Introduction: Severe acute malnutrition, is characterized by wasting (marasmus), oedema (as a result of kwashiorkor), or both (marasmic kwashiorkor), and occurs mostly in children. Globally, co morbidities such as diarrhoea, acute respiratory tract infections and Malaria, which results from a relatively defective immune status, remain the major causes of death among children with severe acute malnutrition. This study was carried out to find out co-morbidities such as infections and micronutrient deficiencies in children with severe acute malnutrition. Methods: In this hospital based descriptive type of observational study, 125 severe acute malnourished children were included. Patients undergo relevant investigation to find out associated infectious co morbidities. Micronutrient deficiencies assessed by clinical signs. Results: 42% had diarrhea and 27% had acute respiratory tract infections as co morbid condition. Tuberculosis was diagnosed in 13% of cases. Anemia was present in 86% cases. Signs of vitamin B and vitamin A deficiency were seen in 24% and 6% cases. 97% children have inadequate vitamin D levels. Conclusions: Timely identification and treatment of various co-morbidities is likely to break undernutrition-disease cycle, and to decrease mortality and improve outcome. Nearly all SAM patients have inadequacy of Vitamin D. So Vitamin D supplement should be given to all SAM patients.

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