Determinants of severe acute malnutrition among children under five years in a rural remote setting: A hospital based study from district Tharparkar-Sindh, Pakistan.

Aurangzeb Sand,Ramesh Kumar,Dalpat Rai,Ratana Somrongthong,Assad Hafeez,Babar Tasneem Shaikh

doi:10.12669/pjms.342.14977

Aurangzeb Sand, Ramesh Kumar + Show 4 more

Open Access

https://doi.org/10.12669/pjms.342.14977

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Abstract

Objectives:To understand and catalogue the specific determinants of this alarming rate of malnutrition among children of Tharparkar district, Sindh Pakistan.Methods:This was a hospital based analytical survey. Data was collected through a semi-structured questionnaire by interviewing mothers of the children (age 6-59 months), admitted in the hospital. Following WHO guidelines, weight and length/ height of 105 children were recorded. Study was conducted in District Headquarters Hospital, Tharparkar district of Sindh province.Results:Almost 48% children admitted in the hospital were identified with severe acute malnutrition. More males (55%) were malnourished as compared to females (45%). Maternal education, household income, family size, breastfeeding, vaccination status, and frequent infections were found to be significantly associated with the severe acute malnutrition.Conclusion:Specific interventions on promoting exclusive breastfeeding, vaccination, and timely health care seeking behaviors would definitely improve the outcomes. Nevertheless, sector wide approaches would be needed on girls’ education, poverty, and food security in the district in order to address the issue of malnutrition.

Highlights

The word ‘Malnutrition’ is generally used for both over nutrition and under nutrition cases; whereby the under nutrition means solely a deficiency of nutrition
The assessment of nutritional status of the children admitted in the hospital revealed that 21% children were normal, 31.4% were suffering from moderate acute malnutrition, and 47.6% children manifested severe acute malnutrition
Association of socio-demographic characteristics with Severe Acute Malnutrition (SAM): We found that the age and sex of the child was not associated with SAM status

Summary

Introduction

The word ‘Malnutrition’ is generally used for both over nutrition and under nutrition cases; whereby the under nutrition means solely a deficiency of nutrition. Undernutrition includes being underweight for one’s age, too short for one’s age (stunted), dangerously thin (wasted), and deficient in vitamins and minerals (micronutrient malnutrition).[1] Food deprivation, lack of maternal education, inappropriate feeding and infections could be the major causes for the latter type of malnutrition.[2] Malnutrition is a leading killer in children under five years.[3] World Health Organization (WHO) defines Severe Acute Malnutrition (SAM) as a very low weight for height, by visible severe wasting, Pak J Med Sci March - April 2018 Vol 34 No 2 www.pjms.com.pk 260 or by the presence of nutritional edema. Under nutrition in childhood, including fetal growth restriction, stunting, wasting, deficiencies of vitamin A and zinc, and suboptimal breastfeeding, have been causing 3.1 million child deaths annually, representing 45% of the total childhood mortality.[4] Acute malnutrition is a serious public health problem, at times, and in regions reaching to the epidemic proportions. SAM is prevalent in areas affected by natural disasters and conflict, and requires immediate action to save the precious lives of children.[7]

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