Severe acute malnutrition morphological patterns in children under five.
Ontology highlight
ABSTRACT:
SUBMITTER: Medialdea L
PROVIDER: S-EPMC7895927 | biostudies-literature | 2021 Feb
REPOSITORIES: biostudies-literature
Publications
Severe acute malnutrition morphological patterns in children under five.
Medialdea Laura L Bogin Barry B Thiam Mbeugue M Vargas Antonio A Marrodán María D MD Dossou Nicole I NI
Scientific reports 20210219 1
Current methods for infant and child nutritional assessment rely on anthropometric measurements, whose implementation faces technical challenges in low- and middle-income countries. Anthropometry is also limited to linear measurements, ignoring important body shape information related to health. This work proposes the use of 2D geometric morphometric techniques applied to a sample of Senegalese participants aged 6-59 months with an optimal nutritional condition or with severe acute malnutrition ...[more]
Similar Datasets
Project description:BackgroundSevere acute malnutrition (SAM) affects about 13 million under-five children (U5), with an estimated one million dying every year. In this study we aimed at determining the in hospital mortality and its associated factors among U5s admitted with SAM.MethodsThis was a prospective cohort study of children 6 months to 5 years with SAM admitted at Mbarara Regional Referral Hospital (MRRH) between June and August 2015. Care-takers were interviewed to collect socio-demographic and clinical information. Children under-went physical examination and had blood drawn for HIV, serum glucose, malaria, full blood count, culture and serum electrolytes investigation. Children were managed according to WHO treatment guidelines for SAM. All participants were followed up for a maximum period of 30 days. The proportion of U5 deaths within the first 48 hours and during the entire admission period was calculated. Using Poisson regression analysis, predictors of in-hospital mortality were analyzed with STATA/IC 11.0.ResultsWe enrolled 122 children, median age of 15 months [IQR:11-24], 58.2% males, 90% immunized, 81% ill for more than 2 weeks before admission, 71% from lower health facilities and majority with unknown HIV status(76%). Overall, 13 (10.7%) children died in hospital. Seven (5.7%) died within the first 48 hours. Intravenous (IV) fluid administration significantly predicted in-hospital mortality (adjusted IRR: 7.2, 95%CI: 2.14-24.08, p = 0.001).ConclusionThe in-hospital mortality in U5s with SAM was lower than that previously reported in central Uganda. Intravenous fluid administration significantly predicted overall in-hospital mortality. While Administration of intravenous fluids is still the main stay of managing severely malnourished children with shock, more research needs to be conducted in order to review the parameters presently used to assess children for shock with a view of diagnosing and managing shock in these children when it is still early. Adequate guidance on use of IV fluids in management of severely malnourished children should be prioritized during continuous medical education for healthcare workers and in the treatment guidelines.
| S-EPMC7319331 | biostudies-literature
Project description:BACKGROUND:Despite consistent efforts to enhance child nutrition, poor nutritional status of children continues to be a major public health problem in Nepal. This study identified the predictors of severe acute malnutrition (SAM) among children aged 6 to 59?months in the two districts of Nepal. METHODS:We used data from a cross-sectional study conducted among 6 to 59?months children admitted to the Outpatient Therapeutic Care Centers (OTCC). The nutritional status of children was assessed using mid-upper arm circumference (MUAC) measurement. To determine which variables predict the occurrence of SAM, adjusted odds ratio was computed using multivariate logistic regression and p-value <?0.05 was considered as significant. RESULTS:Out of 398 children, 5.8% were severely malnourished and the higher percentage of female children were malnourished. Multivariate analysis showed that severe acute malnutrition was significantly associated with family size (five or more members) (Adjusted Odds Ratio [AOR]: 3.96; 95% Confidence Interval [CI]: 1.23-12.71). Children from severely food insecure households (AOR: 4.04; 95% CI: 1.88-10.53) were four times more likely to be severely malnourished. Higher odds of SAM were found among younger age-group (AOR: 12.10; 95% CI: 2.06-71.09) children (0-12 vs. 24-59?months). CONCLUSIONS:The findings of this study indicated that household size, household food access, and the child's age were the major predictors of severe acute malnutrition. Engaging poor families in kitchen gardening to ensure household food access and nutritious diet to the children, along with health education and promotion to the mothers of young children are therefore recommended to reduce child undernutrition.
| S-EPMC7249365 | biostudies-literature
Project description:BackgroundDespite consistent efforts to reduce child undernutrition, severe acute malnutrition (SAM) continues to be a serious obstacle to child survival and development in Ethiopia. This study aimed to identify severe acute malnutrition and associated factors among children aged 6-59 months in Ethiopia.MethodsA cross-sectional study was undertaken with 384 under-five children from February to March, 2020 in Ethiopia. A mid-upper arm circumference (MUAC) tape, weight scale, height board (standing) and recumbent length measurements (for children <24 months) were measured. To determine the variables associated with SAM, adjusted odds ratio was computed using multivariable analysis and p < 0.05 was declared as significant.ResultsThe prevalence of acute undernutrition was 26%; 18% and 8% of the children were moderately and severely undernourished, respectively. Family size (≥5 members) (AOR: 3.71, 95% CI: 1.55-8.89), younger age group (6-11 months) (AOR: 4.80, 95% CI: 1.61-14.31) and history of diarrhea in the two weeks prior to the survey (AOR: 5.36, 95% CI: 1.97-14.61) were independently associated with SAM in the study population.ConclusionLarge family size, child age, diarrheal and household insecurity were important determinants of SAM among children. Therefore, aligning social protection programmes and improving health related interventions along with improving optimal breastfeeding, prevention and control of child morbidity, and strengthening family planning services are recommended to reduce child SAM.
| S-EPMC9529577 | biostudies-literature
Project description:BackgroundGlobally, approximately 19 million children under 5 years are suffering from Severe Acute Malnutrition (SAM). It is a major cause of morbidity and mortality in low-income countries including Ethiopia. However, little is known regarding predictors of mortality among these children in Ethiopia. The current study aimed to assess the potential predictors of mortality among under-five children with SAM admitted to a stabilization center.MethodA retrospective cohort study was conducted in 527 under-five children who were admitted for SAM at the University of Gondar comprehensive specialized hospital from 2014 to 2016. Data were collected from a randomly selected chart after getting ethical clearance. Data were cleaned, coded and entered to Epi-info (version 7) and analyzed using STATA (version14). The outcome was computed by using tables and graphs. A multivariable cox proportional hazards model was fitted to identify predictors of mortality.ResultOverall, the median follow-up period was 10 days with interquartile range (Q1, Q3: 8, 17). At the end of the follow-up, the mortality rate was 66(12.52%). Anemia (AHR(Adjusted Hazard Ratio): 2.3, 95% CI: 1.2, 4.5), Shock (AHR: 7.9, 95% CI: 3.7, 16.7), no intake of antibiotics (AHR: 2.3 95% CI: 1.2, 4.4), IV-Fluid (AHR: 3.2, 95% CI: 1.7, 5.8), no intake of F75 (AHR: 6.6,95% CI: 2.9, 14.7) and no intake of F100 (AHR: 3, 95% CI: 1.6, 5.4) were independent predictors of mortality.ConclusionThe survival status of under-five children with SAM was lower than the national standard protocol. Altered general conditions such as shock, anemia, not adhering to medical and nutritional therapies were identified as predictors of mortality among SAM children. Health education on early medical seeking behavior and adherence on the routine regimens may improve this gap in child survival.
| S-EPMC6158814 | biostudies-literature
Project description:BackgroundSevere acute malnutrition (SAM) poses a significant threat to child health globally, particularly in low- and middle-income countries. Zambia, like many Sub-Saharan African nations, faces high rates of child malnutrition, with SAM contributing significantly to under-five mortality. Therefore, this study aimed to determine the prevalence and factors associated with SAM.MethodsThis retrospective cross-sectional study was conducted at Livingstone University Teaching Hospital in Zambia (LUTH). SAM was defined according to the World Health Organization (WHO) criteria as either weight-for-height less than -3 standard deviations, mid-upper arm circumference (MUAC) less than 115 mm, or presence of bilateral pitting edema in children between 6 months and 5 years old who were attended to between 2020 and 2022. Data abstraction from pediatric patient records was conducted between August 2023 and January 2024. The records without the age and outcome variable were excluded. A total of 429 participants between 6 months and 5 years old were included, with demographic, clinical, and hematological parameters analyzed. Univariable and multivariable logistic regression were employed to investigate factors associated with SAM.ResultsOverall, 429 medical records were included in the study and the prevalence of SAM was 27.0% (n = 116). Age group 6-24 months (Adjusted Odds Ratio [AOR]: 11.60; 95% Confidence Interval [CI]: 3.34-40.89, p<0.001), living with HIV (AOR:3.90; 95% CI: 1.14-13.70, p = 0.034), Tuberculosis (TB) (AOR:22.30, 95% CI: 4.53, 110.3, p < 0.001), comorbidities (AOR: 2.50; 95% CI 1.13, 5.88, p = 0.024) and platelet count (AOR: 1.00; 95% CI 1.00, 1.00, p = 0.027) were positively associated with SAM.ConclusionsThis study found a high prevalence of SAM, exceeding the WHO target of reducing SAM to 5% by 2025. SAM was associated with younger age (6-24 months), HIV infection, TB, comorbidities and platelet count. Therefore, there is need to enhance strategies aimed at reducing SAM among young children, children living with HIV, TB and comorbidities, particularly by intensive treatment, continuing and strengthening nutrition services.
| S-EPMC11346641 | biostudies-literature
Project description:Background:Severe acute malnutrition is one of the major public health problems in developing countries having a devastating effect on the lives of many children under 5 years of age. In Ethiopia, there has been isolated studies conducted on malnutrition with no study attempting to identify the determinants of severe acute malnutrition in the rural district of Enebsie Sarmidr.This study intends to identify the determinants of severe acute malnutrition in rural district located in North West Ethiopia. Methods:A Community based un matched case -control study was carried on 311 (64 cases and 247 controls) children aged between birth-59 months with their respective mothers or care takers from March 1-30/ 2016. Odds Ratio along with 95% confidence interval was estimated to identify determinants of severe acute malnutrition using the multivariable logistic regression. Results:The response rate was 97.8%. Severe acute malnutrition was significantly associated with age groups birth-24 months (AOR?=?2.64, 95% CI 1.17-5.95), late initiation of breast feeding greater than an hour after birth (AOR?=?4.26, 95% CI 1.74-10.42), nonexclusive breast feeding (AOR =5.81, 95% CI 1.80-18.79), diarrheal disease in the preceding 2 weeks before SAM (AOR?=?7.98, 95% CI 2.57-24.74), febrile illnesses preceding 2 weeks before SAM (AOR?=?2.87 95% CI 1.13-7.63), decreased or maintained mealing of the mother compared to the regular during pregnancy or lactation (AOR?=?8.15, 95% CI 3.70-17.98) and birth interval less than 2 years (AOR?=?3.34, 95% CI 1.55-7.20) after controlling other variables effect. Conclusion:A child's age, late initiation of breast feeding, nonexclusive breast feeding, diarrheal diseases and febrile illnesses preceding 2 weeks before SAM, decreased or maintained mealing compared to the regular during pregnancy and lactating of the mother and narrow birth interval were identified as determinants of SAM. Therefore, collaborative efforts are needed to improve promotion of better child caring practices specifically, child and maternal feeding practices and prevention and treatment of acute illnesses.
| S-EPMC7050716 | biostudies-literature
Project description:BackgroundSevere forms of malnutrition have drastic effects on childhood morbidity and mortality in sub-Saharan countries, including Ethiopia. Although few studies have previously estimated treatment outcomes of severe acute malnutrition (SAM) in Ethiopia, the findings were widely varied and inconsistent. This study thus aimed to pool estimates of treatment outcomes and identify predictors of mortality among children with SAM in Ethiopia.MethodsA systematic review was carried out to select 21 eligible articles from identified 1013 studies (dating from 2000 to 2018) that estimated treatment outcomes and predictors of mortality among SAM children. Databases including PubMed, CINHAL, Web of Sciences; Cochrane, Psych INFO and Google Scholar were comprehensively reviewed using medical subject headings (MESH) and a priori set criteria PRISMA guideline was used to systematically review and meta-analyze eligible studies. Details of sample size, magnitude of effect sizes, including Hazard Ratio (HRs) and standard errors were extracted. Random-effects model was used to calculate pooled estimates in Stata/se version-14. Cochran's Q, I2, and meta-bias statistics were assessed for heterogeneity and Egger's test for publication bias.ResultTwenty-one studies were included in the final analysis, which comprised 8057 under-five children with SAM in Ethiopia. The pooled estimates of treatment outcomes, in terms of death, recovery, defaulter and transfer out and non-response rates were 10.3% (95% CI: 8.3, 12.3), 70.5% (95% CI: 65.7, 72.2), 13.8% (95% CI: 10.8, 16.9) and 5.1% (95% CI: 3.3, 6.9), respectively. Diarrhea (HR: 1.5, 95% CI: 1.1, 2.2), dehydration (HR: 3.1, 95% CI: 2.3, 4.2) and anemia (HR: 2.2, 95% CI: 1.5, 3.3) were statistically significant predictors of mortality among these children. No publication bias was detected.ConclusionTreatment outcomes in under-five children with SAM are lower than the World Health Organization (WHO) standard, where mortality is being predicted by comorbidities at admission. Children with SAM need to be treated for diarrhea, dehydration and anemia at the primary point of care to reduce mortality.
| S-EPMC6712890 | biostudies-literature
Project description:BACKGROUND:Low- and Middle-Income Countries (LMIC) have remained plagued with the burden of severe acute malnutrition (SAM). The decomposition of the educational inequalities in SAM across individual, household and neighbourhood characteristics in LMIC has not been explored. This study aims to decompose educational-related inequalities in the development of SAM among under-five children in LMIC and identify the risk factors that contribute to the inequalities. METHODS:We pooled successive secondary data from the Demographic and Health Survey conducted between 2010 and 2018 in 51 LMIC. We analysed data of 532,680 under-five children nested within 55,823 neighbourhoods. Severe acute malnutrition was the outcome variable while the literacy status of mothers was the main exposure variable. The explanatory variables cut across the individual-, household- and neighbourhood-level factors of the mother-child pair. Oaxaca-Blinder decomposition method was used at p?=?0.05. RESULTS:The proportion of children whose mothers were not educated ranged from 0.1% in Armenia and Kyrgyz Republic to as much as 86.1% in Niger. The overall prevalence of SAM in the group of children whose mothers had no education was 5.8% compared with 4.2% among those whose mothers were educated, this varied within each country. Fourteen countries (Cameroon(p <?0.001), Chad(p <?0.001), Comoro(p =?0.047), Burkina Faso(p <?0.001), Ethiopia(p <?0.001), India(p <?0.001), Kenya(p <?0.001), Mozambique(p =?0.012), Namibia(p =?0.001), Nigeria(p <?0.001), Pakistan(p <?0.001), Senegal(p =?0.003), Togo(p =?0.013), and Timor Leste(p <?0.001) had statistically significant pro-illiterate inequality while no country showed statistically significant pro-literate inequality. We found significant differences in SAM prevalence across child's age (p?<?0.001), child's sex(p?<?0.001), maternal age(p?=?0.001), household wealth quintile(p?=?0.001), mother's access to media(p?=?0.001), birth weight(p?<?0.001) and neighbourhood socioeconomic status disadvantage(p?<?0.001). On the average, neighbourhood socioeconomic status disadvantage, location of residence were the most important factors in most countries. Other contributors to the explanation of educational inequalities are birth weight, maternal age and toilet type. CONCLUSIONS:SAM is prevalent in most LMIC with wide educational inequalities explained by individual, household and community-level factors. Promotion of women education should be strengthened as better education among women will close the gaps and reduce the burden of SAM generally. We recommend further studies of other determinate causes of inequalities in severe acute malnutrition in LMIC.
| S-EPMC7183681 | biostudies-literature
Project description:BackgroundIn India, under-five children with Severe Acute Malnutrition (SAM) are referred to Nutritional Rehabilitation Centers (NRCs). NRCs screen the causes of SAM including tuberculosis (TB). The national TB programme recommends upfront testing with a rapid molecular test if TB is suspected in children.ObjectiveWe estimated the yield of and adherence to the TB diagnostic guidelines (clinical assessment and assessment for microbiological confirmation) among under-five children with SAM admitted at NRCs (six in district Sagar and four in district Sheopur) of Madhya Pradesh, India in 2017. We also explored the challenges in screening from the health care providers' perspective.MethodsIt was an explanatory mixed method study. The NRC records were reviewed This was followed by three key informant interviews and three focus group discussions among staff of NRC and TB programme. Manual descriptive thematic analysis was performed.ResultsOf 3230, a total of 2665(83%) children underwent Mantoux test, 2438(75%) underwent physical examination, 2277(70%) were asked about the symptoms suggestive of TB, 1220(38%) underwent chest radiograph and 485(15%) were asked for recent contact with TB. A total of 547(17%) underwent assessment for microbiological confirmation. Of 547, a total of 229 gastric aspirate specimens underwent rapid molecular test (24% positive) and 318 underwent sputum microscopy (44% positive). A total of 223 were diagnosed as TB (195 microbiologically and 28 clinically confirmed) and 209 were initiated on anti-TB treatment. The treatment outcome was favourable (cure or treatment completed) for 70(31%) and not recorded for 121(54%). The main perceived challenges in screening for TB were poor team skills, lack of diagnostic facilities and poor understanding of the guidelines due to inadequate training.ConclusionThough NRCs provided a unique window of opportunity for the screening and management of TB among under-five children with SAM, the utilization of this opportunity remained suboptimal.
| S-EPMC7954324 | biostudies-literature
Project description:IntroductionWith growing attention globally to the childhood tuberculosis epidemic after decades of neglect, and with the burden of severe acute malnutrition (SAM) remaining unacceptably high worldwide, the collision of these two diseases is an important focus for improving child health.Areas coveredThis review describes the clinical and public health implications of the interplay between tuberculosis and SAM, particularly for children under the age of five, and identifies priority areas for improved programmatic implementation and future research. We reviewed the literature on PubMed and other evidence known to the authors published until August 2021 relevant to this topic.Expert opinionTo achieve the World Health Organization's goal of eliminating deaths from childhood tuberculosis and to improve the abysmal outcomes for children with SAM, further research is needed to 1) better understand the epidemiologic connections between child tuberculosis and SAM, 2) improve case finding of tuberculosis in children with SAM, 3) assess unique treatment considerations for tuberculosis when children also have SAM, and 4) ensure tuberculosis and SAM are strongly addressed in decentralized, integrated models of providing primary healthcare to children.
| S-EPMC9280657 | biostudies-literature