ABSTRACT
Background: Indicators showing levels of nutritional status in children are often regarded as representative of the health and general well-being of a society at large. Malnutrition stands as a consequence of several key social and economic factors such as lack of education, inadequate health care services and ill-informed cultural behaviors.' In order to holistically address the issues surrounding malnutrition, a comprehensive understanding of the multi-dimensional complexities at play in society is crucial. Objective was to identify determinants of severe acute malnutrition among children with severe acute malnutrition under 5 years (between 6 months to 60 months) of age. Methods: A cross sectional study design involving 64 patients with severe acute malnutrition between 6 to 60 month of age was employed to identify the risk factors of severe acute malnutrition among children admitted in pediatric wards and nutritional rehabilitation centers, Civil hospital Ahmedabad, from April 2018 to march 2019. A detailed history of all the patients were taken and data collected using structured interviewer-administered questionnaire.Results: Thus, from the above study, it is clear' that age of the child <2 years, female gender, bigger family size, poverty, illiteracy in mother, poor feeding practices, improper complementary feed introduction, poor nutritional status of mother whose child were breastfed, acute or chronic illness in child and narrow birth spacing were the chief determinants of SAM in under five children.Conclusions: Socio demographic characters, nutrition and child caring practices, infection and other childhood illness as well as obstetric history of mother are important determinants of severe acute malnutrition in children under five years of age. As a result, collaborative efforts should be organized to improve promotion of better child caring practices through appropriate age specific child and maternal feeding practices, prevention and early treatment of acute childhood illnesses and promotion of family planning.
ABSTRACT
Background: Several sick neonates require transfer to tertiary level care neonatal unit for treatment. The facilities of neonatal transport in India are not optimal and the newborn thus transported can become hypothermic, hypoxic and/or hypoglycemic which can affect the neonatal outcome. These parameters can be maintained during transport by adopting simple measures. The aim and objective of this study is to study impact of acute physiological parameters during transfer of neonates on their immediate outcome by using TOPS score. TOPS score - Temperature, Oxygenation, Perfusion (Assessed by capillary refill time), Blood sugar.Methods: This prospective observational study was conducted at the special newborn care unit, Civil Hospital, Ahmedabad enrolling 460 transported neonates. TOPS scoring for each neonate was done at admission, and then the parameters of the TOPS score were correlated with the outcome at 48 h of admission.Results: A total of 460 transported newborns were assessed, 47.8% newborns were hypothermic, 33.9% had poor perfusion, 27.8% were hypoxemic, and 22% were hypoglycemic. On correlating with the outcome, Hypoxemia and hypo perfusion had the highest sensitivity (92.2% and 57.3%, respectively) while hypoglycemia had the highest specificity (88%), for an adverse outcome.Conclusions: TOPS score is a useful and easy to use the method to assess the physiological status and predict early mortality in transported neonates.