Severe acute malnutrition and its associated factors among children under-five years: a facility-based cross-sectional study

Ghimire, Umesh; Aryal, Binod; Gupta, Ankush; Sapkota, Suman

doi:10.1186/s12887-020-02154-1

Cited by 51 publications

(48 citation statements)

References 28 publications

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“…Several studies have found the association between SAM and low socio economic status [ 12 ], late initiation of breast feeding after one hour of the birth, non-exclusive breast feeding, birth interval less than two years [ 13 ], mother’s age at birth [ 10 ], maternal education [ 14 ], and family size [ 11 ]. Along with malnutrition among children and women, food insecurity remains an alarming problem in Nepal [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the 2019 Global Hunger Index, Nepal ranks 73rd out of 117 qualifying countries and with a score of 20.8, Nepal suffers from a level of hunger that is serious [ 16 ]. Similarly, a study conducted in two Terai districts of Nepal (Jhapa and Bara) found that children from severely food insecure households were four times more likely to be severely malnourished [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Determinants of severe acute malnutrition among under 5 children in Satar community of Jhapa, Nepal

et al. 2021

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Background Severe acute malnutrition (SAM) is the most extreme and visible form of undernutrition plagued by chronic poverty, household food insecurity, lack of education. One of the indigenous and marginalized community of Nepal, Satar/Santhal has often been neglected and is devoid of good education and are economically deprived. This predisposes under 5 children of Satar into malnutrition. The study aims to assess determinants of SAM among children under 5 years of age in Satar community of Jhapa district, Nepal. Material & methods A community based matched case control study was carried from September 2019 to February 2020 among under five children of Satar community residing in Jhapa district. Multistage random sampling technique was used to select 50 cases and 100 controls in the ratio of 1:2. Information was collected through personal interview with the parents and anthropometric measurement of the children was measured. Bivariate and multivariate conditional logistic regression analysis was used to explore the determinants of severe acute malnutrition. Results A total of 664 children between the age group of 6–59 months were screened for SAM. The prevalence of SAM was found 7.53%. Factors like, low economic status, birth interval less than 2 years, frequency of breast feeding <8 times/day and household food insecurity were found to be significant determinants of SAM. Multivariate logistic regression documented low economic status (AOR: 11.14, 95% CI 1.42 to 87.46); and frequency of breast feeding <8 times/day (AOR: 2.09, 95% CI 1.00 to 4.37) as determinants of SAM. Conclusion Low economic status and frequency of breast feeding less than 8times/day were major determinants of SAM among children under 5yrs of age. Ending malnutrition will require greater efforts and integrated approaches to eradicate extreme poverty. Multi-sector approaches have been conducting for SAM in Nepal but there are no specific approaches for marginalized community.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Determinants of severe acute malnutrition among under 5 children in Satar community of Jhapa, Nepal

et al. 2021

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“…Eventually, a stunted toddler will has a problem in gaining optimal physical and cognitive growth. 19 In this case, anthropometrics measurement revealed the length of age was below -3 SD of WHO Z-score curve. Its consequence of chronic malnutrition was accompanied by chronic infection.…”

Section: Discussionmentioning

confidence: 75%

A Child with HIV (Human Immunodeficiency Virus) Infection Accompanied by Severe Acute Malnutrition: A Case Report

Darma

Nawing

Pelupessy

et al. 2020

GMJ

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Joint United Nations Programme in HIV/AIDS (UNAIDS) reported that 1.8 million children under 15 years old had HIV with 150,000 new pediatric cases in 2015, and only 49% had an antiretroviral (ARV) therapy. Mortality in HIV-infected children with severe acute malnutrition was 30.4% in Africa. A 1-year and 8-months-old girl was hospitalized due to diarrhea, vomiting, oral thrush, and recurrent fever before admission. She has been hospitalized for HIV infection one month ago and treated with ARV. Her mother was treated with ARV before. Physical examination showed a severely ill, poorly nourished, stunting, and conscious child with normal vital signs. There was oral thrush. The evidence of nutritional marasmus was old man face, piano sign, wasting, and baggy pants. Laboratory findings revealed anemia, positive antigen and antibody of HIV infection, and low Cluster of Differentiation 4 (CD4). She was treated with ARV, Cotrimoxazole, and management of malnutrition and diarrhea. The prognosis of the patient was poor. A 1-year and 8-months-old girl with HIV infection complicated with severe acute malnutrition, acute diarrhea, oral thrush, and anemia of chronic disease were reported. The diagnosis was based on clinical and laboratory findings. Management focused on the therapy of HIV and accompanying illness. The prognosis was poor.

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“…The proportion of females (51.5%) among the admitted children was higher. These two features are very important and evidence shows that severe acute malnutrition is very high among females and among the younger age group of children 19 and they should be given priority in programs for tackling malnutrition. Similar findings were reported in others studies where a greater number of females were admitted in NRCs as compared to males.…”

Section: Discussionmentioning

confidence: 99%

“…9 Other studies have reported mortality varying between 0.4% and 3.5% in different States which is less than other countries. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] This compares favourably with the national and international standards of care (<10% child deaths). 11,27 This is a significant finding as the primary objective of facility-based management of SAM is to reduce fatality rates.…”

Section: Discussionmentioning

confidence: 99%

Performance and costing of nutrition intervention measures on admitted children in malnutrition treatment center: a case study from Jharkhand, India

Sinha¹,

Kiran²,

Kashyap³

et al. 2020

Int J Community Med Public Health

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Background: Children with severe acute malnutrition (SAM) having medical complications require immediate care at malnutrition treatment centers (MTC). Thus, it becomes important to assess the effect and treatment cost of such children in these facilities. Hence, the present study was done with these aims in two MTCs in Jharkhand, India.Methods: A retrospective record review was done of the children admitted to these two MTCs between 1st April 2017 and 31st March 2018. A predesigned proforma was used to collect child related information. The data collected was entered in Microsoft excel sheet and analysed.Results: Majority of the admitted children (90.6%) were in 6-23 months age group. 358 (51.5%) children were females. Only, 194 (27.9%) children admitted were SAM had any medical complication. 690 (99.3%) children were discharged of whom 499 (72.3%) were discharged after achieving the target weight. The average weight gain during their stay was 8.1±2.4 g/kg/day and average length of stay was 16.7±3.2 days. Post discharge follow up rates were found to be low and only 130 (18.8%) children completed all three follow ups. Average cost per SAM child treated was Rs. 18,599 (US$ 272) and per SAM child cured was Rs. 25,904 (US$ 379).Conclusions: MTCs are effective in managing medically complicated SAM children. However, improvements are necessary to ensure that more such children should be treated at facility level, complimented with a community based programme for managing uncomplicated SAM children to improve coverage and ensure continuum of care.

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Severe acute malnutrition and its associated factors among children under-five years: a facility-based cross-sectional study

Cited by 51 publications

References 28 publications

Determinants of severe acute malnutrition among under 5 children in Satar community of Jhapa, Nepal

Determinants of severe acute malnutrition among under 5 children in Satar community of Jhapa, Nepal

A Child with HIV (Human Immunodeficiency Virus) Infection Accompanied by Severe Acute Malnutrition: A Case Report

Performance and costing of nutrition intervention measures on admitted children in malnutrition treatment center: a case study from Jharkhand, India

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