scholarly journals Acute Malnutrition in Children: Pathophysiology, Clinical Effects and Treatment

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2413 ◽  
Author(s):  
Valeria Dipasquale ◽  
Ugo Cucinotta ◽  
Claudio Romano
Keyword(s):  
Protein Intake ◽  
Social Economic ◽  
Severe Acute Malnutrition ◽  
Underlying Disease ◽  
Nutrient Loss ◽  
Acute Malnutrition ◽  
Household Food Security ◽  
Clinical Effects ◽  
Household Food ◽  
Inadequate Food Supply

Acute malnutrition is a nutritional deficiency resulting from either inadequate energy or protein intake. Children with primary acute malnutrition are common in developing countries as a result of inadequate food supply caused by social, economic, and environmental factors. Secondary acute malnutrition is usually due to an underlying disease causing abnormal nutrient loss, increased energy expenditure, or decreased food intake. Acute malnutrition leads to biochemical changes based on metabolic, hormonal, and glucoregulatory mechanisms. Most children with primary acute malnutrition can be managed at home with nutrition-specific interventions (i.e., counseling of parents, ensuring household food security, etc.). In case of severe acute malnutrition and complications, inpatient treatment is recommended. Secondary acute malnutrition should be managed by treating the underlying cause.

scholarly journals Severe acute malnutrition and its associated factors among children under-five years: a facility-based cross-sectional study

2020 ◽  
Author(s):  
Umesh Ghimire ◽  
Binod Kumar Aryal ◽  
Ankush Kumar Gupta ◽  
Suman Sapkota Sapkota
Keyword(s):  
Odds Ratio ◽  
Food Access ◽  
Adjusted Odds Ratio ◽  
Severe Acute Malnutrition ◽  
Cross Sectional Study ◽  
Acute Malnutrition ◽  
Sectional Study ◽  
Cross Sectional ◽  
Household Food ◽  
Nutritional Status Of Children

Abstract Background: Despite consistent efforts to enhance child nutrition, poor nutritional status of children continues to be a major public health problem in Nepal. This study identified the predictors of severe acute malnutrition (SAM) among children aged 6-59 months in the two districts of Nepal. Methods: We used data from a cross-sectional study conducted among 6 to 59 months children admitted to the Outpatient Therapeutic Care Centres (OTCC). The nutritional status of children was assessed using mid-upper arm circumference (MUAC) measurement. To determine which variables predict the occurrence of SAM, adjusted odds ratio was computed using multivariate logistic regression and p-value <0.05 was considered as significant. Results: Out of 398 children, 5.8 percent were severely malnourished and the higher percentage of female children were malnourished. Multivariate analysis showed that severe acute malnutrition was significantly associated with family size (five or more members) (Adjusted Odds Ratio [AOR]: 3.96; 95% Confidence Interval [CI]: 1.23 - 12.71). Children from severely food insecure households (AOR: 4.04; 95% CI: 1.88-10.53) were four times more likely to be severely malnourished. Higher odds of SAM were found among younger age-group (AOR: 12.10; 95% CI: 2.06 - 71.09) children (0 - 12 vs. 24 - 59 months). . Conclusions: The findings of this study indicated that household size, household food access, and the child’s age were the major predictors of severe acute malnutrition. Engaging poor families in kitchen gardening to ensure household food access and nutritious diet to the children, along with health education and promotion to the mothers of young children are therefore recommended to reduce child undernutrition.

scholarly journals Determinants of Severe Acute Malnutrition Among Under 5 Children in Satar Community of Jhapa, Nepal

2020 ◽  
Author(s):  
Kajol Dahal ◽  
Deepak Kumar Yadav ◽  
Dharanidhar Baral ◽  
Birendra Kumar Yadav
Keyword(s):  
Logistic Regression ◽  
Food Insecurity ◽  
Breast Feeding ◽  
Severe Acute Malnutrition ◽  
Economic Status ◽  
Acute Malnutrition ◽  
Anthropometric Measurement ◽  
Household Food Insecurity ◽  
Household Food ◽  
Marginalized Community

Abstract Background: Severe acute malnutrition is the most extreme and visible form of undernutrition plagued by chronic poverty, household food insecurity, lack of education. One of the indigenous and marginalized community of Nepal, Satar/Santhal has often been neglected and is devoid of good education and are economically deprived. This predisposes under 5 children of Satar into malnutrition. The study aims to assess determinants of SAM among children under 5 years of age in Satar community of Jhapa district, Nepal. Material & Methods: A community based matched case control study was carried from September 2019 to February 2020 among under five children of Satar community residing in Jhapa district. Multistage random sampling technique was used to select 50 cases and 100 controls in the ratio of 1:2. Information was collected through personal interview with the parents and anthropometric measurement of the children was measured. Bivariate and multivariate conditional logistic regression analysis was to explore the determinants of severe acute malnutrition. Results: A total of 664 children between the age group of 6 – 59 months were screened for SAM. The prevalence of SAM was found 7.53%. Factors like, low economic status, birth interval less than 2 years, frequency of breast feeding <8 times/day and household food insecurity were found to be significant determinants of SAM. Multivariate logistic regression documented low economic status (AOR: 11.14, 95% CI 1.42 to 87.46); and frequency of breast feeding <8 times/day (AOR: 2.09, 95% CI 1.00 to 4.37) as determinants of SAM. Conclusion: Low economic status and frequency of breast feeding less than 8times/day were major determinants of SAM among children under 5yrs of age. Ending malnutrition will require greater efforts and integrated approaches to eradicate extreme poverty. Multi-sector approaches have been conducting for SAM in Nepal but there are no specific approaches for marginalized community.

scholarly journals Determinants of severe acute malnutrition among under 5 children in Satar community of Jhapa, Nepal

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245151
Author(s):  
Kajol Dahal ◽  
Deepak Kumar Yadav ◽  
Dharanidhar Baral ◽  
Birendra Kumar Yadav
Keyword(s):  
Logistic Regression ◽  
Food Insecurity ◽  
Breast Feeding ◽  
Severe Acute Malnutrition ◽  
Economic Status ◽  
Acute Malnutrition ◽  
Anthropometric Measurement ◽  
Household Food Insecurity ◽  
Household Food ◽  
Marginalized Community

Background Severe acute malnutrition (SAM) is the most extreme and visible form of undernutrition plagued by chronic poverty, household food insecurity, lack of education. One of the indigenous and marginalized community of Nepal, Satar/Santhal has often been neglected and is devoid of good education and are economically deprived. This predisposes under 5 children of Satar into malnutrition. The study aims to assess determinants of SAM among children under 5 years of age in Satar community of Jhapa district, Nepal. Material & methods A community based matched case control study was carried from September 2019 to February 2020 among under five children of Satar community residing in Jhapa district. Multistage random sampling technique was used to select 50 cases and 100 controls in the ratio of 1:2. Information was collected through personal interview with the parents and anthropometric measurement of the children was measured. Bivariate and multivariate conditional logistic regression analysis was used to explore the determinants of severe acute malnutrition. Results A total of 664 children between the age group of 6–59 months were screened for SAM. The prevalence of SAM was found 7.53%. Factors like, low economic status, birth interval less than 2 years, frequency of breast feeding <8 times/day and household food insecurity were found to be significant determinants of SAM. Multivariate logistic regression documented low economic status (AOR: 11.14, 95% CI 1.42 to 87.46); and frequency of breast feeding <8 times/day (AOR: 2.09, 95% CI 1.00 to 4.37) as determinants of SAM. Conclusion Low economic status and frequency of breast feeding less than 8times/day were major determinants of SAM among children under 5yrs of age. Ending malnutrition will require greater efforts and integrated approaches to eradicate extreme poverty. Multi-sector approaches have been conducting for SAM in Nepal but there are no specific approaches for marginalized community.

scholarly journals Household Food Security, Nutritional Intake, and Nutritional Status of Pregnant Women in the Central Tapanuli Regency

2021 ◽  
Vol 9 (E) ◽  
pp. 1560-1564
Author(s):  
Etti Sudaryati ◽  
Fikarwin Zuska ◽  
Herta Masthalina
Keyword(s):  
Food Security ◽  
Nutritional Status ◽  
Pregnant Women ◽  
Significant Relationship ◽  
Protein Intake ◽  
Nutrient Intake ◽  
Household Food Security ◽  
Household Food ◽  
Food Security Status ◽  
Low Levels

BACKGROUND: Malnutrition that occurs during pregnancy can result in inadequate household food security so that it will affect the baby to be born. AIM: This study aims to determine household food security, nutrient intake, and nutritional status of pregnant women in the Central Tapanuli Regency. METHODS: This research is part of the DRPM research with the title of improving the nutrition of pregnant women and the success of breastfeeding immediately after birth through strengthening household food security in the Central Tapanuli Regency. The stages of this research are to identify the level of household food security and nutrient intake as well as the nutritional status of pregnant women. The study was conducted using observation and interviews as well as measuring LILA, examination of Hb levels, and iodine levels in the urine of 131 pregnant women purposively in eight districts of the Central Tapanuli. RESULTS: The household food security of status that is food insecure is 18.3%. The nutritional status of pregnant women with anemia was 58.7% and those with SEZ were 19.1% fiber with the low levels of iodine in the urine as much as 63.9%. Adequate intake of energy nutrients is 42% and sufficient protein is 38.9%. There was a significant relationship between food security status and energy intake (p = 0.000; OR = 53.9) and protein intake (p = 0.004; OR = 4.1). CONCLUSIONS: There is a significant relationship between household food security status with energy and protein intake of pregnant women. Increased consumption of foods containing animal protein is recommended for pregnant women related to household food insecurity.

scholarly journals Time to Recovery and Determinants of Uncomplicated Severe Acute Malnutrition Among 6–59 Months Children From the Outpatient Therapeutic Feeding Program in North Shewa Zone of Oromia Region, Ethiopia. A Prospective Follow-Up Study.

2021 ◽  
Author(s):  
Amare Bekalu Taye ◽  
Degemu Sahlu Asebe ◽  
Addisu Walelign Tadesse
Keyword(s):  
Food Security ◽  
Median Time ◽  
Acute Malnutrition ◽  
Household Food Security ◽  
Health Post ◽  
Follow Up Study ◽  
Household Food ◽  
Correct Dose ◽  
Food Security Status

Abstract Introduction: Community-based management of acute malnutrition is implementing in Ethiopia. But there is scarce information in our study set up regarding the time to recovery and its predictors of SAM among 6-59 months children, so this study aimed to assess the time to recovery and its predictors of uncomplicated SAM among 6-59children managed at the OTP in north Shewa zone, Ethiopia.Methods: A health post-based prospective follow-up study had conducted on 6-59months children from November 20/2020 – February 20/2021. A total of 423 children had included in the study. A structured interviewer-administered questionnaire had used. The median time to recovery had calculated using the Kaplan Meier (KM) curve. The predictors of time to recovery were determined using both bi-variable and multi-variable Cox regression models with a 95% confidence interval (CI). Finally, the variable that had a p-value < 0.05 in the multi-variable analysis was declared as the predictors of time to recovery. Proportional hazard assumption was checked graphically and using Schoenfeld residual test.Result: From the total 423 Children, 327 (77.3%) recovered. The median time to recovery was 42 + IQR of 14 days. Children from food secure households; AHR= 9.6 with 95% CI (8.1-18.5), mild food insecure; AHR= 6.5 with 95% CI (3.1, 13.8), moderate food insecure; AHR= 2.5 with 95% CI (1.2-5.3). Mothers who traveled less than 2 hours walking distance to the health post; AHR=2.6 with 95% CI (1.8-18.7). Children who received the correct dose of the RUTF AHR=1.6 with 95% CI (1.1-2.3), children who measured their weight weekly AHR= 1.5 with 95% CI (1.1-2.0), and children treated by health extension worker who took the Nutrition-related training AHR= 2.1 with 95% CI (1.0-4.5) were predictors of time to recovery. Conclusion and recommendation: The median time to recovery was within the acceptable range of the Ethiopian protocol for the management of uncomplicated SAM in the Outpatient setup. Household food security status, the distance between home and health posts, the correct dose of RUTF, weekly weight measurement per protocol, and HEWs nutrition-related training status were the significant predictors of time to recovery. It is advisable to improve the household food security status, and the Health extension worker's (HEWs) nutrition-related training.

scholarly journals Severe acute malnutrition and its associated factors among under-five children in two districts of Nepal

2020 ◽  
Author(s):  
Umesh Ghimire ◽  
Binod Kumar Aryal ◽  
Ankush Kumar Gupta ◽  
Suman Sapkota Sapkota
Keyword(s):  
Nutritional Status ◽  
Odds Ratio ◽  
Associated Factors ◽  
Food Access ◽  
Adjusted Odds Ratio ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Major Public Health Problem ◽  
Household Food ◽  
Nutritional Status Of Children

Abstract Background: Despite consistent efforts to enhance nutritional child nutrition, poor nutritional status of children continues to be a major public health problem in Nepal. This study identified the predictors of severe acute malnutrition (SAM) among children aged 6-59 months in the two districts of Nepal. Methods: We used data from a cross-sectional study conducted among mothers of 6 to 59 months children admitted to the Outpatient Therapeutic Centres (OTCs). The nutritional status of 398 children was assessed using mid-upper arm circumference (MUAC) measurement. To evaluate associated factors with SAM, adjusted odds ratio was computed using multivariate logistic regression and p-value <0.05 was considered as statistically significant. Results: Among 398 children, 5.8 percent were found to be severely malnourished including under-two years and female children. Family size (five or more members) (Adjusted Odds Ratio [AOR]: 3.96; 95% Confidence Interval [CI]: 1.23 - 12.71) was positively associated with SAM. Children from severely food insecure households (AOR: 4.04; 95% CI: 1.88-10.53) were four times more likely to be severely malnourished. Younger age-group (AOR: 12.10; 95% CI: 2.06 - 71.09) children (0 - 12 vs. 24 - 59 months) were significantly associated with childhood undernutrition. Conclusions: The findings of this study indicated that household size, household food access, and child’s age were the major predictors of severe acute malnutrition. Hence, nutrition health programs should be targeted to improve the nutritional status of children by ensuring household food access by focusing poor families engaging them in kitchen gardening to promote nutritious diet to the children.

scholarly journals Severe acute malnutrition and its associated factors among children under-five years: a facility-based cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Umesh Ghimire ◽  
Binod Kumar Aryal ◽  
Ankush Kumar Gupta ◽  
Suman Sapkota
Keyword(s):  
Odds Ratio ◽  
Food Access ◽  
Adjusted Odds Ratio ◽  
Severe Acute Malnutrition ◽  
Cross Sectional Study ◽  
Acute Malnutrition ◽  
Sectional Study ◽  
Cross Sectional ◽  
Household Food ◽  
Nutritional Status Of Children

Abstract Background Despite consistent efforts to enhance child nutrition, poor nutritional status of children continues to be a major public health problem in Nepal. This study identified the predictors of severe acute malnutrition (SAM) among children aged 6 to 59 months in the two districts of Nepal. Methods We used data from a cross-sectional study conducted among 6 to 59 months children admitted to the Outpatient Therapeutic Care Centers (OTCC). The nutritional status of children was assessed using mid-upper arm circumference (MUAC) measurement. To determine which variables predict the occurrence of SAM, adjusted odds ratio was computed using multivariate logistic regression and p-value < 0.05 was considered as significant. Results Out of 398 children, 5.8% were severely malnourished and the higher percentage of female children were malnourished. Multivariate analysis showed that severe acute malnutrition was significantly associated with family size (five or more members) (Adjusted Odds Ratio [AOR]: 3.96; 95% Confidence Interval [CI]: 1.23–12.71). Children from severely food insecure households (AOR: 4.04; 95% CI: 1.88–10.53) were four times more likely to be severely malnourished. Higher odds of SAM were found among younger age-group (AOR: 12.10; 95% CI: 2.06–71.09) children (0–12 vs. 24–59 months). Conclusions The findings of this study indicated that household size, household food access, and the child’s age were the major predictors of severe acute malnutrition. Engaging poor families in kitchen gardening to ensure household food access and nutritious diet to the children, along with health education and promotion to the mothers of young children are therefore recommended to reduce child undernutrition.

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