INFLUENCE OF RISK FACTORS ON MALNUTRITION, IN CHILDREN OF ONE TO FIVE YEARS AGE GROUP: A CASE CONTROL STUDY

Shaji SM; Vidya; Lalitha Kailas

Volume : IX, Issue : VII, July - 2019

INFLUENCE OF RISK FACTORS ON MALNUTRITION, IN CHILDREN OF ONE TO FIVE YEARS AGE GROUP: A CASE CONTROL STUDY

Shaji Sm, Vidya, Lalitha Kailas

Abstract :

Introduction: Malnutrition is a global health problem and an estimated forty per cent of the world‘s severely malnourished under 5 children lives in India. The causes and impact of childhood under nutrition are complex and manifold..In developing countries, particularly where the population is high, hunger and malnutrition are wide spread among the preschool age children .Failure to combat child malnutrition of preschool age reduces potential economic growth of the country because major growth and development domains get matured during this period and failure to attain full potential. The extent of malnutrition can be countered by educating the parents and care takers with respect to basic nutritional requirements of their children and encouraging them to consume locally available low cost nutritious foods. Methodology:. This case control study conducted at a tertiary level teaching hospital in rural setting for a period of 1year from April 2014 to March 2015. Among 200 children enrolled the 100 cases of undernourished children were matched for age and sex with 100 well nourished control group between the age of 1 to 5years attending nutrition clinic of the hospital.. Instituitional Ethical committee approved the study and written Informed consent was obtained from parents. The diagnosis of protein energy malnutrition was made according to the Indian Academy of Paediatrics (IAP) classification. The weight for age of the control group had to be greater than 80% of the standard without oedema.Those children with severe illness were excluded from this study. A thorough history including, socioeconomic status, feeding pattern, including east feeding and Complementary feeding, nutritional assessment , history of recurrent respiratory tract infections was documented. The anthropometric measurements include height, weight, head circumference and mid–upper arm circumference were recorded. Protein Energy Malnutrition (PEM) based on weight for age (WFA) as per IAP classification for wasting; Height for Age (HFA) for stunting and Weight for Height (WFH) for wasting and obesity as per Waterlow’s classification were designed.The demographic and socioeconomic status were indended from ration card. The calorie intake was calculated by 24 hour recall method. Questionnaire based detail collection of data was recorded in excel sheet and was analyzed using Statistical software (SSPS) and interpreted to find out the relevant association, and was expressed as frequency, percentage tables, charts and figures. Results: Out of the 100 cases studied, 61% were females and 39% were males 70% were born by normal deliveries and 30% by LSCS. 83% belonged to APL class and 17% belonged to BPL. History of IUGR 10 were among cases and 3 were among the controls. 40% had a low birth weight of <2500gms and 60% had birth weight >2500g ,while among the controls studied only 17% had low birth weight and 83% had birth weight>2500g ,67% had grade 1 underweight,28% had grade 2 underweight and 2% had grade 3 under weight. There were none with grade 4 underweight .50% had normal height for age while38% had 1st degree stunting and 12% had 2nd degree stunting. Significant difference between the mean calorie gap and protein gap of cases and controls.10% had no wasting 51%had 1st degree wasting and 35% had grade 2 wasting and 4% had grade3 wasting. Mean MAC of cases were 14.659 and that of the control group was 13.962.This difference was statistically was significant [p value.000]. After doing logistic regression, female sex was found to be a significant risk factor[p value.004] and mothers education above 10th standard[p value.041] and birth weight above 2500g[p value .001] were found to be significant protective factor for malnutrition Conclusion: Female sex, low birth weight, inadequate calorie and protein intake and, low maternal education were found to be significant risk factors of childhood malnutrition. Low socio economic status, preterm birth, exclusive east feeding did not seem to have a significant influence on nutrition status