Spotlighting risk factors for severe acute malnutrition under 5 years: a case control study

Abstract

Objective: Malnutrition remains one of the most common causes of morbidity and mortality among children throughout the world. W.H.O. has defined Severe and Moderate acute Malnutrition (SAM, MAM) as per specific criteria and there are specific guidelines for better inpatient management of SAM children. Unfortunately, there is not much literature on modifiable risk factors which not only govern the causation but have large impact on prognosis. This study is an attempt to understand and prioritize modifiable risk factors in SAM.

Methods: This is a prospective observational case control study with 200 subjects conducted at a tertiary care hospital after taking written informed consent. A total of 100 cases were enrolled who were children between 6months to 59 months with severe acute malnutrition (diagnosed as per WHO criteria). The 100 controls chosen were age matched children with weight for height >-2SD admitted for other causes. Data regarding birth, maternal education, feeding practices, socio-demographic parameters, immunization, past illnesses and detailed anthropometric measurements were compared by statistical analysis using SPSS package (version 17.0).

Result: A total of 100 cases and 100 controls were enrolled. Out of which 65% cases were below 2 years and 59% of controls were between 2-5years. The study showed that following variables had independent association with severe acute malnutrition: age <2years, low birth weight, birth order >3, younger age of mother at conception, prelacteal feeds, top feeds, delayed initiation of complementary feeds, and partial immunization.

Conclusion: The present study helps to identify significant risk factors associated with severe acute malnutrition which can be of help in deciding preventive measures, management and policy making in future.