Prevalence Of Protein-energy Malnutrition Research Articles

P-48: Relative prevalence of protein energy malnutrition after Roux-en-Y bypass and bilio-pancreatic diversion in morbidly obese patients

Massive weight loss after bariatric surgery corresponds to a situation of low food intake and some degree of malabsorption. The latter is significant with bilio-pancreatic diversion with duodenal switch (BPD-DS) but may be less prevalent after Roux-en-Y bypass (RYGB).

Factors associated with malnutrition among children in internally displaced person's camps, northern Uganda.

Since mid 1990s, Uganda has had an estimated 1.6 million internally displaced persons (IDPs) in the northern and eastern districts. A major cause of morbidity and mortality amongst children in displaced settings is protein energy malnutrition. To estimate the prevalence of and describe the risk factors for protein energy malnutrition among under five years old children living in internally displaced persons camps in Omoro county Gulu district. This was a cross sectional study undertaken among internally displaced people's in Omoro county, Gulu district during 13 - 23(rd) September 2006. Anthropometric measurements of 672 children aged 3 - 59 months were undertaken and all their caretakers interviewed. The anthropometric measurements were analyzed using z-scores of height-for-age (H/A) and weight-for-height (W/H) indices. Qualitative data were collected through 6 focus group discussions, key informant interviews and observation. Data were captured using Epi Data version 3.0 and analyzed using EPI-INFO version 3.3.2 and SPSS version 12.0 computer packages respectively. ResultsThe prevalence of global stunting was found to be 52.4% and of global acute malnutrition 6.0%. Male children are at risk of being stunted Adjusted OR 1.57 95% CI 1.15-2.13; p value=0.004. Children in the age group 3 - 24 months were at risk of acute malnutrition Adjusted OR 2.78 95% CI 1.26-6.15; p value=0.012 while de-worming was protective Adjusted OR 0.44 95% CI 0.22-0.88; p value=0.018. The main sources of foodstuff for IDPs include food rations distributed by WFP, cultivation and purchase. There is high prevalence of protein energy malnutrition (stunting) among children in the internally displaced people's camps in Gulu district. Male children are at an increased risk of stunting while children aged between 3 - 24 months are at an increased risk of suffering from acute malnutrition. Stakeholders including local government and relief organizations should intensify efforts to improve the nutritional status of IDPs especially children in the camp settings. The quantity of and access to household food supplies, health education on infant and child feeding and integrated management of childhood illnesses (IMCI) activities in the camps should be strengthened.

Malnutrition and obesity on a Paediatric Ward of a tertiary teaching hospital in Kerala, India.

We report the nutritional profile of children 5 years of age or younger admitted to a ward of a tertiary teaching hospital in Kerala, India. We surveyed 40 children admitted to a ward of the Sri Avittam Thirunal Hospital (SAT), Trivandrum, during one calendar month in 2008. The measures included an assessment of Protein Energy Malnutrition (PEM), Stunting, Wasting and Obesity. We also explored the socioeconomic, gender and age factors impacting on these measures. Prevalence of Protein Energy Malnutrition (PEM) was 27.5 % as classified by the Indian Academy of Pediatricians (IAP), 48 % of subjects were found to be stunted. 50 % had wasting and 13 % were overweight. Boys were more likely to develop PEM (O.R=2.9), stunting (O.R=1.9) and wasting (O.R=2.2). Girls were more likely to be overweight/obese (O.R= 2.00). Those classified ‘Below Poverty Line’ (BPL) were less likely to develop PEM (O.R= 0.3), stunting (O.R=0.4) or wasting (O.R=0.8).Those ‘Above Poverty Line’ (APL) were more likely to be overweight (O.R=1.60). This study indicates the prevalence of both malnutrition and obesity in an Indian hospital population.

Protein energy malnutrition (PEM) in cancer patients

Cancer patients show protein energy malnutrition (PEM) throughout the evolution of the disease. The main objective of this work is to find out the prevalence of PEM in the studied sample, as well as how to assess the nutritional state of patients. Non-interventionist, longitudinal and prospective study. Cancer patients from 103 researchers (6 specialties) from 65 hospitals of 15 Spanish Autonomous Communities. Results 561 patients were included in the study. The mean age was 62.6 years and 68.8% were men. The average basal body mass index (BMI) was 22.1 kg/m2. In 18.2% the BMI was low; 21.6% were overweight, pre-obese or obese; 22.9% had a localised tumour and 77.1% had an advanced one, first and foremost located in the head and neck, digestive system and lungs. In 72.7% of cases, it was treated with chemotherapy (CT) and in 38.3% with CT and radiotherapy (RT). 96.4% had nutrition problems: 70.9% (398/561) had anorexia, 34.8% (195/561) gastrointestinal pro blems, 32.6% (183/561) dysgeusia, 40.5% (227/561) dysphagia and others 8.6% (48/561). Weight loss occurred in 90.7% (an average of 4.2 months). If we analyse the BMI of patients, it can be seen that 60.2% have an adequate weight according to their size against 17.3% of patients who are overweight or preobese, and the remaining 4.3% are obese. Only 18.2% of patients are underweight. Over 90% have suffered recent weight loss.

PENGARUH PEMBERIAN MAKANAN TAMBAHAN PADA BALITA KURANG ENERGI PROTEIN (KEP) PENGUNJUNG BALAI PENELITIAN DAN PENGEMBANGAN GANGGUAN AKIBAT KEKURANGAN IODIUM (BPP GAKI) Magelang

The Impact of Supplementary Food On The Child With Protein Energy Malnutrition (PEM) The Visitor of Centre IDD Magelang. Background: Economic crisis result the purchasing power of society become to descend and weak. This matter affect at downhill it health and nutrition status at the under five child. Problem of Insuffiency of Energi Protein Malnutrition (PEM) at the under five child visitor of Center IDD Magelang show the real indication that is in the 2002 found prevalence of PEM was 63.2%. The aim of this study was measured the impact nutrition supplementary with nutritional status the under five child visitor of Center IDD Magelang. Methods: Study design was pre and post test. Research type was applicative research. Subject were 30 child old age 6-59 of month at Centre 100 Magelang. It was conducted by purposive taken with quota sampling. The intervention inform supplementary food made by flour of rice, soybean/tempe, fish/lele, spinach, flour of carrots and sugar. Data analysis were used the t-test. Results: The t-teat are result which significant of at measurement of nutritional status use the weight-for-age (W/A) index (t=3.465; p<0.05) and there are increase of weight after intervension as much 700g. Measurement of nutrition status use the weight-for-high (W/H) index give the impact which significant (t=3.156; p<0.05) and there are increase addition of high as much 1.5 cm. There are decreased of several PEM equal to 6.6% with W/A and 16.7% with W/H index, improvement become the normal status equal to 13.3%. Conclusion: The food supplementary of children under five years old the impact of there are difference of weight in before and after intervention also give impact of nutritional status. Keywords: supplementary food, PEM, children under five years old.

Low prevalence of malnutrition in a rural Nigerian community

This study was carried out to determine the prevalence of malnutrition in a rural Nigerian community. Using the modified Wellcome Classification, the prevalence of protein energy malnutrition (PEM) was 20.5%. The prevalence of underweight, wasting and stunting were 23.1%t, 9% and 26.7%, respectively. The low prevalence of PEM in this rural Nigerian community may be due to the services and intervention provided by a non-governmental organization in the community. This method of intervention is similarly achievable in any other community.

ESTIMASI KERUGIAN EKONOMI AKIBAT STATUS GIZI BURUK DAN BIAYA PENANGGULANGANNYA PADA BALITA DI BERBAGAI PROVINSI DI INDONESIA

&lt;p class="MsoNormal" style="margin: 0cm 12.6pt 6pt 18pt; text-align: justify; text-indent: 27pt;"&gt;&lt;span style="font-size: 10pt;" lang="en-us" xml:lang="en-us"&gt;The study was aimed to estimate GDP lost due to Protein Energy Malnutrition (PEM) among under five children at various provinces in Indonesia. It was a descriptive study used secondary data. Data analysis was conducted in Bogor, from January to March 2006. The data uses are prevalence of PEM among under five children in various provinces in 2003, Gross Regional Domestic Product (GRDP) of provinces in Indonesia by industrial origin 2000 - 2004, population by province, sex and age group 2003, composite Consumers Price Index (CPI) of 45 cities (2002 = 100). The study showed that the economic lost due to malnutrition (PEM) among under five children in Indonesia was ranged from 0.27% to 1.21% GDP.&lt;/span&gt;&lt;/p&gt;

Prealbumin Serum Concentrations as a Useful Tool in the Assessment of Malnutrition in Hospitalized Patients

Protein-energy malnutrition (PEM) is a common condition among patients admitted to hospitals, and it is associated with a worse prognosis and increased mortality. Although several screening systems have been developed, PEM is still poorly recognized, and there is no consensus on which test is more reliable and feasible in clinical practice. Prealbumin (PAB) is a potential useful PEM marker because its serum concentrations are closely related to early changes in nutritional status. We studied PEM prevalence and PAB serum concentrations in 108 hospitalized patients. The Detailed Nutritional Assessment (DNA) was used as the reference method to determine PEM. PAB performance was compared with that of 2 other methods, the Subjective Global Assessment (SGA) and the Prognostic Inflammatory and Nutritional Index score (PINI). According to the DNA reference method, 41% of patients were classified with mild malnutrition and 19% with severe malnutrition. PAB showed the best concordance with the standard DNA method (concordance index, 76.8%) and a good sensitivity/specificity profile (83.1%/76.7%) compared with SGA and PINI. We conclude that PAB could represent a feasible and reliable tool in the evaluation of malnutrition, especially in settings where it is difficult to obtain a more detailed and comprehensive nutritional assessment such as the DNA.

The Use of Parenteral Nutrition in a Severely Malnourished Hemodialysis Patient With Hypercalcemia

There is a high prevalence of protein-energy malnutrition (PEM) in chronic dialysis patients. Causes of PEM include the catabolic effects of hemodialysis treatments, acidemia associated with end-stage renal disease, common comorbid conditions, and uremia-induced anorexia. Morbidity and mortality increase with PEM. Before considering parenteral nutrition (PN) as a nutrition intervention in a maintenance dialysis patient, all other efforts to promote optimal nutrition need to be exhausted. The first step is careful evaluation of protein-energy status, followed by intensive nutrition counseling. If necessary, this is followed by oral nutrition supplementation, appetite stimulation, enteral tube feedings, and finally PN. Short-term parenteral nutrition (PN) became a crucial component of the management of a 38-year-old hemodialysis (HD) patient who endured serious complications after kidney transplant rejection. A profound and prolonged malnourished state followed her treatment for necrotizing pancreatitis. She had developed persistent hypercalcemia believed secondary to tertiary hyperparathyroidism (HPT) and immobilization. Later, she developed hungry bone syndrome (HBS) after parathyroidectomy (PTX). She also developed refeeding syndrome after initiation of PN. The patient's persistent, poorly understood hypercalcemia did not resolve even after PTX and removal of all other sources of vitamin D and calcium from her feedings, medications, and dialysis bath. The close communication of the inpatient and outpatient dialysis multidisciplinary teams became a key component to the successful outcome in this complex patient.

Nutritional status study of inpatients in hospitals of Galicia

To know the prevalence of malnutrition and to validate a nutritional screening protocol (SP) in patients hospitalised in Hospitals representative of inpatients admitted for acute illnesses in Galicia. Cross-sectional study of 376 randomised patients (189 female, 210 > or =65 y old) from 12 public hospitals admitted to hospital for acute medical, surgical or trauma illnesses. The patients elicited were evaluated by a simple SP, including variables relative to recent weight changes, serum albumin, lymphocytes, food ingestion and diagnosis at admission (Cardona's Protocol), and with a diagnostic protocol (DP, Subjective Global Assessment). Both SP and DP were performed by personnel trained in nutritional evaluation. Results of SP and DP were compared; principal factors related to malnutrition were also analysed; statistical significance was considered at P<0.05. From patients studied, according to DP 169/360 (46.94%), patients presented malnutrition (134 B category and 35C category). SP rate was significantly related to severity of malnutrition detected by DP (P<0.001). The principal factors related to the presence of malnutrition were older age and degree of metabolic stress. In adult patients admitted for acute illnesses, the prevalence of protein-energy malnutrition is high. The risk was related to age and to metabolic stress. The risk of malnutrition in a hospital setting is evaluated appropriately by a simple screening procedure that may contribute to detecting and correcting malnutrition risk.

Prevalence and risk factors associated to malnutrition in elderly inpatients

Malnutrition is a frequent clinical finding in elderly inpatients that is deleterious to the physiologic function of several body's organs or systems that is accompanied of an increase of the length of hospitalization, economic burden and mortality. Protein-energy malnutrition risk factors in elderly patients are not well defined. A transversal study of inpatients over 70 years in a internal medicine ward was undertaken in order to know the protein-energy malnutrition's prevalence a possible risk factors. It was considered that a patient suffered from had protein-energy malnutrition if he or she had a tricipital skinfold thickness or an arm circumference under 10th percentile and/or had low levels of two of the following clinical parameters: plasmatic albumin (under 3.5 mg/100 ml). Plasmatic transferrin (under 150 mg/100 ml) or a lymphocytic cell count (under 1,500 cells/ml). A hundred and five patients were included. Mean age was 83.0 +/- 6.4 years with a predominance of the female sex (61%). Thirty-three patients (31%) were sent from nursing homes. A 35% were very dependent and frail elderly patients. Fifty-eight patients presented at hospital with protein-energy malnutrition (prevalence = 57.1%; CI 95% 47.1%-66.8%). Chronic obstructive pulmonary disease (COPD) and a acute infectious disease were independent risk factors associated protein-energy malnutrition (prevalence ratio of 1.4 and 0.5, respectively). Protein-energy malnutrition's prevalence in elderly inpatients is very important. Infectious diseases and COPD are positively and negatively associated with protein-energy malnutrition.

A study on under five nutritional status and its determinants in a semi-rural community of Ile-Ife, Osun State, Nigeria.

Ten variables were assessed as they influence the under five (U5) nutritional status of children at Oranfe, a semi-rural community in Ife East Local Government Area of Osun state, Nigeria. The two types of protein energy malnutrition (PEM) that are prevalent in the community are stunting and wasting. Of the 230 children assessed using Waterlow's technique, 23% and 22.6% were stunted and wasted respectively. The results confirmed that mothers' educational level, age, parity, types of family and children's immunization status and age are some of the key determinants of nutritional status of U5 children. The intensification of exclusive breast feeding, female education, a compulsory food demonstration unit in all health centres, use of complementary feeds from 7 months upwards, growth monitoring and promotion are some of the strategies to reduce the high prevalence of PEM in both rural and urban areas of developing countries.

National immunization day to assess nutritional status of underfives in Chandigarh.

National Immunization Days (NIDs) are an additional opportunity to reach a large number of children and can be used to undertake additional activities beside immunization. This study highlights an attempt to assess nutritional status of under five children by using a NID. Seven thousand four hundred and thirteen underfives were selected randomly from urban, rural and slums areas of Chandigarh. Nutritional status was assessed by using weight for age criteria. Prevalence of protein energy malnutrition (PEM) was found to be about 42% while 22.7%, 14.5%, 4.1% and 0.7% children had grade I, II, III and IV PEM respectively. The prevalence of PEM was significantly higher among females (47.6%), in 1-3 years age group (53.80%), in slum area (67%) and children of labour class (60.5%) (p < 0.001). With increase in family size, the prevalence of malnutrition also significantly increased, and decreased with high literacy rate in parents (p < 0.001). The prevalence of PEM in present study (42%) was comparable to a community based survey (51.6%) among pre-school children of an ICDS block of Chandigarh. National immunization days can be successfully used to assess nutritional status of children. This approach can be used by others for screening common childhood problems, preparing normogram for a region or country, administering Vitamin A and educating mothers.

The health status of rural school children in the Amazon basin of Ecuador.

An assessment of the health status among school children of the Naporuna ethnicity was conducted in north-eastern Ecuador. Prevalence of protein-energy malnutrition (PEM), parasitic infections, and pathology was investigated among 511 school children. The overall nutritional status of the school children was found to be good despite a high prevalence of helminthic infections. The prevalence of stunting was 1.4 per cent and of wasting 1.8 per cent. Sixty-four per cent of the children surveyed were found infected with one or more of the soil-transmitted helminths. In the clinical examination high prevalence of pterigium (89.2 per cent) was found. Upper respiratory infections (5.2 per cent), septic skin lesions (4.4 per cent), mycotic otitis (3.8 per cent), tinea (3.4 per cent) and bronchitis (2 per cent) were the main infectious pathology found. Likely explanations of these findings are discussed.

A Study of Prevalence of Protein Energy Malnutrition among 0–5 Years in Rural Benue State, Nigeria

Three hundred and seventy pre-school children (181 males and 189 females) were studied in order to document the prevalence of protein energy malnutrition and factors that militate it. The prevalence of protein energy malnutrition among the children was revealed to be 41.6% (154). One hundred and fiftyone (40.8%) of them were found to have weight-for-height below -2SD indicating level of stunting among the children. Most malnourished children belonged to mothers who were illiterate 97 (54.8%) when viewed from the mothers' educational perspective. This study also showed the following factors that were statistically significant with PEM: educational status of mothers (p<0.05), marital status (p<0.05) of mothers, occupational status of mothers (p=0.000), parental income per annum (p=0.000), length of breastfeeding (p=0.000), water supply and regularity, type of housing and toilet facilities. Intensification of health education aimed at encouraging beneficial childhood feeding practices in the community is needed together with further study on the subject, which will be directed at actual analysis of the nutritive values of available local foodstuffs as a prerequisite for an effective intervention programme.

Prevalence of protein-energy malnutrition at diagnosis in children with acute lymphoblastic leukemia.

The purpose of the present study was to test the hypothesis that protein-energy undernutrition is common in patients with acute lymphoblastic leukemia at diagnosis. Previous studies have failed to establish whether undernutrition is a common feature at diagnosis. Body mass index (BMI, weight/height2), expressed as a standard deviation score (SDS) relative to contemporary United Kingdom reference data, was used as the index of nutritional status. The index was calculated in a national cohort of standard-risk patients (n = 1019) treated in the same protocol in the United Kingdom. Prevalence of undernutrition (defined as BMI SDS <-2.0) exceeded expected frequencies in boys (7.6%) and girls (6.7%). These differences were statistically significant (p < 0.001), with a 95% confidence interval for the prevalence of undernutrition of 5.8% to 9.0%. Undernutrition is relatively common in patients with newly diagnosed acute lymphoblastic leukemia, with a threefold excess of patients below the cutoff used to define undernutrition. Screening for undernutrition at diagnosis of acute lymphoblastic leukemia is indicated, and the BMI SDS is a simple index of nutritional status that could be readily calculated using measurements routinely made at diagnosis. The same simple screening technique could also be used clinically to detect and manage or prevent overnutrition (obesity), which is common in these patients after diagnosis.

A study on the effects of urbanization on the nutritional status of primary school children in Lagos, Nigeria.

A study on the effects of urbanization on the nutritional status of primary school children aged 5-10 years was carried out in Lagos. A total of 328 children and their parents were studied with the aid of a questionnaire, anthropometric measurements of weights and heights and stool microscopy. The study revealed a prevalence of protein energy malnutrition (PEM) among the children to be 37.9%. 125 (38.2%) of them were found to have weight-for-height below -2SD (standard deviation) signifying wasting, while another 133 (40.5%) had a height-for-age below -2SD, indicating the level of stunting among the children. Most of the malnourished children 125 (60.7%) were found to belong to mothers with a maximum of primary school education and 73 (52.5%) were from mothers who were skilled workers. There was a preponderance of malnourished children from single parents. All the children (100%) from single parents were found to be clinically malnourished. And 280 (84.9%) of all children examined had ova and cyst of intestinal parasites (Ascaris, Tricuris, Amoeba, etc.) in their stools. And finally, most children 223 (67.7%) spent less than 6 hours contact time with their parents per day.

Validity of single-weight measurements to predict current malnutrition and mortality in children.

In this cross-sectional study of a random cluster sample of 4238 rural Zairian children aged 0-5 y, we assessed underweight and wasting, defined as weight-for-age < 75%, and weight-for-height < 80% of the U.S. National Center for Health Statistics reference median, respectively. We determined the diagnostic validity of underweight and wasting for protein-energy malnutrition, taking a low arm circumference and clinical signs of muscle loss as criteria. Both underweight and wasting had low sensitivity in recognizing low arm circumference, any clinical muscle loss and even severe marasmus, especially in the weaning period of 12-30 mos. Receiver operating characteristic (ROC) analysis showed that the diagnostic validity of weight-for-height can be improved by using a cutoff for wasting at Z-score -0.75 instead of Z-score -2 or 80% of reference median. ROC analysis of 30-mo mortality revealed a poor prognostic validity of weight-for-height and weight-for-age and better performances of arm circumference (cm) and of age. These data suggest that nutritional intervention programs targeted at wasted or underweight children can have only a limited effect on the prevalence of protein-energy malnutrition in the community or on the long-term mortality associated with it.

The effect and causes of protein-energy malnutrition in Nigerian children

Protein-energy malnutrition is still highly prevalent in Nigeria due to faulty weaning practices, poverty, poor sanitary conditions, minimal medical attention, and endemic childhood infections. Insufficient food intake affects the child principally as a result of one of these causes: 1) the child is offered little food and is unable to get more by him/herself; (for example, restricted intake of protein during illness or prolonged exclusive breast feeding); 2) the child is offered ample foods but the quantity is of inadequate quality for his/her needs, resulting in low protein and/or energy density; 3) improper feeding practices such as nonhygienic preparation of over-diluted formula or starch gruels, which give rise to early-age severe protein-energy malnutrition. Studies in Nigeria found that protein-energy malnutrition was the second cause of death in children under six years. This review covers 1) the prevalence of protein-energy malnutrition; 2) morbidity and mortality rate due to malnutrition; and 3) the hematological parameters of Nigerian children.

The Standard Physical Growth Chart for Saudi Arabian Preschool Children

This study presents growth charts of preschool based on cross-sectional data of the population in Riyadh, Saudi Arabia. Charts on weights and heights per age were designed separately for boys and girls. Boys consistently weighed more than girls for this age group at every age. Also, the boys were taller than the girls after the age of one year. Since the growth deficits in children from Saudi Arabia compared with internationally recommended reference populations may be attributed to genetic and environmental factors, the charts presented will suffice as a standard in monitoring the growth of Saudi children in particular and those in the Gulf region in general.