scholarly journals PREVALENCE OF FAT-SOLUBLE VITAMIN DEFICIENCIES ASSOCIATED WITH SEVERE ACUTE MALNUTRITION: A PROSPECTIVE OBSERVATIONAL STUDY

2021 ◽  
Vol 12 (11) ◽  
pp. 8-12
Author(s):  
M. A. Shende ◽  
S. N. Kadam ◽  
M. B. Mokal ◽  
M. P. Balvir
Keyword(s):  
Severe Acute Malnutrition ◽  
District General Hospital ◽  
Acute Malnutrition ◽  
Micronutrient Deficiencies ◽  
Z Score ◽  
Vitamin Deficiencies ◽  
Vitamin Status ◽  
Childhood Morbidity ◽  
Capital Development ◽  
Fat Soluble Vitamins

Background: Severe acute malnutrition (SAM), among children below five years of age is global health problem contributing to childhood morbidity, mortality and remains a major embarrassment to optimal human capital development in India. Objectives: Study aim was to accesses fat soluble vitamins deficiencies among children with SAM and outcomes after treatments with F-75/F-100 plus vitamins mix. Methods: The study was prospective observational conducted in the nutritional rehabilitation center (NRC) at district general hospital for 6 months. Anthropometric measurements were taken to determine their nutritional status. Results: 100 patients of NRC were enrolled in the study. Sixty nine percent (69) patients had weight/height (WT/HT) Z score<−3 standard deviation (3 SD), 16 % with Z score<−2 and 15% of them had Z score<−4 malnutrition. Out of 100 children, 46% children were males, and 56% children were females. Vitamin E deficiencies (54%) were highly prevalent in hospitalized SAM groups, followed by 28% vitamin D and 18% were vitamin A deficient. Conclusion: Micronutrient deficiencies were highly prevalent with fat soluble vitamins and recovered on application of WHO protocols during hospitalization induced satisfactory fat-soluble vitamin status recovery significant (p<0.05).

scholarly journals Examining Response to Treatment of Severe Acute Malnutrition in Children 6–59 Months Old in Afghanistan, Chad, Mali, and Niger (P12-002-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Erin Boyd
Keyword(s):  
Weight Gain ◽  
Health Center ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Daily Weight Gain ◽  
Z Score ◽  
Factors Affecting ◽  
Number Of Children ◽  
Status Number ◽  
Significant Factors

Abstract Objectives Identify the most significant factors affecting the trajectory of recovery from severe acute malnutrition (SAM), as measured by average daily weight gain in each child 6–59 months of age who were diagnosed and treated for SAM and treated, adjusting for covariates including: breastfeeding status, number of children in household, illness, and distance to health center. Hypothesis 1a: Children 6–59 months enrolled in SAM treatment have slower times to recovery and slower weight gain if they are admitted for treatment at a lower anthropometric cut-off admission (weight for height z-score < −4) than children admitted for treatment at a higher anthropometric cut-off (weight for height z-score ≥ −4). Hypothesis 1b: Older children (24–59 months) recover more quickly than younger children (6–23 months) controlling for ration size. Methods A retrospective panel data analysis on children 6–59 months enrolled in standard outpatient treatment for severe acute malnutrition (SAM) between 2014 and 2016 was conducted. The study period was between September-December 2018. Children were exhaustively sampled. Children with edema, children with implausible z-scores for W/H (<−5 and >5) and H/A (<−6 and >6), children who were referred for inpatient therapeutic feeding to a stabilization center, and children from the same household, except in the case of twins, were eliminated from the analysis. There was one database per country. A total of 1384 children between 6–59 months were included in the analysis. Results The most significant factors affecting the proportional weight gain include age at enrollment (P = 0.001, 95%CI = −0.00—0.00) and Weight for height z-score (WHZ) (P = 0.00, 95%CI = 0.04—0.05) in each child 6–59 months of age who were diagnosed with SAM and treated, adjusting for covariates including: breastfeeding status, number of children in household, illness, and distance to health center. Sex of child did not significantly affect proportional weight gain (P = 0.404, 95%CI = −0.012–0.005). Conclusions The existing protocol to treat severe acute malnutrition should be modified to treat younger children and children who are admitted with a lower weight for height z-score due to different vulnerabilities. Funding Sources The research was conducted as part of a dissertation at The Friedman School of Nutrition Science and Policy at Tufts University. Data were obtained from World Vision.

scholarly journals Effect of Fat-Soluble Vitamins A, D, E and K on Vitamin Status and Metabolic Profile in Patients with Fat Malabsorption with and without Urolithiasis

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3110
Author(s):  
Roswitha Siener ◽  
Ihsan Machaka ◽  
Birgit Alteheld ◽  
Norman Bitterlich ◽  
Christine Metzner
Keyword(s):  
Vitamin D ◽  
Metabolic Profile ◽  
Plasma Vitamin ◽  
Baseline Serum ◽  
Vitamin Deficiencies ◽  
Vitamin Status ◽  
Stone Formers ◽  
Before And After ◽  
Fat Malabsorption ◽  
Fat Soluble Vitamins

Patients with intestinal fat malabsorption and urolithiasis are particularly at risk of acquiring fat-soluble vitamin deficiencies. The aim of the study was to evaluate the vitamin status and metabolic profile before and after the supplementation of fat-soluble vitamins A, D, E and K (ADEK) in 51 patients with fat malabsorption due to different intestinal diseases both with and without urolithiasis. Anthropometric, clinical, blood and 24-h urinary parameters and dietary intake were assessed at baseline and after ADEK supplementation for two weeks. At baseline, serum aspartate aminotransferase (AST) activity was higher in stone formers (SF; n = 10) than in non-stone formers (NSF; n = 41) but decreased significantly in SF patients after supplementation. Plasma vitamin D and E concentrations increased significantly and to a similar extent in both groups during intervention. While plasma vitamin D concentrations did not differ between the groups, vitamin E concentrations were significantly lower in the SF group than the NSF group before and after ADEK supplementation. Although vitamin D concentration increased significantly in both groups, urinary calcium excretion was not affected by ADEK supplementation. The decline in plasma AST activity in patients with urolithiasis might be attributed to the supplementation of ADEK. Patients with fat malabsorption may benefit from the supplementation of fat-soluble vitamins ADEK.

scholarly journals Nutrition Assessment of Under-Five Children in Sudan: Tracking the Achievement of the Global Nutrition Targets

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 363
Author(s):  
Mohamed Abu-Manga ◽  
Ayoub Al-Jawaldeh ◽  
Abdul Baseer Qureshi ◽  
Amira M. Elmunier Ali ◽  
Damiano Pizzol ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Secondary Data ◽  
Well Being ◽  
Acute Malnutrition ◽  
Survey Method ◽  
Micronutrient Deficiencies ◽  
Severe Stunting ◽  
Under Five ◽  
The Government ◽  
Global Nutrition

Background: Malnutrition places a heavy burden on the health, well-being, and sustainable development of populations in Sudan, especially a country affected by conflict, which continues to experience high levels of food insecurity, undernutrition, and micronutrient deficiencies; 3.3 million are acutely malnourished, with 522,000 children suffering from severe acute malnutrition and approximately 2.2 million children requiring treatment for moderate acute malnutrition. This study aims to describe the nutritional status of children under five years old and identify the progress toward the achievement of the Global Nutrition Targets. Methods: This is a secondary data analysis of a quantitative survey, using the second-round of the Simple Spatial Survey Method (S3M II) in Sudan in the period 2018–2019. The analysis used an area-based sampling methodology in all 18 Sudanese states. Data from the WHO Tracking Tools of the Global Nutrition Targets was used to reflect the progress in achieving the targets in Sudan. Results: Global stunting prevalence was at 36.35 percent including moderate stunting prevalence and severe stunting prevalence (21.25 percent and 15.06 percent respectively). Global wasting prevalence was 13.6 percent including moderate wasting prevalence and severe wasting prevalence (10.8 percent and 2.7 percent respectively). Sudan has made great progress in achieving the target of increasing exclusive breastfeeding. However, despite the welcome commitments by the Government and all stakeholders, Sudan is still struggling to implement strategies, policies, and regulatory measures to address malnutrition and achieve the Global Nutrition Targets in 2025 and the Sustainable Developmental Goals in 2030. Therefore, more than ever, there is a need for comprehensive, multi-sectoral action to address malnutrition in all its forms.

scholarly journals Comparison of Weight-for-Height Z-score and mid-upper arm circumference to diagnose moderate and severe acute malnutrition in children aged 6-59 months

2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Attia Bari ◽  
Mubeen Nazar ◽  
Aisha Iftikhar ◽  
Sana Mehreen
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Z Score ◽  
Roc Curve Analysis ◽  
Upper Arm ◽  
Male Predominance ◽  
Creative Commons ◽  
Rehabilitation Programs ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference

Objective: To compare weight for height (WHZ) and mid upper arm circumference (MUAC) to diagnose malnutrition in children aged 6–59 months and to determine the association of various risk factors with the nutritional status of the children. Methods: Descriptive study conducted at the Department of Paediatric Medicine of The Children’s Hospital Lahore from May 2017 to April 2018. A total of 257 children 6 to 59 months of age having MUAC of <125mm were included. WHZ scoring was done and compared with MUAC. Results: There was slight male predominance 135 (52.5%). Mean age of children was 13.43 + 8.81 months (95% CI: 12.34-14.51). Mean MUAC was 103±13.5 mm (95%CI: 101-105mm). Exclusive breast feeding was present in 82 (32%). Maternal illiteracy was common in SAM (p = was 0.001). More children (73.2%) were identified as SAM by MUAC of <115 mm as compared to WHZ of <-3SD (70%). The ROC curve analysis for MUAC (cut-off value:103, 95%CI; AUC: 101-107 mm) showed it as an excellent predictor (p=<0.001) for children having SAM and WHZ <-3SD, with (AUC= 0.786 [95%CI; 0.725-0.848]). Conclusion: Both MUAC and WHZ showed fair degree of agreement to diagnose moderate and severe acute malnutrition among children aged 6–59 months. At the community level of resource limited countries, MUAC can be used as an appropriate rapid diagnostic method to identify malnourished children to be managed in nutritional rehabilitation programs. How to cite this:Bari A, Nazar M, Iftikhar A, Mehreen S. Comparison of Weight-for-Height Z-score and mid-upper arm circumference to diagnose moderate and severe acute malnutrition in children aged 6-59 months. Pak J Med Sci. 2019;35(2):---------.  doi: https://doi.org/10.12669/pjms.35.2.45 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Diagnostic measures for severe acute malnutrition in Indian infants under 6 months of age: a secondary data analysis

2021 ◽  
Author(s):  
Ranadip Chowdhury ◽  
Nitika Nitika ◽  
Tarun Shankar Choudhary ◽  
Sunita Taneja ◽  
Jose Carlos Martines ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Population Attributable Fraction ◽  
Secondary Data ◽  
Acute Malnutrition ◽  
Adjusted Relative Risk ◽  
Z Score ◽  
Likelihood Ratios ◽  
Predictive Values ◽  
Growth Standards ◽  
Diagnostic Measures

Abstract Background Weight for length z-score (WLZ) <- 3 is currently used to define severe acute malnutrition (SAM) among infants. However, this approach has important limitations for infants younger than 6 months of age as WLZ cannot be calculated using WHO growth standards if infant length is <45 cm. Moreover, length for age z-score (LAZ) and weight for length z-score (WLZ) are least reliable measures, with high chances of variation, and less chances of detecting undernutrition in under 6 months infants. The objective of the current analysis was to compare WLZ with WAZ and LAZ in a cohort of Indian infants in predicting the deaths between 6 weeks and 6 months of age. Methods The data was from an individually randomized trial conducted in slums of Delhi, India in which infants’ weight and length were measured at 6 weeks of age (at the time of the first immunization visit). Vital status of the infants was documented from 6 weeks to 6 months of age. The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios, and area under curve (AUC) were calculated for WAZ<-3, WLZ<-3, and LAZ<-3 for deaths between 6 weeks and 6 months of age. Results For deaths occurring between 6 weeks to 6 months of age, the specificity ranged between 85.9-95.9% for all three anthropometric indicators. However, the sensitivity was considerably higher for WAZ; it was 64.6 % for WAZ<-3, 39.1% for LAZ<-3, and 25.0% for WLZ<-3. WAZ <-3 had higher AUC (0.75; 95% CI: 0.68, 0.82) and hence, better discriminated deaths between 6 weeks and 6 months of age than WLZ<-3. The adjusted relative risk (RR 10.6, 95% CI 5.9, 18.9) and the population attributable fraction (PAF 57.9%, 95% CI 38.8, 71.0%) of mortality was highest for WAZ<-3. Conclusions We found WAZ<-3 at 6 weeks of age to be a better predictor of death in the 6 weeks to 6 months of life in comparison to WLZ<-3 and LAZ<-3 and propose that it should be considered to diagnose SAM in this age group.

scholarly journals Co-morbidities and micronutrient deficiencies in children with severe acute malnutrition

2017 ◽  
Vol 4 (4) ◽  
pp. 1225
Author(s):  
Kumar Saurabh ◽  
Shilpi Ranjan ◽  
J P Narayan
Keyword(s):  
Severe Acute Malnutrition ◽  
Retrospective Chart Review ◽  
Acute Malnutrition ◽  
Nutritional Deficiencies ◽  
Micronutrient Deficiencies ◽  
Medical College ◽  
Paediatric Unit ◽  
High Prevalence ◽  
The Mean ◽  
One Year

Background: To study the co-morbidities and nutritional deficiencies in hospitalized children of severe acute malnutrition (SAM).Methods: One year retrospective chart review of 150 cases of SAM was done in Paediatric unit of a medical college of northern India.Results: The mean age of study group was 17.3 months (6 months to 60 months’ age group). Diarrhoea (34.7%) and respiratory tract infection (31.33%) were the most common co-morbid conditions associated with this study. Tuberculosis was seen in 20% of cases whereas Measles was associated in 6.7% cases. Anaemia and Vitamin A deficiencies were common micronutrient deficiencies. A very high prevalence of intestinal helminthic infestation was present in this study. Ascaris lumbricoides being the most common parasite involved. Polyparasitism was present in 20% of cases.Conclusions: Early identification and management of co-morbidities can improve overall outcome and survival.

scholarly journals Diagnostic Measures for Severe Acute Malnutrition in Indian Infants Under 6 Months of Age: a Secondary Data Analysis

2020 ◽  
Author(s):  
Ranadip Chowdhury ◽  
Nitika Nitika ◽  
Tarun Shankar Choudhary ◽  
Sunita Taneja ◽  
Jose Carlos Martines ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Population Attributable Fraction ◽  
Secondary Data ◽  
Acute Malnutrition ◽  
Adjusted Relative Risk ◽  
Z Score ◽  
Likelihood Ratios ◽  
Predictive Values ◽  
Growth Standards ◽  
Diagnostic Measures

Abstract Background Weight for length z-score (WLZ) <- 3 is currently used to define severe acute malnutrition (SAM) among infants. However, this approach has important limitations for infants younger than 6 months of age as WLZ cannot be calculated using WHO growth standards if infant length is <45 cm. Moreover, length for age z-score (LAZ) and weight for length z-score (WLZ) are least reliable measures, with high chances of variation, and less chances of detecting undernutrition in under 6 months infants. The objective of the current analysis was to compare WLZ with WAZ and LAZ in a cohort of Indian infants in predicting the deaths between 6 weeks and 6 months of age. Methods The data was from an individually randomized trial conducted in slums of Delhi, India in which infants’ weight and length were measured at 6 weeks of age (at the time of the first immunization visit). Vital status of the infants was documented from 6 weeks to 6 months of age. The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios, and area under curve (AUC) were calculated for WAZ<-3, WLZ<-3, and LAZ<-3 for deaths between 6 weeks and 6 months of age. Results For deaths occurring between 6 weeks to 6 months of age, the specificity ranged between 85.9-95.9% for all three anthropometric indicators. However, the sensitivity was considerably higher for WAZ; it was 64.6 % for WAZ<-3, 39.1% for LAZ<-3, and 25.0% for WLZ<-3. WAZ <-3 had higher AUC (0.75; 95% CI: 0.68, 0.82) and hence, better discriminated deaths between 6 weeks and 6 months of age than WLZ<-3. The adjusted relative risk (RR 10.6, 95% CI 5.9, 18.9) and the population attributable fraction (PAF 57.9%, 95% CI 38.8, 71.0%) of mortality was highest for WAZ<-3.Conclusions We found WAZ<-3 at 6 weeks of age to be a better predictor of death in the 6 weeks to 6 months of life in comparison to WLZ<-3 and LAZ<-3 and propose that it should be considered to diagnose SAM in this age group.

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