torent young scholar award

1. P value < 0.01 (SIGNIFICANT)
INTRODUCTION
RISK FACTORS FOR SEVERE ACUTE
MALNUTRITION - A CASE CONTROL STUDY
Dr.JAGAN MOHAN VARAKALA,
Affiliation with NRC Government civil hospital
METHODS
0
10
20
30
40
50
60
70
< 1hr 1-4
hr
>4hr
TIME OF BREAST FEED
INITIATION VS SAM
cases
controls
0
20
40
60
80
<6 m 6m
EXCLUSIVE BREAST
FEEDING VS SAM 79
21
0
20
70
10
0
10
20
30
40
50
60
70
80
90
UL IV LM III UM II
cases
contro
SOCIO ECONOMIC CLASS
VS SAM
INCLUSION CRITERIA
CASES: 100 children of age 6 m to 59 m with severe
acute malnutrition as per WHO definition, admitted in
NRC ward, district civil hospital ,karimnagar.
CONTROLS :100 children of age 6 m to 59m with
normal nutritional status admitted with other medical
ailment in pediatric wards of Prathima hospital.
EXCLUSION CRITERIA
Children of age Less than 6 months, more than 5years.
SAM children who are sick and admitted in ICU
Children whose parents have not given consent
METHODOLOGY
Detailed nutrition and socioeconomic history is taken
in both the groups using a predesigned proforma to
study the risk factors of malnutrition Modified
kuppuswamy scale is used for scoring socioeconomic
class.
MATERNAL
LITERACY VS SAM
24
7
69
6 10
84
0
20
40
60
80
100
illiterate primary higher
cases
controls
Severe Acute Malnutrition is defined as weight for
height less than -3SD and/or visible severe wasting
and/or edema of both feet (excluding other causes of
edema), mid arm circumference less than 11.5 cm
among 6m- 59m children.
Globally, 17.3 million children, or 2.6% of the pre-
school aged children, were severely wasted in 2012 .
With a national prevalence of severe wasting of 6.8%,
or approximately 8.4 million children, India is home to
about half the total wasted.
According to National Family Health Survey (NFHS)
III there are nearly 57 million undernourished children
in India which is 1/3 of the world’s share .
Chi square value 12 , P value < 0.01
(SIGNIFICANT)
BOTTLE FEED VS SAM
53
47
14
86
0
20
40
60
80
100
yes noP value < 0.01 (SIGNIFICANT
COLSTRUM VS
SAM
62
38
88
12
0
20
40
60
80
100
Given Not givenP value < 0.01 (SIGNIFICANT

2. REFERENCES
CONCLUSION/SUMMARY
1. Amsalu S, Tigabu Z. Risk factors for severe acute malnutrition in children under the age of five; A casecontrol study. Ethiop J Health Dev 2008;2
2. Risk factors for severe acute malnutrition in children under the age of five year in Sukkur Pak J Med Res , Vol 51, No 4,2012
3. Nahar B, Ahmed T, Brown KH, Iqbal H. Risk factors associated with severe underweight among young children reporting to a diarrhoea treatme
facility in Bangladesh. J Health Popul Nutr 2010;28:476-83.
4. Sharghi A, Kamran A, Faridan M. Evaluating risk factors for protein-energy malnutrition in children under the age of six years: a case-control
study from Iran. Int J Gen Med. 2011; 4: 607-611.
5. Dhatrak PP, Pitale S, Kasturwar NB, Nayse J, Relwani N. Prevalence and Epidemiological Determinants of Malnutrition among Under-Fives in a
Urban Slum, Nagpur. Natl J Community Med 2013; 4(1): 91-5.
6. World Health Organization multi-centre growth reference study group. World Health Organization. Geneva (2006). WHO child growth standards
•Inappropriate infant and young child feeding practices, poor maternal education and poor
socioeconomic status are identified as risk factors for severe acute malnutrition.
• There is a need to have a targeted approach to modify these risk factors.
•There is a need to strengthen feeding practices and improve the knowledge of parents or
caregivers regarding feeding methods.
This study shows statistically significant association between severe acute malnutrition and
feeding practices and socioeconomic class.
SAM is associated with delayed initiation of breast feeding with p value <0.01 , lack of colustrum
feeds with p value <0.01, lack of exclusive breast feeding for 6 m with p value < 0.01, dilution of
top feeds with p value 0.02, bottle feeds with p value <0.01, maternal illiteracy with p value
<0.01, low socioeconomic status with <0.01.
RESULTS