Publication:

Clinical profile and co-morbidities in children with moderate and severe acute malnutrition

Background Malnutrition as a problem is multidimensional and multifactorial with varied clinical profiles and comorbidities. The objectives of this study were to evaluate the clinical profile and comorbidities in children suffering from malnutrition and to estimate the association of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) with demographic parameters, feeding, and immunization.

Methods This cross-sectional study was conducted on 132 children with malnutrition, aged between 6 to 59 months, at Hind Institute of Medical Sciences, Sitapur over 18 months. Demographic details, clinical history, clinical evaluation, anthropometric measurements, and investigations, were noted on predesigned performa. All the data were analyzed by SPSS software. A p-value<0.05 was considered significant.

Result The mean age of children with malnutrition was 25.79(15.68) months. Wasting and severe wasting among children with malnutrition were 51.5 % and 48.5% respectively. Major comorbidities were diarrhoea (70.5%), severe anemia (67.4%), pneumonia (62.9%), vitamin A deficiency (59.8%), sepsis (54.6%), urinary tract infection (54.5%), vitamin D deficiency (35.6%), worm infestation (30.3%), and tuberculosis (28.8%). A significant association of malnutrition was found with children of younger age (p<0.0001), Hindu religion (p<0.0001), not exclusively breastfed (p=0.004), delayed initiation of complementary feeding (p=0.029), and incomplete immunization (p=0.006).

Conclusion Malnutrition is closely linked to poor infant and young child feeding practices. Malnourished children suffer from various infections and micronutrient deficiencies. Adequate and timely nutritional support plays a vital role in breaking the vicious cycle of undernutrition-disease-undernutrition resulting in recovery.