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Background: Childhood under-nutrition is an important public health and development challenge in India. Undernourished children have significantly higher risk of mortality and morbidity. Objective of present study was to identify the anthropometric status of complicated Severe acute malnutrition (SAM) in Southern Rajasthan, India.Methods: It was a retrospective study conducted in children admitted at Malnutrition Treatment Centre attached to a tertiary hospital. Basic socio-demographic and anthropometric records of all children between 6 months to 5 years of age were analysed.Results: Out of the total 1554 SAM children admitted in last two years, 855 (55.01%) were males and 699 (44.98%) were females. Mean weight was 6.17±1.59 kg, mean height was 71.65±8.6 cm and Mid upper arm circumference (MUAC) was 10.99±1.53 cm. Among these, 1375 (88.48%) children fulfilled weight for height (WFH) criteria, 919 (59.13%) fulfilled MUAC criteria and 246 (15.83%) had edema. On WFH Zscore analysis, 53% had <-3SD and <-4SD, 19.88% had <-5SD, 9.97% had <-6SD, 3.47% had <-7SD and 1.67% had <-8SD. Also, we observed that lower values of MUAC ranging from <11.5cm to <9cm. MUAC of 11.5-10cm was in 43.43% of children and 15% had MUAC <10cm. Among the children of all age group, we observe that males of 6-24 months of age are more significantly affected as compared to females.Conclusions: The study highlights the fact that extreme grades of malnutrition exist in our area ranging upto Z-score of -8SD and beyond, and is not limited to -3SD and -4SD. Also, males are the more affected of the two sexes in our rural and tribal area setting.

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