Developmental delay and its predictors among children under five years of age with uncomplicated severe acute malnutrition: a cross-sectional study in rural Pakistan

Abstract

Background In developing countries, malnutrition in children and developmental delays are two major challenges for public health. To achieve the vision of the Sustainable Development Goals from the broader perspective of child health, early identification of developmental delays and timely intervention are crucial. The aim of this study is to assess the prevalence of suspected developmental delay and their predictors in children under the age of 5 years with uncomplicated severe acute malnutrition in rural areas of Pakistan. Methods A multicentre cross-sectional study was conducted among 185 children with uncomplicated severe acute malnutrition. We screened children aged 6–59 months for their nutritional status and clinical complications. Children fulfilling the inclusion criteria underwent the Denver Development Screening Tool II (DDST-II). The children’s global developmental profile was calculated according to the established protocols of DDST-II, which are based on four important domains of development: personal and social behaviour, language, gross motor adaptive skills and fine motor adaptive skills. A pretested questionnaire was used to collect data on socio-demographic and nutritional factors for assessing predictors of developmental delay, which were analysed using a multivariate logistic regression model. Results Out of 177 children with severe acute malnutrition, 69 (38.9%) had normal global development and 108 (61.1%) had delayed global development. Significant associations were found between global developmental delay and younger children (6–24 months vs. 25–59 months; AOR = 4.53, 95% CI: 1.56–13.10, p < 0.01), children who were not exclusively breastfed (AOR = 3.07, 95% CI: 1.24–7.56, p = 0.01), and a history of contact with a tuberculosis smear-positive adult (AOR = 2.67, 95% CI: 1.30–5.49, p < 0.01). Conclusion About two thirds of the study participants showed delayed or unstable global development. Thus, according to DDST-II-established protocols, there is a high prevalence of suspected developmental delay among children under the age of five years with uncomplicated severe acute malnutrition in rural areas of Pakistan. Children in their first 2 years of life were at particularly high risk due to insufficient breastfeeding. This emphasizes the need to provide adequate infrastructure and information to parents for the prevention of developmental delay in remote areas.

Efficacy of ready‐to‐use food supplement for treatment of moderate acute malnutrition among children aged 6 to 59 months

“…A higher consumption rate of RUFs product would result in a faster and greater recovery rate in terms of weight gain among infants compared to CSB+. However, the weight gain obtained in the present study was higher than the one reported in previous studies for children receiving regular CSB+ (Thakwalakwa et al, 2010).…”

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“…The variability of findings may be attributed to differences in sample size, socioeconomic status, nutritional status, health conditions and the methods implemented. For example, an extremely high magnitude (61.1%) of developmental delay was found among children with severe acute malnutrition in a study conducted elsewhere 21 and 50% of developmental delay was observed among children under five with chronic under-nutrition. 20 Moreover, higher prevalence of developmental delay was reported in underweight, wasted and stunted under-five children elsewhere.…”

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