A hospital based Study on Co-morbidities in children with severe acute malnutrition

Abstract

Introduction: Severe acute malnutrition, is characterized by wasting (marasmus), oedema (as a result of kwashiorkor), or both (marasmic kwashiorkor), and occurs mostly in children. Globally, co morbidities such as diarrhoea, acute respiratory tract infections and Malaria, which results from a relatively defective immune status, remain the major causes of death among children with severe acute malnutrition. This study was carried out to find out co-morbidities such as infections and micronutrient deficiencies in children with severe acute malnutrition. Methods: In this hospital based descriptive type of observational study, 125 severe acute malnourished children were included. Patients undergo relevant investigation to find out associated infectious co morbidities. Micronutrient deficiencies assessed by clinical signs. Results: 42% had diarrhea and 27% had acute respiratory tract infections as co morbid condition. Tuberculosis was diagnosed in 13% of cases. Anemia was present in 86% cases. Signs of vitamin B and vitamin A deficiency were seen in 24% and 6% cases. 97% children have inadequate vitamin D levels. Conclusions: Timely identification and treatment of various co-morbidities is likely to break undernutrition-disease cycle, and to decrease mortality and improve outcome. Nearly all SAM patients have inadequacy of Vitamin D. So Vitamin D supplement should be given to all SAM patients.

Clinical Profile and Outcome of Children of Aged 6 -59 Months Admitted with Severe Acute Malnutrition at Medical College, Silchar, Assam

“…These findings are consistent with previous reports. 23 On analysis of outcome of SAM cases in this study, it is found that 54% recovered (wt gain >15% of admission wt) and 30% did not respond (wt gain < 10 gm/kg/day) to treatment. Average weight gain and mean duration of hospital stay were 7.5 gm/kg/day and 10.28 ± 5.84 days.…”

Comorbidities of Child Malnutrition in Low and Medium Income Countries : A Systematic Review

“…This will make it easier for the children to be treated, which will ultimately lead to improved results. Garg, 2017 13 India Cross sectional study 125 severe acute malnourished If several co-morbidities are identified and treated in a timely manner, it is conceivable that the cycle of undernutrition and disease can be broken, leading to a reduction in mortality and an improvement in outcome. Patients with SAM almost universally have insufficient levels of vitamin D. Therefore, a vitamin D supplement must to be administered to each and every SAM sufferer.…”

“…Garg, et al (2017) 13 conducted a study with 125 children. They showed 42% of those with this condition also had diarrhoea, and 27% of those with this condition also had acute respiratory tract infections.…”

Anemia in Severe Acute Malnutrition: Ten Steps of Management Need to be Fine-Tuned

“…These include pneumonia, acute diarrhea/ gastroenteritis, sepsis and anemia. In recent studies on hospitalized children with SAM, pneumonia occurred in 27.8 to 39%, diarrhea in 26.5 to 61% while anemia was observed in 73.5% to 90% [6][7][8][9][10]. True, all grades of anemia do not lead to immediate threat of life, which complications such as pneumonia or gastroenteritis will pose.…”