Risk factors for severe acute malnutrition among children aged 6–59 months: A community-based case-control study from Vellore, Southern India

Abstract

Background: Malnutrition plays an important role in the economic burden of society as well as the country. This study aimed to identify the various risk factors and determinants of severe acute malnutrition (SAM) as defined by WHO growth reference standards in children aged 6 months to 59 months living in Vellore. Methods: A community-based case-control study matched for age (±2months), gender and location was done among the children of the age group 6- 59 months residing in both rural and urban Vellore. Children of age group 6-59 months with SAM according to WHO definition, i.e., weight for height of less than -3SD with or without nutritional oedema were classified as cases. Children with weight-for-height z-score more than -1 SD and MUAC ≥13.5cms were classified as controls. With 2 controls per case, the required sample size was 54 cases and 108 controls. A questionnaire used to identify the risk factors including dietary intake. Uni-variate and multivariate analysis was done to generate an odds ratio and 95% confidence interval for the risk factors. Results: Majority of the cases 64.8% and 50% of the controls belonged to low SES. After adjusting all confounders, Severe Acute Malnutrition was significantly associated with birth weight <2.499kg [AOR- 8.95 (95% CI: 2.98-26.85)], not exclusively breastfed for 6 months [AOR 4.67 (95% CI: 1.72-12.65)], inadequate calorie intake [AOR 8.09 (95% CI: 3.15-20.82)] and mother being underweight [AOR 6.87 (95% CI: 1.92-24.55)]. Conclusion: Programs should be implemented to reduce the poor nutritional status of young girls and women in the reproductive age group. The importance of exclusive breastfeeding for the first six months, the time of weaning and appropriate feeding practice for the child should be emphasized to postnatal mothers during their hospital visits.

Analysis of Risk and Prognostic Factors in a Population of Pediatric Patients Hospitalized for Acute Malnutrition at the Chiulo Hospital, Angola

“…Among the family risk factors, age, educational level and BMI of the mother, according to our data, do not seem to be signi cantly associated with childhood malnutrition, although the small number of samples does not allow us to exclude a correlation, which has instead been demonstrated in other studies (7,25).…”

Analysis of risk and prognostic factors in a population of pediatric patients hospitalized for acute malnutrition at the Chiulo hospital, Angola

“…Among the family risk factors, age, educational level and BMI of the mother, according to our data, do not seem to be significantly associated with childhood malnutrition, although the small number of samples does not allow us to exclude a correlation, which has instead been demonstrated in other studies [ 7 , 25 ].…”

Assessment of nutritional status of children (12-36 months of age) in urban area of district Rohtak, Haryana: a cross-sectional study

“…Similar studies by Hasan et al in Bangladesh, Dabar et al in South Delhi, David et al in Vellore and Inkane et al in Nagpur have shown that children of mothers with secondary or higher education were at lower risk of childhood malnutrition when compared with children of mothers with no education. [11][12][13] While taking children birth weight into consideration, it was observed in present study that wasting, stunting and underweight were higher among children who had history of LBW as compared to children with normal birth weight, which is found to be statistically significant (p<0.01). This is due to the fact that, as birth order of child increases, the care given to them decreases, because mothers will have to take care of more number of children, which will have a negative impact on their nutritional status.…”

“…Similar findings were observed in the studies conducted by David et al in Vellore, Basit et al in Udupi and Priyanka et al in Maharashtra. [13][14][15][16] In present study children with higher birth order (three or more) or children belonging to a family size of three or more, had higher prevalence of wasting, stunting and underweight. Similar findings were observed in studies of Dabar et al in South Delhi and Gladius et al in Tamil Nadu, where higher birth order was significantly associated with malnutrition.…”