Epidemiological and Clinical Profile of Hospitalized Children with Moderate and Severe Acute Malnutrition in South India
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To evaluate the clinico-epidemiological profile, pattern of infections, feeding practices, socio-demographic risk factors and outcome of hospitalized children with moderate acute malnutrition (MAM) and severe acute malnutrition (SAM).
Cases (children aged 1–60 mo with SAM or MAM) and controls (children with weight for height z score more than −1 SD) were recruited from November 2011 through July 2013. Overall, 126 cases and 126 controls were included.
Only 33 % of malnourished children (cases) were exclusively breast fed. Among controls, 71 % were exclusively breast fed for the first 6 mo after birth. Most cases had associated infections (p 0.004) and anemia (p < 0.001). ROC curve revealed 120 mm mid upper arm circumference (MUAC) as the best cut off for predicting SAM. Mothers’ education, pre-lacteal feeds and co-morbidities were independent predictors of malnutrition (R2 = 22.1 %) by logistic regression.
Though 11.5 cm MUAC has been mentioned by WHO as the cut off for identifying SAM, a higher cut off (12 cm) may be required to use it as a screening tool. Mothers’ education, pre-lacteal feeds and co-morbidities were found to be independent determinants for malnutrition in the present patient population, indicating the need towards a targeted approach for modifying these factors.
KeywordsCo-morbidities Moderate acute malnutrition Mid-upper arm circumference Severe acute malnutrition
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