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Association of severe acute malnutrition with infections in under-five children admitted to Nutritional Rehabilitation Center—study from central India

Yogesh Shukla, Pratibha Verma, Rajesh Tiwari, Pradeep Kumar Kasar, Shashi Prabha Tomar.


Background: Infectious disease is the foremost reason of illness and death in developing countries, especially in children with severe acute malnutrition (SAM). Protein energy malnutrition is the basic reason for the heightened vulnerability to infections that can lead to a vicious cycle.

Objective: To study the association of SAM with infection, cause of delay in admission, and action taken by health worker in under-five children admitted to Nutritional Rehabilitation Center (NRC).

Materials and Methods: This was a case–control study design conducted at Nutritional Rehabilitation Center of NSCB Medical College, Jabalpur, Madhya Pradesh, India, and neighbourhood control subjects were selected from affected community. The X2-test, Student’s t-test, and qualitative analysis were done for data analysis using SPSS software, version 17.

Result: A total of 700 subjects were taken for the study, of which 350 were severely malnourished children and 350 well-nourished control subjects. Severe malnourished children on an average present most commonly with fever (2.8 episodes, 11 days in last 3 months), followed by diarrhea (2.7 episodes, 10 days illness in last 3 months) and acute respiratory infection (ARI) (1.6 episodes, 7 days illness in last 3 months). There is a significant difference in illness owing to fever, diarrhea, and ARI between the severe malnourished children and normal nourished children. The average time between identification of child as severe malnourished and their admission was 4.38 months. The most important cause of delay in admission to NRC was because no information regarding NRC was given by health worker in early stage of disease, care of other sibling, and work at home in severe malnourished children.

Conclusion: There is strong association of SAM and infections. SAM and infections should be treated urgently to decrease morbidity and mortality.

Key words: Severe acute malnutrition (SAM), childhood infections, Nutritional Rehabilitation Center (NRC)

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