasting was constant at 2·2 %, the burden of severe acute malnutrition, defined as either severe wasting or low MUAC, increased from 2·46 to 17·26 % with cut-offs of <115 and <135 mm, respectively. An MUAC cut-off <115 mm preferentially selected children aged ≤12 months (OR=11·8; 95 % CI 8·4, 16·6) or ≤24 months (OR=23·4; 95 % CI 12·7, 43·4) and girls (OR=2·2; 95 % CI 1·6, 3·2).ConclusionsBased on important considerations for screening and case detection in the community, modification of the current WHO definition of severe acute malnutrition may not be warranted, especially in the Indian context.

scholarly journals A quantitative cross-sectional survey of psychosocial stimulation and counselling interventions at nutritional rehabilitation units in Southern Malawi

2019 ◽  
Vol 31 (4) ◽  
pp. 238-243
Author(s):  
Allison I Daniel
Keyword(s):  
Health Workers ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
World Health ◽  
Limited Information ◽  
Nutritional Rehabilitation ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Psychosocial Stimulation ◽  
Counselling Interventions

BackgroundInpatient treatment at nutritional rehabilitation units (NRUs) is needed for children who have severe acute malnutrition (SAM) and acute illness, loss of appetite, or severe oedema. World Health Organization guidelines state that nutritional counselling should be done with primary caregivers at NRUs. These recommendations also include psychosocial stimulation interventions to improve developmental outcomes in children with SAM. However, there is limited information about the delivery of these types of interventions for caregivers and children in NRU settings. The primary objective of this research was therefore to obtain data about NRU resources, activities, and protocols relevant to psychosocial stimulation and counselling interventions during inpatient treatment of children with SAM. MethodsA cross-sectional survey was administered by interview at all 16 NRUs in seven districts in Southern Malawi. Participants were health workers, nurses, and nutritionists employed at the respective NRUs. ResultsThe response rate was 100% across NRUs. Half of participants said that psychosocial stimulation interventions are conducted at their respective NRUs, yet none of the NRUs have protocols for delivery of these interventions. Furthermore, 7/16 (44%) NRUs have no resources for psychosocial stimulation including play materials. Thirteen of 16 (81%) participants said that they feel this type of intervention is very important and 3/16 (19%) participants said that this somewhat important for children with SAM. All NRUs provide counselling to caregivers about breastfeeding and nutrition; 15/16 (94%) also give counselling about water, sanitation and hygiene. ConclusionsUltimately, results from this survey highlighted that there is a need to invest in comprehensive interventions to improve developmental and nutritional outcomes in these vulnerable children requiring admission to NRUs. 

scholarly journals Incidence Correction Factors for Moderate and Severe Acute Child Malnutrition From 2 Longitudinal Cohorts in Mali and Burkina Faso

2020 ◽  
Vol 189 (12) ◽  
pp. 1623-1627
Author(s):  
Francisco M Barba ◽  
Lieven Huybregts ◽  
Jef L Leroy
Keyword(s):  
Burkina Faso ◽  
Low Income ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Cross Sectional ◽  
Incidence Data ◽  
Moderate Acute Malnutrition ◽  
Cluster Randomized ◽  
Definition Of ◽  
Mid Upper Arm Circumference

Abstract Child acute malnutrition (AM) is an important cause of child mortality. Accurately estimating its burden requires cumulative incidence data from longitudinal studies, which are rarely available in low-income settings. In the absence of such data, the AM burden is approximated using prevalence estimates from cross-sectional surveys and the incidence correction factor $K$, obtained from the few available cohorts that measured AM. We estimated $K$ factors for severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) from AM incidence and prevalence using representative cross-sectional baseline and longitudinal data from 2 cluster-randomized controlled trials (Innovative Approaches for the Prevention of Childhood Malnutrition—PROMIS) conducted between 2014 and 2017 in Burkina Faso and Mali. We compared K estimates using complete (weight-for-length z score, mid-upper arm circumference (MUAC), and edema) and partial (MUAC, edema) definitions of SAM and MAM. $K$ estimates for SAM were 9.4 and 5.7 in Burkina Faso and in Mali, respectively; K estimates for MAM were 4.7 in Burkina Faso and 5.1 in Mali. The MUAC and edema–based definition of AM did not lead to different $K$ estimates. Our results suggest that $K$ can be reliably estimated when only MUAC and edema-based data are available. Additional studies, however, are required to confirm this finding in different settings.

scholarly journals Clinico-epidemiological profile of acute respiratory infections and malnutrition in urban and rural population of central India

2016 ◽  
Vol 4 (1) ◽  
pp. 159
Author(s):  
Pranav G. Jawade ◽  
Neelam D. Sukhsohale ◽  
Gayatri G. Jawade ◽  
Binish Z. A. Khan ◽  
Pratik K. Kakani ◽  
...  
Keyword(s):  
Rural Population ◽  
Urban Population ◽  
Respiratory Infections ◽  
Severe Acute Malnutrition ◽  
Pediatric Population ◽  
Central India ◽  
Developing Nations ◽  
Acute Malnutrition ◽  
Acute Respiratory Infections ◽  
Cross Sectional

Background: Acute respiratory infections (ARI) and Malnutrition in children have tremendous burden on the health care sector of developing nations including India. The intensity with which these conditions are holding grip in the community is indeed a matter of concern and hence developing nations should develop an insight to assess the severity of it has become a necessity.Methods: A hospital based cross sectional study was carried out in children aged 0-14 years. Children were clinically assessed and diagnosis was made as URTI or LRTI Also anthropometry was performed and accordingly children were divided into categories of no malnutrition (NM), severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) in ‘under 5’ years age children according to WHO guidelines, whereas children aged ‘above 5’ years were categorized as per the IAP guidelines.Results: It was observed that most of the mothers of children were illiterate with inadequate or absent ventilation and use of biomass fuels (chulha) for cooking purpose in households of rural children. The proportion of malnutrition was found to be equal in Under 5 children. In ‘above 5 years’ age study subjects, 52.4% of urban study subjects were normal as compared to 16.7% of rural study subjects.Conclusions: Our study implies that ARI and Malnutrition definitely is more prevalent in the pediatric population. Prevalence of URTI was found to be on a higher side in the rural population and LRTI prevalence was found to be higher in the urban population. Similarly, the prevalence of malnutrition was almost similar in ‘Under 5’ aged children, whereas the prevalence of malnutrition in ‘Above 5’ aged children was higher in the rural population than urban population.

scholarly journals Coverage Assessment For Community-Based Management Of Acute Malnutrition In Rural And Urban Ghana: A Comparative Cross-Sectional Study. 

2021 ◽  
Author(s):  
Joana Apenkwa ◽  
Sam K Newton ◽  
Samuel Kofi Amponsah ◽  
Reuben Osei-Antwi ◽  
Emmanuel Nakua ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Qualitative Approach ◽  
Rural District ◽  
Urban Setting ◽  
Acute Malnutrition ◽  
Rural Setting ◽  
Community Based ◽  
Cross Sectional ◽  
Study District ◽  
Point Coverage

Abstract Background: Ghana for years has implemented the Community-based Management of Acute Malnutrition (CMAM) among children in order to reduce malnutrition prevalence. However, the prevalence of malnutrition remains high. This study aimed to determine CMAM coverage levels in the Ahafo Ano South (AAS), a rural district, and Kumasi Subin sub-metropolis (KSSM), an urban district. Methods: The study was a cross-sectional comparative study with a mixed-methods approach. In all, 497 mother/caregiver and child under-five pairs were surveyed using a quantitative approach while qualitative methods were used to study 25 service providers and 40 mother/ caregivers who did not participate in the quantitative survey. Four types of coverage indicators were assessed: point coverage (defined as the number of Severe Acute Malnutrition cases [SAM] in treatment divided by total number of Severe Acute Malnutrition cases in the study district), geographical coverage (defined as total number of health facilities delivering treatment for SAM divided by total number of healthcare facilities in the study district), and treatment coverage (defined as children with SAM receiving therapeutic care divided by total number of SAM children in the study district) and program coverage (defined as number of SAM cases in the CMAM programme ÷ Number of SAM cases that should be in the programme). The qualitative approach was used to support the assessment of the coverage indicators. Data were analyzed using STATA version 14, and Atlas.ti, version 7.5 for the quantitative and qualitative data respectivelyResults: Geographically, only 6% of the facilities in the urban communities were participating in the CMAM programme as against 29% of rural district facilities. The districts had point coverage of 41% and 10% for the urban and rural districts respectively. The urban setting recorded a SAM prevalence of 52% as against 36% in the rural setting. The proportion of SAM children enrolled in CMAM was higher in KSSM when compared with AAS; 41% and 33% respectively. In both districts, the most likely factors to attract mothers/caregivers to utilize the CMAM services were: ‘free services’ and ‘a cured child.’ The qualitative approach showed that coverage improvement in both districts is hampered by barriers such: distance, transportation cost, lack of trained personnel in the communities for community mobilization and home visits, and insufficient feeds. Conclusion: To improve CMAM coverage, there is the need to train health workers to embark on aggressive health education strategies to encourage mothers/caregivers of malnourished children to utilize CMAM while ensuring that services reach those who need them. Trial registration: This study is approved and registered with The Kwame Nkrumah University of Science and Technology Committee on Human Research, Ethics and Publications (CHRPE/AP/314/15)

scholarly journals Prevalence of hypoglycemia in diarrheal dehydration at hospitalization in severe acute malnutrition

2018 ◽  
Vol 5 (3) ◽  
pp. 1092 ◽  
Author(s):  
Rameshwar Ninama ◽  
Chakshu Chaudhry ◽  
Rameshwar Lal Suman ◽  
Suresh Goyal ◽  
Ramprakash Prakash Bairwa ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Acute Diarrhea ◽  
Severe Acute Malnutrition ◽  
Cross Sectional Study ◽  
Acute Malnutrition ◽  
Severe Dehydration ◽  
Cross Sectional ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Average Blood Glucose

Background: Diarrhea is the major cause of death in children below five years of age. Hypoglycemia has been a potential fatal complication of infectious diarrhea in both well-nourished and poorly nourished children. But prevalence of hypoglycemia in diarrheal dehydration is not exactly known. This study was done to evaluate the glycemic status in children having acute diarrhea with dehydration and specifically associated with severe acute malnutrition (SAM).Methods: This descriptive cross-sectional study was conducted during July 2017 to December 2017 at Bal Chikitsalaya Udaipur, Rajasthan, India. Blood glucose levels were assessed in 150 children of acute diarrhea with dehydration, comprising of 100 SAM and 50 Non SAM children.Results: Average blood glucose of SAM children was 89 mg/dl and of non-SAM, it was 120 mg/dl. Average blood glucose was low in SAM as compared to non-SAM in both some dehydration (116.08±21.26) and severe dehydration (66.69±19.80) as well as with or without ORS intake. Overall 18 (12%) of children had hypoglycemia and all were in severe dehydration and not taking ORS. Blood glucose levels were statistically low in severe dehydration and those who were not taking ORS at the time of hospitalization (p = 0.001). In severe dehydration 25% of children had hypoglycemia means every fourth child had low blood glucose <54 mg/dl.Conclusions: Overall prevalence of hypoglycemia is 12% in diarrheal dehydration and 20% in SAM with dehydration. Twenty five percent of severe dehydration children had hypoglycemia, and all have not started ORS. None of the child started ORS developed hypoglycaemia.

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