A study of clinical profile and outcome of SAM children admitted in nutritional rehabilitation centre, Patna Medical College and Hospital, Patna, Bihar, India

Abstract

Background: Severe Acute malnutrition (SAM) with severe wasting remains a major killer of children. In Bihar 48% of children are stunted, 21 % are wasted and 7% are severely wasted. Even during the first six months of life, 31% are wasted. Under nutrition generally decreases with the increasing mother’s schooling, better nutritional status of the mother. Stunting and under nutrition are higher in rural areas than in urban areas.Methods: It is a hospital based observational study done between June 2017 to December 2017. A total of 55 SAM patients with medical complications in the age group of 6 months to 60 months admitted in Nutritional Rehabilitation center (NRC), Department of Pediatrics, Patna Medical College, Patna were included in the study. Socio-Economic profile, effectiveness of NRC in treating SAM children, and effect of timely initiation of complementary feed on nutritional status of children were assessed.Results: A total of 55 children were admitted in the NRC of PMCH, Patna during the period of June 2017 to Dec 2017. 56.4% were males and 43.6% were females. 36% o were in the age group of 12months to 24months. 78% belonged to below poverty line. Major medical complications were anemia (53%), LRTI (33%) and acute gastroenteritis (29%). Immunisation was complete in only 45%. In only 53% babies Complimentary feeding was initiated after 6 months of age. 67% of the mothers of SAM children were illiterate. 95% children were discharged after gaining proper weight. Defaulter rate was 4% and death rate was 2%. 78% of the admitted children showed good weight gain i.e.>10 gm/kg/day, whereas in 15% children weight gain was in the range of 5-10 gm/kg/day.Conclusions: Many factors such as literacy, income, age of marriage and sanitation facility indirectly or directly influence the nutritional status of children. NRCs provide life-saving care for children with SAM as demonstrated by the high recovery rate (95%).