Risk Factors for Severe Acute Malnutrition in Children below 5 y of Age in India: A Case-Control Study
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To determine the possible risk factors for severe acute malnutrition (SAM) in children below 5 y admitted in a hospital in north India.
This case-control study was conducted in a medical college hospital in children below 5 y of age. All cases of SAM (diagnosed as per WHO definition) between 6 and 59 mo of age were compared with age-matched controls with weight for height above -2SD of WHO 2006 growth standards. Data regarding socio-demographic parameters, feeding practices and immunization were compared between the groups by univariable and multivariable logistic regression models.
A total of 76 cases and 115 controls were enrolled. Among the 14 factors compared, maternal illiteracy, daily family income less than Rs. 200, large family size, lack of exclusive breast feeding in first 6 mo, bottle feeding, administration of pre-lacteals, deprivation of colostrum and incomplete immunization were significant risk factors for SAM. Regarding complementary feeding, it was the consistency, rather than the age of initiation, frequency and variety which showed a significant influence on occurrence of SAM. Multivariate analysis revealed that the risk of SAM was independently associated with 6 factors, namely, illiteracy among mothers, incomplete immunization, practice of bottle feeding, consistency of complementary feeding, deprivation of colostrum and receipt of prelacteals at birth.
The present study identifies certain risk factors which need to be focused on during health planning and policy making related to children with SAM in India.
KeywordsSevere acute malnutrition Risk factors Children India
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- 1.United Nation’s Children’s Fund. Tracking progress on child and maternal nutrition a survival and developmental priority. [homepage on the Internet]. 2009 [cited 2011 Oct 6]. Available from: UNICEF, Web site: http://www.unicef.pt/docs/Progress_on_Child_and_Maternal_Nutrition_EN_110309.pdf.
- 2.International Institute for Population Sciences. National Family Health Survey 3, 2005–2006. Mumbai: IIPS; 2006.Google Scholar
- 3.Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al.; Maternal and Child Undernutrition Study Group. Maternal and child undernutrition: Global and regional exposures and health consequences. Lancet. 2008;371:243–60.Google Scholar
- 4.Amsalu S, Tigabu Z. Risk factors for severe acute malnutrition in children under the age of five: A case-control study. Ethiop J Health Dev. 2008;22:21–5.Google Scholar
- 10.World Health Organization, United Nations Children’s Fund. WHO/WHO child growth standards and the identification of severe acute malnutrition in infants and children. [homepage on the Internet]. 2009 [cited 2013 Apr 27]. Available from: http://www.who.int/nutrition/publications/severemalnutrition/9789241598163/en/.
- 18.Patwari AK, Kumar S, Beard J. Undernutrition among infants less than 6 months of age: An underestimated public health problem in India. Matern Child Nutr. 2013; doi: 10.1111/mcn.12030.