Abstract

Background: India has one of the highest number of severely malnourished children in the world. It is estimated that around 93.4 lakh children are having severe acute malnutrition (SAM) as per National Family Health Survey (NFHS) 4 and out of this, 10 per cent of SAM with medical complications may require admission to Nutrition rehabilitation centre (NRC). In Odisha, despite laudable progress in reducing child under nutrition between the last two rounds of the NFHS survey (1998-99 and 2005-06; child underweight declining from 54% to 44% respectively) and at a faster rate than the national average, there has been little change in SAM children. While no national level survey data have been made available since the NFHS-3 (2005/6), many independent assessments report note that malnutrition levels in the state remain stubbornly high. Severe acute malnutrition (SAM) continues to be an important cause of mortality. Critical care, management of infections, nutritional therapy followed by nutritional rehabilitation is a very important aspect for these children. The present study was, therefore, undertaken to evaluate incidence and clinical profile of patients admitted with severe acute malnutrition in Odisha.

Objective: To assess the clinical profile of SAM among children aged 1–59 months in the NRC of a District Headquater Hospital (DHH), Berhampur

Materials and Method: A hospital based prospective study was carried out from- 1-12-2016 to 30.11.2017. A total of 223 children who were admitted to NRC were  enrolled in this study and their data was compared and evaluated.        

Results: Out of the 223 enrolled in the study, 54.3% were female.63.4% were in the age group of 7-24 months.48.4% belonged to schedule cast.55% of the children stayed between 7-15 days. The most common co-morbid condition was anemia (94%) followed by pneumonia or other ARIs (28%). Out of these 84% had z score < -3 SD. The recovery rate was 85%.Mean duration of stay was 14 days. Cure rate was 85%.Defaulter rate was 7%.Average weight gain was 12gms/kg/day. Follow up rates were 72%.

Conclusions:  With cure rate of 85% and no deaths, NRCs provide live-saving care for children with SAM as demonstrated by the high survival rates of the program. Community-based therapeutic care for children with uncomplicated SAM needs to become a key component of the continuum of care for children with SAM. 

Keywords: NRC, Outcome, Severe acute malnutrition.