International Journal of Contemporary Pediatrics | July-September 2016 | Vol 3 | Issue 3 Page 954
International Journal of Contemporary Pediatrics
Suman RL et al. Int J Contemp Pediatr. 2016 Aug;3(3):954-959
http://www.ijpediatrics.com
pISSN 2349-3283 | eISSN 2349-3291
Research Article
Clinico-laboratory profile and outcome of edematous severe acute
malnutrition in children aged 6 months to 5 years
Rameshwar Lal Suman*, Bharat Lal Sharma, Pradeep Meena, Neeraj Kumar
INTRODUCTION
Globally malnutrition is the underlying cause of about 5.6
million of 10 million child deaths per year, with severe
malnutrition contributing to about 1.5 million of these
deaths. The nutritional status of children is the best
indicator of the wellbeing of children.
1
According to National Family Health Survey-3, in India,
43% children under 5 years of age are underweight (low
weight for age), 48% children under 5 years of age are
stunted (low height for age) and 20% children under 5
years of age are wasted (low weight for height); 6.4% of
these children are severely wasted (<-3SD).Since wasting
denotes acute malnutrition, these children are said to have
severe acute malnutrition or SAM. The median case
fatality rate in children under 5 years is approximately
23.5% in SAM, which may reach 50% in edematous
malnutrition.
2
According to NFHS -3, 20% of children
under 3 years of age in Rajasthan are wasted, 34%
stunted and 44% are underweight.
3
ABSTRACT
Background: Malnutrition is still rampant in India. There are so many cases of edematous malnutrition present in
Rajasthan. So we planned to study the Clinico-Laboratory profile And Outcome of Edematous Severe Acute
Malnutrition in children aged 6 months to 5 years.
Methods: An observational hospital based prospective study was conducted at Malnutrition Treatment Center
(MTC), Bal Chikitsalya, RNT Medical College, Udaipur, Rajasthan, India from July 2015 to Dec 2015. We enrolled
total 50 SAM children aged 6 Months to 5 years having nutritional edema with medical complications. All the
enrolled cases were hospitalized, acute complications were treated and nutritional rehabilitation by WHO feeding
protocol was done. Clinical, laboratory parameters and outcome of E-SAM were analyzed.
Results: A total of 50 children were studied. Mean age of children was 16.54±11.05 months, 52.0% were male and
48.0% were female children, Majority of them were under <-3SD and <-4SD z-score (48.0%) followed by <-2SD and
in <-1SD z-score (32.0%). Onset of edema reduction occurs on 3.22±0.91day, complete disappearance of edema
occurs in 10.02±2.80 days, mean weight fall was 0.91±0.31% per day, mean length of stay in hospital was 14.93
±4.10 days. Mean weight gain was 14.18±5.42 gm/kg/day and case fatality rate was nil. All these outcomes except
weight gain were significantly associated with grade of edema (p value <.05).
Conclusions: Majority of the patients they were in WHO z-score of <-3SD and <-4SD z-score but extremes are also
occurring up to <-8SD z-score Pneumonia and tuberculosis are the affected co morbidities for outcome of E-SAM
children. Disappearance of edema, and length of stay are little bit longer than usual WHO guideline recommendations
and they had a significant association with grade of edema. Percentage of wt. fall also had association with grade of
edema.
Keywords: Edematous severe acute malnutrition, Malnutrition treatment center, Nutritional rehabilitation, WHO
feeding protocol
Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India
Received: 26 April 2016
Accepted: 04 June 2016
*Correspondence:
Dr. Rameshwar Lal Suman,
E-mail: sumanrl@yahoo.co.in
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20162372