Title: Outcome of Severe Acute Malnutrition Management at a Tertiary Care Nutrition Rehabilitation Centre
Authors: Prakash Chandra Panda, Girtha Soren, Shradhananda Rout, Rupashree Behera
Background: Globally, 35.0% of the 7.6 million deaths among children under 5 can be attributed to nutrition-related factors and 4.4% to severe wasting. NFHS-4 India (2015-2016) show that the national prevalence of severe acute malnutrition (SAM) is 7.5 % in children below 5 years with 100 focus districts having high prevalence of malnutrition being situated in 6 states: Bihar, Jharkhand, Madhya Pradesh, Rajasthan, Odisha and Uttar Pradesh.
Objective: To evaluate the clinical and epidemiological profile of SAM children admitted to the NRC of VSSIMSAR, Burla.
Methodology: An observational analytical cross sectional hospital based study was conducted in the Nutritional Rehabilitation Centre (NRC) in Dept. of Pediatrics, VSSIMSAR, Burla from Jan 2016 to August 2018 after institutional ethics committee approval. Continuous data were analyzed in terms of mean or median and categorical data were analyzed by Fischer exact test. For all statistical purpose p < 0.05 was taken as significant. All the tests were done with SPSS v 23 (IBM, New York).
Result: Out of the 239 children, 189(79.1%) were discharged after variable durations of hospitalization, 8(3.3%) died and 42(17.5%) got defaulted. The mean age was 23.1±14.5 months with sex ratio= 0.97. Majority of families belonged to lower socio-economic status. The mean age of starting complementary feeding was 6.602 ± 0.909 months. Children with exclusive breast feed till 6 months of age (chi=10.275, p= 0.002) and with anorexia (chi=6.691, p <0.011) during presentation are more likely to recover. Pneumonia was the most prevalent disease complicating SAM followed closely by anorexia. The average duration of hospitalization was 15.75±5.53 days. No statistically significant difference was observed among the different age groups with respect to duration of stay at the centers (F=2.190, p=0.140). The mean MUAC at admission and discharged was observed to be statistically significant (t=10.930, p<0.001). Dropout rates of 9.89%, 23.07%, and 61.76% were obtained for the three follow-up visits conducted 15 days, 1 month and 2months from the day of discharge as per recommended guidelines.
Conclusion: NRC is extremely vital and is providing life-saving care for children as demonstrated by the high cure rates.
Keywords: Severe acute malnutrition, Nutrition rehabilitation centre