Background: Acute lymphoblastic leukemia (ALL) has 5-year survival of more than 90% in many advanced cancer research institutes. However, advanced cancer care is not available to majority of poor in developing countries. The experience of treating such patients in a resource-scarce setting is described herewith. Of the 75 individuals studied, 11% of the children were stunted, >21% were underweight, and 16% of the under-five children had acute malnutrition. Massive hepatosplenomegaly and lymphadenopathy were present in 75% and 77% children, respectively. About 71% patients achieved complete remission (CR). A total of 30 (40%) children lived for >5 years after diagnosis and 21 (28%) of them had event-free 5 years. Weight for height for under-five children ( P = 0.029) and total count ( P = 0.019) were found to be significantly associated with deaths during induction. Weight for age ( P = 0.024), weight for height of under-five children ( P = 0.009), and lymphadenopathy ( P = 0.049) had a strong association with 5-year event-free survival. Using multivariate model, only weight for height among under five remained significantly associated with induction deaths ( P = 0.021) and absence of lymphadenopathy with event-free 5-year survival ( P = 0.042). Context: ALL has 5-year survival of >90% in many advanced cancer research institutes. However, advanced care is not available to majority of poor in the periphery of developing countries. Data available on the survival and the factors affecting the outcome among patients treated in poor resource settings are limited. Aims: This study aims to find the 5-year survival rate and the factors for risk-directed therapy in the region. Settings and Design: Cross-sectional analytical study at a tertiary center of public health in central Kerala. Subjects and Methods: Retrospective analysis of case sheets of 75 children who were treated at the institute from March 2006 to March 2011. Statistical Analysis Used: Univariate and Multivariate analysis using IBM SPSS Statistics for Windows, Version 20.0. Results: : Of the 75 individuals studied, 11% of the children were stunted, >21% were underweight, and 16% of the under-five children had acute malnutrition. Massive hepatosplenomegaly and lymphadenopathy were present in 75% and 77% children, respectively. About 71% patients achieved CR. A total of 30 (40%) children lived for >5 years after diagnosis and 21 (28%) of them had event-free 5 years. Weight for height for under-five children ( P = 0.029) and total count ( P = 0.019) were found to be significantly associated with deaths during induction. Weight for age ( P = 0.024), weight for height of under-five children ( P = 0.009), and ly...
Background: Suboptimal maternal–child nutrition leading to malnutrition is the major cause increasing morbidity and mortality from severe acute lower respiratory infection (ALRI) among under two children. This research compares the infant and young child feeding (IYCF) practices in children with ALRI and children coming for routine immunization to find out the independent risk factors.Methods: The study was a hospital-based case control study. Infant and young children from 6 months to two years with ALRI admitted to the pediatric ward were studied as cases. Infant and young children of same age coming for routine immunization to the pediatric immunization clinic were studied as controls. Feeding patterns, socio-demographic, environmental and parenting factors were obtained from them in between May 2019 to April 2020.Results: Mixed feeding till 6 months (adjusted OR=34.191; 95% CI, 2.158–541.801; p=0.012), early initiation of complimentary feeding (AOR=30.389; 95% CI, 1.426–647.603; p=0.029), late initiation of complimentary feeding (AOR=28.696; 95% CI, 1.217–676.566; p=0.037) and inadequate amount of complimentary feeding (AOR=14.406; 95% CI, 1.898–109.371; p=0.010) were significant in multivariate analysis.Conclusions: Interventions to increase awareness of breastfeeding and complimentary feeding practices seldom reach lower sections of the society. Feeding visits, mother support groups and community projects to provide home based counselling on IYCF are needed to improve the situation.
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