Clinical Profile of Severe Acute Malnutrition in Western Rajasthan: A Prospective Observational Study from India

Abstract

Introduction: The present study is undertaken to evaluate incidence and clinical profile of patients admitted with severe acute malnutrition and the assessment of relative contribution of various variables. Methods and material: This prospective study was conducted at department of paediatrics Umaid hospital, Dr. S.N. medical college Jodhpur, for a period of 7 months on patients of severe acute malnutrition admitted in malnutrition treatment corner. A total of 75 cases were enrolled in the study and a detailed history and physical examination finding were recorded in pretested proforma at the time of admission by using standard methodology and anthropometric measurement expressed in standard deviation from the median of the reference population (NCHS). Results: Incidence of severe acute malnutrition is 3.28%. Mean age of admitted patients was 14.92 ± 7.48 months and mostly belonged to lower socioeconomic scale, rural area and large family. Most of the caretakers were illiterate and in all cases, caretakers were mothers. In our study that 41.3%, 32.1%, 21.3% and 5.3% patients were in PEM grade IV, III, II and I respectively. Female patients were more severely malnourished than males (84.2% v/s 68.21%).Most common presenting symptom was fever (70.7%), followed by vomiting (52) and co morbidity associated with PEM was gastrointestinal (60%) followed by respiratory tract infection (52%). Mean duration of exclusive breast feeding was 2.6 ± 1.5 months and mean age of weaning was 8.4±3.9 months.78.7% children were still on breast feed at the time of hospitalisation and among them 40.7% of children were above 12 months of age. Mean age of starting semisolid and solid food was 11.6+3.53 months and most commonly used supplementary food was top milk in (100%), followed by chapati (42.3%) in patients. Conclusion: On the basis of this study, we conclude that the problem of severe malnutrition is multi-dimensional and inter-generational in nature. The determinants of severe malnutrition includes household food insecurity, illiteracy, low socioeconomic status, lack of awareness to access health services, large family size and poor purchasing power etc. Besides these, faulty feeding practices, poor complementary feeding practices, ignorance about nutritional needs of infants and young children and repeated infections, also aggravates the malnutrition amongst