ABSTRACT
Background: Nearly half of all deaths in children under 5 are attributable to under nutrition. Under nutrition puts children at greater risk of dying from common infections, increases the frequency and severity of such infections, and contributes to delayed recovery. The WHO recommends the use of Z scores or standard deviation score (SDS) for evaluating anthropometry, so as to accurately classify individuals with indices below the extreme percentile. In India most paediatricians use IAP classification to classify malnutrition. The aim of the study is to assess the nutritional status of children between 6 months to 5 years of age attending tertiary rural hospital according to WHO criteria and to compare the result of this study with IAP classification for grading malnutrition. The objectives of the study is to assess the knowledge of mothers regarding feeding practices among these children particularly below 2 years of age and to observe associated clinical problems and state of other nutrient deficiencies. Materials and methods: A cross sectional and observational study of 200 children admitted in pediatric ward and NRC (nutritional rehabilitation centre) of Dhiraj Hospital were taken for the study, Piparia, Waghodia, Vadodara. Study was carried for a period of 18 months from April 2015 to September 2016 to assess the nutritional status of children according to WHO criteria and to compare it with IAP classification. Assessment of the nutritional status was done by clinical examination and anthropometry. Interrogation was done with children’s mothers in the language they understood regarding young children feeding practices and accordingly their knowledge was assessed. Data was compiled, categorized and analyzed by appropriate statistical method in consultation with a statistician. Pathak S, Yadav T, Joshi C, Sharma N, Gulabani S, Gandhi D. Study of nutritional assessment of children between 6 months to 5 years. IAIM, 2017; 4(2): 42-52. Page 43 Results: Total 200 patients were taken in the study. Result shows that out of 200 patients 108(54%) were males and 92(46%) were females. The distribution of patients was more in age group between 13 and 36 months with 86(43%), of which distribution of males more than females were. Distribution of patients according to SAM and MAM (WHO classification) shows 127(63.5 %) fall under SAM and73 (36.5%) fall under MAM. Distribution of patients according to SAM and MAM (WHO classification) was studied. Result shows that out of 200 children taken in the study 127(63.5 %) fall under SAM and73 (36.5%) fall under MAM according to WHO classification. Distribution of children according to IAP classification in the present study interprets that 103 (51.5%) of the total children came under grade II of IAP classification. WHO classification detected more children with malnutrition than IAP classification, which was true for both boys and girls. Comparison of MUAC (WHO) with WHO (SAM and MAM) of children taken in the present study interprets that 67 (33.5%) had SAM and 95 (47.5%) had MAM according to MUAC criteria, remaining 19% did not fall under SAM and MAM. Comparison of MUAC (SAM) with WHO (SAM) of children in present study interprets that only 67 (52.75%) children came under SAM according to MUAC criteria out of the 127 children of SAM according to WHO classification. Comparison of MUAC (WHO) and IAP classification of children in the present shows that 67 children had MUAC <11.5 cm, out of 67 children (with SAM according to MUAC criteria) 28 (41.79%) came under grade II and 21 (31.3 %) came under grade III of IAP classification. Out of 95 children (MUAC between 11.5 cm and 12.5 cm) 18 (18.94%) came under grade I and 58 (61.05%) came under grade II of IAP classification. Associated co morbidities among children in the present study shows that among 200 patient 152 (76%) had anaemia, 44 (22%) had diarrhoea, 14 (7%) had pedal oedema, 12 (6%) had vitamin A deficiency, 44 (22%) had URTI and 24 (12%) had LRTI. Knowledge Aptitude and Practice study was done among 50 mothers and the result shows that mothers had less knowledge regarding what to be given in complementary feed, importance of immunization, birth spacing interval, and danger signs indicating illness. Conclusion: The present study shows that WHO classification detected more children with malnutrition than IAP classification, which was true for both boys and girls. There was also disparity among results of WHO criteria IAP classification and MUAC classification. Single criteria can’t be justified in assessing malnutrition. KAP study reveals that mother’s knowledge is important in combating malnutrition