Abstract
Background: Severe acute malnutrition (SAM) is the main contributing factor for under-five morbidity and mortality. Nutritional Rehabilitation Centre (NRC) provides a protocol based management of SAM based on the guidelines laid down by the World Health Organization (WHO). The NRC model not only envisages the short term aim to reduce mortality due to SAM but with a community linkage and effective follow up, it is aimed at a comprehensive and long term improvement in quality of life in undernourished children. The NRC at Jorhat Medical College can serve as a model for hospital based management of SAM in our state.
Aims of the Study: To study the clinical profile of children with severe acute malnutrition admitted to the Nutritional Rehabilitation Centre of a teaching hospital of upper Assam.
Materials and Methods: Retrospective study based on review of case records of children between age group of 6months up to 5 years with Severe Acute Malnutrition (SAM) admitted in NRC, Department of Pediatrics, Jorhat Medical College between 1st April 2016 to 31st March 2017.
Results: Out of the total of 150 SAM children admitted in the NRC, 128(85.3%) were from the tea garden community. Majority of SAM (n=52, 34.7%) presented in the second year of life. The mode of referral of cases to NRC was by the physician (n=59, 39.3%) and Anganwadi worker (n= 42, 28%) followed by self referral, ASHA worker and others like NGOs. Fever, cough, feeding problems and loose motion were the chief presenting complaints; Urinary tract infection was the most common co-morbidity (22.7%). The mean duration of stay was 10 days. 13.3% of cases showed satisfactory weight gain of more than 10gm/kg/day while majority had moderate weight gain.
Conclusion: Hospital based management of SAM children in NRC is a significant step in reducing morbidity and mortality among undernourished children. However, there is a need to improve the quality of care and ensure satisfactory follow up with active involvement of the community stake holders.
Keywords: Nutritional Rehabilitation Centre, SAM, weight for height, MUAC.
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Corresponding Author
Manab Narayan Baruah
Department of Pediatrics, Jorhat Medical College, Jorhat, Assam, India-785001
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