Predicators for Weight Gain in Children Treated for Severe Acute Malnutrition: A Prospective Study at Nutritional Rehabilitation Center

Abstract

Introduction. Despite being an important health problem in developing countries, there is little information available on factors affecting the severe acute malnutrition, especially nondietary factors. Objective. To study the impact of various factors, especially nondietary ones affecting directly or indirectly the weight gain in children with severe acute malnutrition. Method. A total of 300 children in the age group of 6 to 60 months meeting the WHO criteria for severe acute malnutrition were enrolled in the study. These children were provided special therapeutic diet as recommended by WHO/UNICEF protocol. Children were called for followup every 15 days up to 2 months after discharge to evaluate whether these children have achieved a final target weight gain of 15% of their admission weight. The impact of nondietary factors related to child, mother, and socioeconomic status was evaluated. Data collected through structured questionnaire were analyzed. Result. 172 (57.4%) of the total 300 children did not gain final target weight despite giving adequate diet. We observed that impact of various nondietary factors like mother's educational status and her knowledge about feeding practices, socioeconomic status, previous history, and present evidence of infection in child was important in determining the weight of child. No association was found with gender of child, BMI of mother, and father's educational status on the weight gain of child. Conclusion. The findings of this study confirm the association of many nondietary factors with weight gain in children treated for severe acute malnutrition. To reduce malnutrition emphasis should be given on these factors.

Evaluation of the Effects of Nutritional Intervention Measures on Sam Children in a Nutritional Rehabilitation Centre, Acsr Government Medical College, Nellore, A. P.

“…Similar finding was reported in a study conducted by Sanghvi J et al who observed that from among 300 malnourished children admitted at an NRC in Indore, females were 52% as compared to 48% males. 6 Hashmi G et al showed similar findings as our study. 7 Weight has been taken as the main anthropometric measure of response to treatment.…”

Outcome of nutritional intervention measures at a nutrition rehabilitation centre in Krishna district, Andhra Pradesh

“…Study conducted by Sanghvi et al among 300 malnourished children admitted at NRC, Indore revealed a greater number of females (52%) admitted as compared to males (48%). 4 The study findings show that a major proportion of the admitted children belonged to the marginalized population groups. The findings are in accordance with that of NFHS-IV, which states that children belonging to the SC, ST, and OBC have the highest rates of malnutrition.…”

Inpatient management of children with severe acute malnutrition: a review of WHO guidelines

“… 3 , 6 The corresponding published rates in Asia tend to be lower, possibly because: Asian health systems are generally stronger than their African counterparts; therapeutic innovations have been introduced in some Asian facilities that have not yet been used in Africa; and children with uncomplicated severe malnutrition are sometimes admitted to Asian health facilities – but not, generally, to African health facilities. 7 , 8 In sub-Saharan Africa, human immunodeficiency virus (HIV) is believed to contribute greatly to malnutrition-related mortality – although, a recent meta-analysis demonstrated an overall case fatality rate of 15% among paediatric inpatients with severe malnutrition without HIV infection. 6 …”