Clinical Profile and Outcome of Children of Aged 6 -59 Months Admitted with Severe Acute Malnutrition at Medical College, Silchar, Assam

Abstract

Background: Inspite of significant economic improvement of India,prevalence of malnutrition specifically severe acute malnutrition is significantly high. According to NFHS-4(2015NFHS-4( -2016) report, 7.4% of malnourished children are severely wasted in India and in Assam it is 6.2%.Clinical profile of acute severe malnutrition (SAM) is different from place to place. Understanding of child health profile in different geographical area will help to prioritize intervention and resource allocation. Material and Method:Hospital based prospective observational study carried out in the department of Pediatrics, Silchar Medical College, Assam, India from July 2018 to June 2019. 50 SAM children of aged 6 months to 59 months were included into the study after meeting the inclusion criteria. Historical,clinical and laboratory data were recorded in a predesigned proforma. Data were analysed using appropriate statistical method.Results: The prevalence of severe acute malnutrition is 2.7%.The mean age of study population is 21.86 ± 14.85 months.68%were male and 32% were female out of the 50 SAM children. Nonedematous SAM were more (56%) than the edematous SAM (44%).Highest incidence of SAM were in the age group of 6 -24 months (68%).Almost all the cases (96%) belonged to low SES.78% mothers were either illiterate or primary school educated. EBF up to 6 months of age were only in 16% of cases. Major clinical presentation were diarrhea (70%), fever (68%), anorexia (66%), ARI (56%), vomiting (38%), eye problems (38%).Comorbid conditions associated with SAM were anemia (86%), pneumonia (42%), worm infestation (40%) followed by UTI (38%) & tuberculosis (16%). Recovery rate is 54%.Mean hospital stay is 10.28± 5.84 days. 2 children (4%) died during hospital stay. Conclusion:Severe acute malnutrition is the most severe life threatening form of malnutrition which requires urgent attention. Timely identification and intervention of various risk factors,clinical and comorbid condition is likely to break the viscious cycle of undernutrition, infection and SAM and thereby improve outcome.