Abstract
Severe Acute Malnutrition (SAM) in infants of less than 6 months of age (U6m) is a serious public health concern globally, especially with declined rates of exclusive breastfeeding. With challenges in the use of the standard anthropometric parameters and higher mortality in these infants than in older children, it is pertinent to document the burden, pattern and risk factors for SAM in U6m. This study aimed to determine the prevalence of SAM in U6m, the pattern and the determinants of malnutrition using weight-for-length (WFL) Z score and mid-upper arm circumference (MUAC), and also to determine the usability of MUAC and WFL in detection of SAM in U6m. Infants six weeks to <6months were recruited. Socio-demographic and nutritional data were collected using researcher administered questionnaire. WFL z scores <-3 and MUAC <11.5cm were used to define SAM. Of the 233 infants aged<6months, mean age was 90.0±38.3days. Females accounted for 52.8%. Nineteen, (8.5%), were born with low birth weight and 11.7% were preterm deliveries. Males had higher mean length for age and weight for age than females but MUAC showed no significant difference. The prevalence of SAM was 2.6% by MUAC and WFL parameters but MUAC identified more SAM subjects in those <3months while WFL identified more in older children. Concordance between MUAC and WFL was poor. Both MUAC and WFL showed more female children than males with MAM. Lower social economic status was significantly associated with SAM while birth weight, birth order, maternal nutritional status and time of first feed did not affect prevalence of SAM in any of the parameters. It is recommended that both WFL and MUAC be employed in the screening of acute malnutrition in this U6m.
Highlights
Childhood wasting is a serious public health concern worldwide.[1]
19 (8.5%) were born with birth weight less than 2.5kg and 3.2% were born with birth weight 4.0kg and above
The prevalence of severe acute malnutrition in the study was 2.6% using WFL. This falls within the global range of Severe Acute Malnutrition (SAM) as reported by Kerac M et al.[10] and similar to finding by Prost et al.12among Malawian children 1-4months of age but is less than 6.3% reported in Kenya from a retrospective study[13] as well as the 14.8% reported by Choudhary et al.[14] in the Indian National Family Health Survey Four
Summary
Childhood wasting is a serious public health concern worldwide.[1]. High rate of malnutrition pose significant public health and development challenges for the country. With declined and varying rates of exclusive breastfeeding among several population groups[2], severe acute malnutrition is increasingly becoming a recognized entity in infants less than 6 months of age (U6m). There is dearth of information on risk factors that determine the prevalence of malnutrition in this population group. This study was designed to determine the prevalence of SAM among children less than 6months of age, the pattern of malnutrition using various anthropometric indices and the risk factors of malnutrition in this population. It intends to determine if MUAC can be used in the diagnosis of SAM in this subset of children
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