SCREENING OF UNDER FIVE CHILDREN TO IDENTIFY MALNOURISHMENT: NEED OF TODAY
Introduction: Malnutrition is one of the leading causes of morbidity and mortality in children under the age of 5 years in developing country like India. Severe acute malnutrition (SAM) remains a major health problem to children, as the mortality rates among SAM children are 9 fold higher than those in well-nourished children. In India there are about 57 million undernourished children according to National Family Health Survey (NFHS)-3. About 5 million children die every year due to the direct or indirect influence of malnutrition and the prevalence of severe underweight, and severe stunting among children in India is 16% and 24%, respectively. SAM needs to be prevented and treated effectively if the United Nations Millennium Development Goals of reducing children malnutrition and mortality by 50% by 2015 are to be met. Material and Methods: Retrospective study is done from outpatient Department of Paediatrics at New civil hospital surat from January 2017 to October 2019.Measurements of height, length, weight and MUAC, assessment of visible severe wasting and bipedal edema was carried out. Weight was measured using digital weighing scale. In children ≥24 months, height was measured using Wall Mounted Stadiometer to the last completed 0.1 cm, and in children <24 months of age, length was measured using infantometer up to 0.1 cm. MUAC tape was used for measurement of MUAC (>6 months of age) up to 0.1 cm. The children having weight for height/length Z score < −3 SD and/or MUAC < 115 mm (6–59 months) and/or bilateral pedal oedema (other causes ruled out) were classified as SAM as per Government of India (GOI) guidelines. Results: Complete anthropometric measurements were done on 11166 children of which 1624 (50.2%) were male and 1613 (49.8%) were female. 549 (4.92%) SAM patients were observed of which 266 (48.5%) were male and 283(51.5%) were female. No significant difference was observed in the distribution of male and female SAM patients with MUAC being 7.09± 2.56 cm. No significant seasonal variation in SAM was observed in all three years. Conclusion: Prevalence of SAM was 4.92%. Both MUAC and Z-scoring showed fair degree of agreement to diagnose SAM among children aged 6-59 months.
Keywords: SAM, MUAC, Z score