Abstract
The primary objective of this study was to determine the clinical improvement after oral magnesium (Mg2+) supplementation in severely malnourished children. The specific objectives were to observe the changes in clinical sign-symptoms between Mg2+ supplemented and un-supplemented group and to see serum Mg2+ level before and after oral Mg2+ supplementation. This observational study was conducted in three tertiary level hospitals in Dhaka city involving 60 severely malnourished children of 6-59 months of age by non-probability purposive sampling from July’2016 to June’2018. Children were divided into two groups; Group I was given standard management for severe acute malnutrition according to the national guideline, Group II received similar treatment plus oral Mg2+ supplementation. Improvement of the clinical profile and the serum Mg2+ level was observed in children treated with Mg2+ supplementation. The mean age of Group I children was 21.13±13.02 months and Group II was 22.52±12.13 months. Male female ratio was 1.2:1. Statistically significant improvement was observed in case of nausea/vomiting, appetite, generalized weakness and weight gain (p<0.01). Appearance, diarrhea, skin changes and edema also improved in Mg2+ supplemented group but the results were not significant. Post-treatment serum Mg2+ levels were significantly different in Group I and Group II i.e., 1.52±0.27mg/dL Vs 2.03±0.31mg/dL respectively (p<0.001). It was observed that oral Mg2+ supplementation improved clinical outcome in severely malnourished children. Further large scale randomized control trial is needed to more precisely delineate the beneficial role of oral Mg2+ supplementation in severely malnourished children.
Highlights
Malnutrition continues to be a major public health problem throughout the developing world
Children were divided into two groups: Group I consisted of 30 children and was treated according to the national guideline for severe acute malnutrition (SAM) without magnesium supplementation
It was observed that Mg2+ supplementation significantly improved the symptoms of SAM like nausea/vomiting, loss of appetite, generalized weakness and weight gain
Summary
Malnutrition continues to be a major public health problem throughout the developing world. Diets in populations are frequently deficient in macronutrients, micronutrients or both [1]. Malnutrition, with its two constituents of protein–energy malnutrition and micronutrient deficiencies, continues to be a major health burden in developing countries [1]. The national child nutrition survey conducted in 2014 demonstrated that 36% of children under 5 are stunted, 14% are wasted and 33% are underweight [2]. Among the South Asian countries prevalence of ‘wasting’ in Bangladesh is 11.6%, India 18%, Pakistan 11%, Nepal 11%, Srilanka 14%, Bhutan 4%, and Maldives 17%3. Protein-energy malnutrition usually manifests early in childhood between 6 months to 2 years of age and is associated with early weaning, delayed introduction of complementary foods, a low-protein diet and severe or frequent infections [1]
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