Socioepidemiological determinants of severe acute malnutrition and effectiveness of nutritional rehabilitation center in its management

Aprameya, HS; Kamath, Shobha; Kini, Prashant K; Baliga, B. Shantharam; Shenoy, UV; Jain, Animesh; Rao, Balakrishna Ns

doi:10.4103/2278-344x.160873

Cited by 12 publications

(5 citation statements)

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“…Independent association of malnutrition with the consistency of complementary feeds was found in studies from other parts of India [18, 25]. Our study showed that the type of weaning and the complementary feeding highly influenced the nutritional status of the children.…”

Section: Discussionsupporting

confidence: 74%

“…It was also noted that the chances of being malnourished were 1.89 times higher among those children who did not receive exclusive breastfeeding. Various studies have shown that lack of exclusive breastfeeding for the first six months was significantly associated with malnutrition [18, 19, 25, 26]. A study done in Bangladesh reported that there was a four-fold increased risk of malnutrition with the lack of breastfeeding [27].…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for malnutrition among preschool children in rural Karnataka: a case-control study

et al. 2018

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BackgroundThe prevalence of malnutrition among children in developing countries is very high. As a step towards reducing the prevalence of malnutrition, there is a need to identify the important determinants of malnutrition in the specific population so that preventive and control measures can be implemented.The objective of the study is to determine the risk factors for malnutrition among preschool children in Rural Karnataka, South India.MethodsA case-control study was carried out among preschool children, aged between three to six years, attending the Anganwadi centers and their mothers’ in Udupi district of Karnataka, India. A total of 570 children (190 cases and 380 controls) were selected by multistage cluster sampling technique. A semi-structured risk factors questionnaire was used to identify the risk factors for malnutrition among children.ResultsThe majority (45.8 and 45.5%) of the children in the study were in the age group of 3.0 to 4.0 years in case and control groups respectively. There was a slight preponderance of illiterate parents among cases in comparison to the controls. Largely, 87.4% of the children belonged to poor socio-economic status in the case groups compared to 82.4% in the control group. After adjusting for the confounders, underweight was significantly associated with socio-economic status of the parents (aOR: 2.05, 95% CI: 1.06, 3.96), birth weight < 2000 g (aOR: 25, 95% CI: 0.10, 0.59), recurrent diarrhoea (aOR: 2.74, 95% CI: 1.56, 4.83), recurrent cold and cough (aOR: 3.88, 95% CI: 1.96, 7.67), worm infestation (aOR: 2.0, 95% CI: 1.19, 3.38) and prelacteal feed given (aOR: 3.64, 95% CI: 2.27, 5.86).ConclusionParental education, childhood illness, short birth interval, open defecation, type of weaning and complimentary food given to children were some of the significant determinants of underweight that were found in the study. Information, Education and Communication (IEC) campaigns alleviating food habits and taboos and promoting birth spacing is the need of the hour for preventing the occurrence of undernutrition among preschool children.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5124-3) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Risk factors for malnutrition among preschool children in rural Karnataka: a case-control study

et al. 2018

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“…Infections are a main cause of mortality during SAM recovery . Growing evidence demonstrates elevated morbidity in the postdischarge period despite anthropometric recovery . Zinc supplementation is effective for reducing diarrhea risk in children, including in those recovering from protein energy malnutrition and particularly in areas with high prevalence of malnutrition and zinc deficiency .…”

Section: Discussionmentioning

confidence: 99%

“… 30 Growing evidence demonstrates elevated morbidity in the postdischarge period despite anthropometric recovery. 9 , 10 , 11 , 12 , 31 Zinc supplementation is effective for reducing diarrhea risk in children, 32 , 33 including in those recovering from protein energy malnutrition 34 and particularly in areas with high prevalence of malnutrition and zinc deficiency. 35 Preventive zinc supplementation might also reduce the incidence of pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Postdischarge Interventions for Children Treated for Moderate or Severe Wasting, Growth Faltering or Failure, or Edema

et al. 2023

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ImportanceChildren treated for acute malnutrition remain at increased risk of relapse, infection, and mortality after programmatic recovery. Global guidelines for the management of acute malnutrition currently provide no recommendations to sustain recovery following treatment discharge.ObjectiveTo inform guideline development by evaluating the evidence on postdischarge interventions to improve outcomes within 6 months after discharge.Evidence ReviewIn this systematic review, 8 databases were searched from inception through December 2021 and included randomized and quasi-experimental studies investigating interventions delivered after discharge from nutritional treatment for children aged 0 to 59 months. Outcomes were relapse, deterioration to severe wasting, readmission, sustained recovery, anthropometry, all-cause mortality, and morbidity within 6 months after discharge. The risk of bias was assessed using Cochrane tools, and the certainty of the evidence was evaluated with the GRADE approach.FindingsOf 7124 records identified, 8 studies, conducted in 7 countries between 2003 and 2019 with 5965 participants, were included. The study interventions included antibiotic prophylaxis (n = 1), zinc supplementation (n = 1), food supplementation (n = 2), psychosocial stimulation (n = 3), unconditional cash transfers (n = 1), and an integrated biomedical, food supplementation, and malaria prevention package (n = 1). Risk of bias was moderate or high for half the studies. Only unconditional cash transfers were associated with reduced relapse, while the integrated package was associated with improved sustained recovery. Zinc supplementation, food supplementation, psychosocial stimulation, and unconditional cash transfers were associated with improvements in postdischarge anthropometry, while zinc supplementation was associated with reductions in multiple postdischarge morbidities.Conclusions and RelevanceIn this systematic review of postdischarge interventions to reduce relapse and improve other postdischarge outcomes among children treated for acute malnutrition, evidence was limited. Biomedical, cash, and integrated interventions showed promise in improving certain postdischarge outcomes for children treated for moderate or severe acute malnutrition in single studies. Further evidence on the efficacy, effectiveness, and operational feasibility of postdischarge interventions in other contexts is needed to inform global guidance development.

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“…There is a want to improvise health training to mothers/ caregivers, hyperlink NRC facilities with community health facilities for better follow-ups and address modifiable socioepidemiological threat factors. [10] A study published in Food and Nutrition bulletin (2006) revealed the effectiveness of rehabilitating severely malnourished kids in the community in non-emergency situation. This study is summarized 33 community-based rehabilitation centers.…”

Section: Methodsmentioning

confidence: 99%

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2023

AJP

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India had been called the golden sparrow," we have grown up listening to these lines since childhood, but today when we look at the figures of National Family Health Survey, World Health Organization, National Institute of Nutrition etc., it hurts a lot. Today, about 45% children of India fall in the stunted category. However, to fight malnutrition, a Nutrition Rehabilitation Centre has been established here in India, in which children are treated with therapeutic diet and if studies are to be believed, its results are also very good. After studying the traditional medical method of our India (Ayurveda), it was found that even from the Ayurvedic point of view, the elements of the therapeutic diet used in this center proved to be equally good and capable of fighting malnutrition. This diet has also proven to be appropriate and generally safe based on over 2000 years of Ayurvedic knowledge.

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Socioepidemiological determinants of severe acute malnutrition and effectiveness of nutritional rehabilitation center in its management

Cited by 12 publications

References 1 publication

Risk factors for malnutrition among preschool children in rural Karnataka: a case-control study

Risk factors for malnutrition among preschool children in rural Karnataka: a case-control study

Analysis of Postdischarge Interventions for Children Treated for Moderate or Severe Wasting, Growth Faltering or Failure, or Edema

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