Study of Anaemia in Children with Severe Acute Malnutrition

Abstract

Introduction: Severe anaemia is a leading cause of paediatric morbidity, hospitalization, and mortality and it is very important co morbidity in children with severe acute malnutrition. Severe Acute Malnutrition (SAM) with anaemia has been shown to have 2.62 times higher mortality as compared to SAM with no anaemia. So this study was done to evaluate this co-morbidity further. The aim of present study was to determine the prevalence and type of anaemia and to evaluate the possible aetiologies of anaemia in severe acute malnourished (SAM) children.Material and Methods: In tertiary care hospital a cross sectional study was conducted over a period of 8 month with 100 cases of SAM children and 101 cases of normal children. In both cases disorders of primary haematological problem were excluded. Auto analysers were used to measure blood counts. Blood smear was analysed by pathology consultant of institute and recorded for all patients with anaemia. Grade of anaemia and morphologic type of anaemia was analysed. Data were entered in Excel spreadsheets and analysed using SPSS 20.0.Results: Patient with SAM 42% had moderate anaemia and 19% had severe anaemia in contrast 41.6% and 16.8% in NON SAM child respectively. Predominant morphologic type in SAM patient was macrocytic anaemia (33%), while in controls microcytic anaemia (40.6%) was more prevalent.Conclusion: There was a high prevalence of anaemia in SAM children. Major morphologic type in SAM children was macrocytic anaemia which may indirectly show vitamin B12 or folic acid deficiency in these children.

To study the prevalence and types of nutritional anemia in under-five children with severe acute malnutrition

“…Dwivedi et al reported 100 cases of SAM, of which 62% were males and 38% were females. The mean age of the children was 15.85 months [12]. Thus, majority of children were <2 years of age as seen in our study.…”

“…Anemia, if not diagnosed and treated may become severe which is a leading cause of pediatric morbidity, hospitalization, and mortality. It has been seen that SAM with anemia shows higher mortality as compared to without anemia [12]. We found that prevalence of anemia was 95% in SAM children.…”

“…In the study by Jain et al, 24.3% had severe anemia, 49.8% children had moderate anemia, and 26.8% had mild anemia [13]. In a study by Dwivedi et al, the majority of SAM children had moderate anemia (42%) with mild anemia in 24% and severe anemia in only 19% patients and 15% children were without anemia [12]. In contrast, Thakur et al found that a majority (67.3%) had severe anemia; and 13.8% had moderate anemia [15].…”

“…In normocytic anemia, no deficiency is shown in Table 3. Anemia among children between 6 and 59 months is still a major social and medical problem [12]. Anemia, if not diagnosed and treated may become severe which is a leading cause of pediatric morbidity, hospitalization, and mortality.…”

“…A total of 56.3% of the children were anemic in 2015-2016; 1.5% children were severely anemic, 27.6% were moderate, and 27.2% were mildly anemic [8]. Dwivedi et al recorded a prevalence rate of 85% in a city in Madhya Pradesh [12]. Jain et al, in their study, found that the prevalence of anemia was 59.9% in 137 children of age 1-2 years in urban slums of Meerut [13].…”