scholarly journals Impact of Socioeconomic Inequalities on Child Malnutrition

Author(s):  
Zamir Ahmed Qambrani ◽  
Asif Nadeem Jamali ◽  
Habibullah Siyal ◽  
Sarah Azhar ◽  
Hafiz Syed Imran-ul Haque ◽  
...  

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.

Author(s):  
Asif Nadeem Jamali ◽  
Habibullah Siyal ◽  
Zamir Ahmed Qambrani ◽  
Naseer Ahmed Memon ◽  
Salman Baig ◽  
...  

Aims: In developing countries malnutrition is characterized as one of the major risk factors for death in children, due to improper management of cases, lack of resources and escaping the guidelines provided by WHO. However, it is also highlighted that prompt treatment and proper management can reduce the mortality rate and improve the quality of life in children. Current study is designed to investigate the frequency of SAM and its outcomes at time of discharge in tertiary care hospital of Hyderabad. Study Design: A cross sectional study was performed. Place and Duration of Study: Study was performed at nutritional stabilization center of pediatric department of tertiary care hospital Hyderabad from July 2019 to Jan 2020. Methodology: Preformed proforma was designed to record the data of participants that included demographic and primary outcome variable. Hospital protocols using WHO guidelines 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-19, p-value <0.05 was considered as significant. Results: Mean age of the study participant was 13 ± 6.3 months while majority of them were male (72%). About 70% participants were below normal as per weight to height ratio. Out of recruited participants (N=273) admitted in nutritional center prevalence of severe acute malnutrition was found to be 32.6%. After admission and management protocols 91.6% recovered however, mortality was observed in 8.9% participants. Conclusion: We conclude that effective and prompt treatment measures and appropriate management of affected patients according provided guidelines shown decrease in mortality and increased the survival rate in admitted children.


2020 ◽  
Vol 27 (09) ◽  
pp. 1799-1803
Author(s):  
Waqas Ali ◽  
Asif Ali Khuhro ◽  
Sanam Bano Rajper ◽  
Fazal Ur Rehman

Objectives: We planned this study to find out morbidity patterns as well as outcome of admitted children aged less than 5 years of age with severe acute malnutrition (SAM). Study Design: Cross Sectional study. Setting: Department of Pediatrics Medicine, Ghurki Trust Teaching Hospital, Lahore. Period: From 1st January 2018 to 30th June 2018. Material & Methods: A total of 80 children aged 1 to 59 months, of both genders, having SAM were considered. Physical examination, detailed clinical as well as laboratory findings related to nutritional status and comorbidities were noted. Outcome in terms of recovery/discharge, left against medical advice (LAMA) or death during the stay was noted in all the children. Results: Out of a total of 80 children, 20 (25.0%) were aged 1 to 6 months, 39 (48.8%) from 7 to 24 months and 21 (26.2%) from 25 to 59 months. Most of the patients, 39 (48.8%) were from 7 to 24 months of age, 62 (77.5%) were admitted through emergency, 52 (65.0%) had WHZ score-4SD and 27 (33.8%) using bottle feeding. Severe wasting without having edema was reported in 67 (83.8%) children. Diarrhea was the commonest comorbidity, found in 43 (53.8%) children, followed by sepsis 17 (21.3%) and pneumonia 15 (18.8%). There were 69 (86.3%) children noted having anemia. Hyponatremia was the commonest metabolic abnormality seen in 40 (25.0%) children. In terms of outcome, 71 (88.7%) children recovered well and got discharged while mortality was reported in 5 (6.3%) children. Conclusion: Diarrhea along with sepsis and pneumonia along with metabolic abnormalities were found to be more prevalent amongst children having SAM. Early identification of anemia as well as infections in children with SAM can contribute to better outcome.


2020 ◽  
Vol 7 (2) ◽  
pp. 300
Author(s):  
Archana Reddy D. ◽  
Lakshmi Aparnadevi V. V.

Background: All possible efforts are being made by the governments, and other agencies to reduce the burden of these problems of malnutrition and deaths associated with it but still it remains a challenge. Severe acute malnutrition continues to constitute an important risk for mortality and morbidity among the under five children. Objective of the study was to study the profile and risk factors of severe acute malnutrition of the under five children in a tertiary care hospital setting.Methods: Hospital based cross sectional study was carried out among 60 under five children with severe acute malnutrition who were admitted for difference causes in the Pediatric wards of SVS Medical College and Hospital, Mahabubnagar. A detailed history and physical examination were done. Anthropometric indices like weight, length/height, MUAC and weight for height were recorded and analysed using WHO growth charts.Results: Majority of the children with severe acute malnutrition were found in the age group of 1-2 years i.e. 48.3%. Males were more (69%) compared to females (31%) and this can be attributed to the hospital based cross sectional nature of the present study. Only 21.6% of the children were completely immunized for age. Majority of the children were found to have grade IV type of malnutrition i.e. 38.3%. Majority of the children presented with fever in 71.6% of the cases. Majority of the children had gastrointestinal related comorbidity in 54.6% of the cases.Conclusions: Incomplete immunization, low social class, inappropriate feeding practices in young age of <1 year are important risk factors of severe acute malnutrition.


2020 ◽  
Vol 27 (11) ◽  
pp. 2357-2362
Author(s):  
Anwar Muhammad ◽  
Muhammad Asghar Ali ◽  
Ali Hammad

Objectives: To determine the frequency of infantile colic in neonates presenting at tertiary care hospital. Study Design: Cross Sectional Study. Setting: Department of Neonatology, Civil Hospital, Bahawalpur. Period: From January 2018 to August 2018. Material & Methods: Total 467 neonates either male or female were selected for this study. Total 467 neonates with complaints of crying and fussing either male or female were selected for this study and infantile colic was assessed in selected neonates by using Wessel criteria. Results: Total 467 neonates were selected for this study.  Mean age of the neonates was 24.94 ± 2.39 months, mean gestational age and mean weight was 39.42 ± 1.22 weeks and 3.27 ± 0.62g respectively.   Infantile colic was found in 322 (69%) neonates.  Infantile colic was found in 61 (33.33%) neonates, 136 (94.44%) neonates, 75 (87.21%) neonates and 50 (92.59%) neonates respectively.  Statistically significant association between infantile colic and type of feeding with p value 0.000.  Infantile colic was found in 147 (84.97%), 95 (67.86), 62 (49.21%) and 18 (64.29%) neonates respectively in 37 weeks, 38 weeks, 39 weeks and 40 weeks gestational age group.  Statistically insignificant association between infantile colic and gestational age was noted with p value 0.000. Conclusion: Results of present study showed higher rate of colic in infants.  Development of colic was highly associated with gestational age, birth weight and type of feeding.  There is no effective medical treatment (like anti-colic and herbal drugs) but alternative measures may relieve or prevent further colic attacks.


Author(s):  
Mohd Junaid ◽  
Swapnil Shinkar ◽  
Amol Patil

Background: Poor knowledge, attitude, and practice (KAP) patterns among patients might reflect the danger of possible high transmission of COVID-19 and the need for awareness campaigns. The need of the hour is to gauge the knowledge, awareness and practices of the people to help prevent the further outbreak of COVID-19.Methods: Questionnaire based cross sectional study was done for a period of 7 days to access the knowledge attitude and practice towards COVID-19 among patients attending a tertiary care hospital in Durg, Chhattisgarh.Results: A total of 288 people participated in the study, majority of respondents were males 53% mean age was 39±15.9 years. Overall, 80.4% of the participants had good knowledge, 68.6% of the participants had a positive attitude, 83.8% of the participants were following good practices. Gender and income influenced knowledge scores, being significantly higher in males and higher income individuals (p value <0.05) while attitude and practices scores had no significant association with gender and income group (p value >0.05).Conclusions: Though the population demonstrated decent knowledge, appropriate practice, and positive attitude towards COVID-19 at the time of outbreak there is still need of on-going health education and awareness campaigns and need of policies and intervention that are more person centred. 


2014 ◽  
Vol 3 (8) ◽  
pp. 309-312 ◽  
Author(s):  
Muhammad Zahid Iqbal ◽  
Muhammad Shahid Iqbal ◽  
Dayana Nicholas ◽  
Jamaluddin Awang ◽  
Amer Hayat Khan ◽  
...  

To assess the adherence of physicians involved in the management of diabetes mellitus with or without co-morbidities with reference to Clinical Practice Guideline 2009 given by Ministry of Health Malaysia in the tertiary care hospital, Pinang General Hospital Malaysia. Cross-sectional study was done at tertiary care hospital, Penang, Malaysia. The total 51 physicians and 1020 patient’s prescriptions written by same physicians were taken from the record of the Penang General Hospital (20 prescriptions for each enrolled physician). All 1020 patients were suffering from diabetes mellitus with or without co-morbidities. These patients were recruited from the different wards of the Penang General Hospital. Depending on the recommendations of CPG 2009 the prescriptions of patients were divided into adherent and non-adherent prescriptions. The overall good level of physician adherence was seen with respect to the recommendations of CPG 2009 in all prescriptions. A statistically significant negative association (?= 0.094, p-value=0.003) was observed between diabetes mellitus control and co-morbidities. CPG adherent had statistically weak negative association (?= -0.081, p-value=0.010) with patients having co-morbidities. No statistically significant association was observed between CPG adherence and any other co-morbidity. The study explored the several features of prescription pattern of physicians involved in the management of diabetes mellitus with or without co-morbidities and recognized the need for improvement in their prescription pattern for treating the diabetes mellitus.DOI: http://dx.doi.org/10.3329/icpj.v3i8.19405 International Current Pharmaceutical Journal, July 2014, 3(8): 309-312


2020 ◽  
Vol 23 (17) ◽  
pp. 3181-3186
Author(s):  
Chabungbam Smilie ◽  
Dheeraj Shah ◽  
Prerna Batra ◽  
Rafat S Ahmed ◽  
Piyush Gupta

AbstractObjective:To determine the prevalence and predictors of hypocalcaemia in under-five children (1–59 months) hospitalised with severe acute malnutrition (SAM).Design:A cross-sectional study was designed to determine the prevalence of hypocalcaemia among children hospitalised with SAM. Serum Ca and 25-hydroxycholecalciferol (25-(OH)D) were estimated. Hypocalcaemia was defined as serum Ca (albumin-adjusted) <2·12 mmol/l. To identify the clinical predictors of hypocalcaemia, a logistic regression model was constructed taking hypocalcaemia as a dependent variable, and sociodemographic and clinical variables as independent variables.Setting:A tertiary care hospital in Delhi, between November 2017 and April 2019.Participants:One-hundred and fifty children (1–59 months) hospitalised with SAM were enrolled.Results:Hypocalcaemia was documented in thirty-nine (26 %) children hospitalised with SAM, the prevalence being comparable between children aged <6 months (11/41, 26·8 %) and those between 6 and 59 months (28/109, 25·7 %) (P = 0·887). Vitamin D deficiency (serum 25-(OH)D <30 nmol/l) and clinical rickets were observed in ninety-eight (65·3 %) and sixty-three (42 %) children, respectively. Hypocalcaemia occurred more frequently in severely malnourished children with clinical rickets (OR 6·6, 95 % CI 2·54, 17·15, P < 0·001), abdominal distension (OR 4·5, 95 % CI 1·39, 14·54, P = 0·012) and sepsis (OR 2·6, 95 % CI 1·00, 6·57, P = 0·050).Conclusion:Rickets and hypocalcaemia are common in children with SAM. Routine supplementation of vitamin D should be considered for severely malnourished children. Ca may be empirically prescribed to severely malnourished children with clinical rickets, abdominal distension and/or sepsis.


2020 ◽  
Vol 27 (09) ◽  
pp. 1966-1970
Author(s):  
Saima Yasmin Qadir ◽  
Hajira Sultana ◽  
Saima Ashraf ◽  
Shazia Siddiq ◽  
Asia Fayyaz

Objective: To determine the frequency of anemia and its causative risk factors in patients attending the gynecology outpatient department of Nishtar Medical University and Hospital. Study Design: Cross sectional study. Setting: Gynecology Outpatient Department attendees of Nishtar Medical University and Hospital. Period: 1st September to 31st December 2019. Material & Methods: Total 361 females between 19-49 years of age were enrolled and included those patients who consented to be tested for blood hemoglobin estimation. Their brief history was taken after proper consent according to predesigned proforma to rule out the risk factors. Patients with chronic kidney disease, chronic lung diseases and liver diseases were excluded. Blood test was done by obtaining the blood sample by finger prick method. Hemoglobin analysis was performed by portable Hemocueanalyser. Frequency of anemia, severity of anemia and their stratification was performed against the risk factors like age, educational status, socioeconomic status, status of pregnancy, parity and contraception were obtained to rule the causative factors. Anemia was defined per standard criteria as hemoglobin less than 11gm/dl. Results:  Majority of patients 65% were between 19-35 years of age and 34% were 36-49years of age. Frequency of pregnant patients and non-pregnant patients was 63.4% and 36.6%.  Frequency of anemia was 56.8%, mean hemoglobin 10.48±1.18 with mild, moderate and severe anemia were 36.8%, 17.2% and 2.8%. Majority of females 82.9%, never went to school and had primary education, 71.70% belong to very poor and poor socioeconomic status, 79.02% were multipara and 81.95% never and infrequently practiced the contraceptive methods. Conclusion:  Frequency of anemia is very high in females presenting to tertiary care hospital being more common in younger age group. Frequent pregnancies, poor socioeconomic status and low level of educational attainment were the major determinants of anemia in females.


2021 ◽  
Vol 15 (8) ◽  
pp. 2093-2095
Author(s):  
Mahwish Adnan ◽  
Ghulam Hassan ◽  
Muhammad Abdul Raziq

Objective: To assess the frequency of depression in type-II diabetics presenting at tertiary care hospital. Materials & Methods: This cross sectional study was conducted at Department of Psychiatry & Behavioral Science, Sheikh Zayed Hospital, Rahim Yar Khan from April 2020 to October 2020 over the period of 6 months. Total 200 type-II diabetics having age 20-65 years either male or female were selected for this study. Depression was assessed in selected by using DSM-IV criteria for Depression. Results: Mean age was 54.37 ± 5.88 years. Out of 200 patients of diabetes, depression was noted in 46 (23%) patients. Most (98,49%) of the patients were between 51-65 years but difference of depression with age group was not statistically significant with p value 0.8958. Total 19 (20.88%) male patients and 27 (24.77%) female patients were found with depression. But depression was insignificantly associated with gender with p value 0.6315. Total 11 (14.29%) patients found with depression having duration of diabetes mellitus ≤3 years and 35 (28.46%) patients found with depression having duration of diabetes mellitus >3 years. Depression was significantly associated with duration of diabetes mellitus with p value 0.032. Conclusion: Our study concluded that prevalence of depression in type 2 diabetes mellitus patients was much higher and have shown positive association with extremes of ages and duration of disease. Keywords: Diabetes mellitus, depression, socioeconomic status, physical recovery


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