Severe acute malnutrition: seasonal variations in Southern Rajasthan, India

Singla, Sanjay; Suman, Rameshwar Lal; Meena, Pradeep; Goyal, Sanjay; Jain, Rohit; Meena, Suresh Kumar

doi:10.18203/2320-6012.ijrms20164200

Cited by 4 publications

(4 citation statements)

References 2 publications

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“…Volume 14; Issue: 5; May 2024 Hospitals need to be well prepared for a higher load in summer months to provide adequate nutritional rehabilitation and appropriate care to these patients. Singla et al also found a seasonal variation in SAM admissions in their setup [2] . Edema was noted in very few of the patients (5, 2.3%) in our setup.…”

Section: Figurementioning

confidence: 84%

Weights Must Not be Taken Lightly: Burden of Severe Acute Malnutrition Patients in a Rural Tertiary Care Hospital of Maharashtra

Panjwani,

Rajib,

P Jadhav

2024

Int J Health Sci Res

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Aim: To identify the magnitude of the burden of co-morbidities of severe acute malnutrition (SAM) in a rural tertiary care centre in Maharashtra, to facilitate necessary planning for care to reduce disparity in urban and rural outcomes of these patients. Methods: From March 2023 to April 2024, data was collected from the wards of a tertiary care rural hospital. Children with SAM were examined and managed for primary complaints, any associated co morbidities, and nutritional rehabilitation was done. Results: Presenting diagnosis was most commonly respiratory tract infection, including tuberculosis, and acute gastroenteritis, followed by anemia and acute febrile illness. Co-morbidities such as chronic diarrhoea (12, 14%), congenital heart disease (4, 4.7%), neurological involvement such as cerebral palsy, meningitis, infantile tremor syndrome and spinal muscular atrophy (14, 16.6%), bony abnormalities such as rickets with spine deformities and bowed legs causing abnormal posture and delayed mobility (10, 11.9%) also contributed to the burden in our setup. Conclusion: This study is an attempt to enhance data about the gravity of malnutrition and thus the need for improvement in facilities for the care of these patients to reduce the vicious cycle of malnutrition and infections. Key words: Malnutrition, child health, SAM, diet, anemia, edema, wasting

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Section: Figurementioning

confidence: 84%

Weights Must Not be Taken Lightly: Burden of Severe Acute Malnutrition Patients in a Rural Tertiary Care Hospital of Maharashtra

Panjwani,

Rajib,

P Jadhav

2024

Int J Health Sci Res

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“…The Community-Based Management of Severe Acute Malnutrition program in Bihar, India (MSF- BIHAR) reported with data from 2009 to 2011 that peaks in admission fell in the months of June to August [ 44 ]. In Southern Rajasthan, a hospital based malnutrition treatment centre site from data in 2014–16 reported highest admissions from July to September [ 45 ]. Even in urban areas such as Delhi, evidence from 2012–2014 of seasonal patterns in admissions for SAM treatment was found with the greatest numbers of admissions with SAM from May to October [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Methods for assessing seasonal and annual trends in wasting in Indian surveys (NFHS-3, 4, RSOC & CNNS)

et al. 2021

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Wasting in children under-five is a form of acute malnutrition, a predictor of under-five child mortality and of increased risk of future episodes of stunting and/or wasting. In India, national estimates of wasting are high compared to international standards with one in five children found to be wasted. National surveys are complex logistical operations and most often not planned or implemented in a manner to control for seasonality. Collection of survey data across differing months across states introduces seasonal bias. Cross-sectional surveys are not designed to collect data on seasonality, thus special methods are needed to analyse the effect of data collection by month. We developed regression models to estimate the mean weight for height (WHZ), prevalence of wasting for every month of the year for an average year and an overall weighted survey estimates controlling for the socio-demographic variation of data collection across states and populations over time. National level analyses show the mean WHZ starts at its highest in January, falls to the lowest in June/August and returns towards peak at year end. The prevalence of wasting is lowest in January and doubles by June/August. After accounting for seasonal patterns in data collection across surveys, the trends are significantly different and indicate a stagnant period followed by a decline in wasting. To avoid biased estimates, direct comparisons of acute malnutrition across surveys should not be made unless seasonality bias is appropriately addressed in planning, implementation or analysis. Eliminating the seasonal variation in wasting would reduce the prevalence by half and provide guidance towards further reduction in acute malnutrition.

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“…Furthermore, the data are unable to account for the effects of seasonality on BMI of married nulliparous adolescents and married nulliparous young women. Weight for height is known to vary seasonally in young children [51, 52]. This paper also does not examine the effects of other variables such as, any illness prior to survey, decision making powers, experience of domestic violence and related empowerment indicators which may be related to both the independent variables of interest and the outcome [53].…”

Section: Discussionmentioning

confidence: 99%

Nutrition status of nulliparous married Indian women 15-24 years: Decadal trends, predictors and program implications

Sethi

Dinachandra

Murira³

et al. 2019

PLoS ONE

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In India, 66% of 8 million married adolescents (~5.3 million) are nulliparous and likely to conceive soon. Among married young women aged 20–24 years about 9.1 million are nulliparous. This group remains relatively less reached in maternal nutrition programs. Current estimates of their nutritional status and predictors of body mass index (BMI) are unavailable. Thinness (BMI <18.5 kg/m 2 ), severe thinness (BMI <16 kg/m 2 ), overweight or obesity (BMI ≥ 23kg/m 2 ) prevalence estimates are presented based on a sample of 11,265 married nulliparous adolescents (15–19 years, married, no parity) and 15,358 young women (20–24 years, married, no parity) drawn from the National Family Health Surveys 2005–06 and 2015–16. Trends by age, time and state were analysed. Predictors of BMI were investigated using linear regression. Using BMI for age z score (BAZ) as standard reference, BMI cut-off was calculated for thinness (-2SD) and overweight or obesity (+1SD) among married nulliparous adolescents as recommended for population under 19 years. 35% sampled adolescents and 26% young women were thin; 4%-5% severely thin. Overweight or obesity was higher among married nulliparous young women than married nulliparous adolescents (21% versus 11%). Eight in 1000 were short, thin and young and six in 1000 were short, thin, anemic and young. At 15 years of age, prevalence of thinness based on BMI was 46.5% while based on BAZ, 7.6%. At 24 years of age thinness was 22.5%. Decadal reduction in thinness was half among married nulliparous adolescents (4% points) compared with married nulliparous young women (8% points). Decadal increase in overweight/ obesity ranged from 4% to 5% in both age groups. Western states had high prevalence of thinness; Tamil Nadu had highest prevalence of overweight or obesity. Incremental increase in age and wealth increased BMI among young women more than adolescents. BMI was lower among adolescents and young women wanting a child later than soon [β -0.28 (CI -0.49- -0.07), β -0.33(CI -0.56- -0.093), respectively]. BMI cut-off 16.49 kg/m 2 and 24.12 kg/m 2 had a high sensitivity (100%, 99.7%) and specificity (98.9%, 98.5%) to screen thin and overweight or obese adolescents, respectively. Owing to the high prevalence of both thinness and overweight/obesity among nulliparous married adolescents and women, nutritional anthropometry based screening should be initiated for this target group, along with a treatment package in states with high and persistent malnutrition. Family planning services should be integrated in nutrition programs for this target group to achieve normal nutritional status before conception.

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Severe acute malnutrition: seasonal variations in Southern Rajasthan, India

Cited by 4 publications

References 2 publications

Weights Must Not be Taken Lightly: Burden of Severe Acute Malnutrition Patients in a Rural Tertiary Care Hospital of Maharashtra

Weights Must Not be Taken Lightly: Burden of Severe Acute Malnutrition Patients in a Rural Tertiary Care Hospital of Maharashtra

Methods for assessing seasonal and annual trends in wasting in Indian surveys (NFHS-3, 4, RSOC & CNNS)

Nutrition status of nulliparous married Indian women 15-24 years: Decadal trends, predictors and program implications

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