RESUMO
Background: About half of the under five children are malnourished in India and so is morbidity associated with it. Malnutrition is also associated with multiple vitamin deficiency one of which is vitamin B12. Vitamin B12 is essential for DNA, RNA and protein synthesis; and for myelination of brain during the early childhood period. Deficiency of vitamin B12 can lead to megaloblastic anemia and neurological problems. So, authors aimed to look prevalence of vitamin B12 deficiency and; its hematological and neurological effects in severe acute malnourished children.Methods: it was an observational case control study, in which severe acute malnourished (SAM) children aged 0- 59 months who were admitted in Nutritional Rehabilitation Centre (NRC) were enrolled. Vitamin B12 levels were estimated and levels <200 pg/ml, 200-350 pg/ml, and >350 pg/ml were considered deficient, insufficiency and sufficient. Complete blood count was done for hematological effects and; developmental assessment was done to look for neurological effects.Results: Vitamin B12 was deficient, insufficient, normal in 15(16.3%), 25 (27.5%) and 52 (56.5%) children respectively. Vitamin B12 deficiency was significantly associated with hyperpigmentation and glossitis. Infant and young child feeding practices were not associated vitamin B12 deficiency. Macrocytic anemia was found in 23.4% SAM children and macrocytosis was not significantly associated with vitamin B12 deficiency.' Developmental delay was found in 55.3 % children and was not significantly associated with severe acute malnutrition.'Conclusions: There is high prevalence of Vitamin B12 deficiency and insufficiency in children with severe acute malnourished children. Macrocytic anemia and developmental delay are not significantly associated with vitamin B12 deficiency.
RESUMO
Background: The life cycle dynamics of the causes and consequences of malnutrition demand a holistic and all inclusive approach to prevent and treat under-nutrition and nutritional deficiencies. In response, Government of Gujarat launched “Mission Balam Sukham” in the year 2012 which focuses on both preventive and curative aspects. Curative aspect consist of three tier approach for integrated management of malnutrition at three different levels. Nutritional rehabilitation Center is a unit in a district health facility where children with severe acute malnutrition are admitted and provided with the nutritional & therapeutic care. Methods: Analysis of data of all the children admitted to Nutritional Rehabilitation Centre of Surendranagar district from June-2012 to November 2013. Statistical analysis was done using SPSS. Results: A total of 280 children were included in the study. The overall mean weight at admission was found 8.30 kg with standard deviation of 2.09 kg and the mean weight at the time of discharge was 8.97 kg with standard deviation of 2.16 kg. Average weight gain among 141 boys was 6.63 g/kg/day and among girls was found 7.60 g/kg/day. Out of total 280 children, 103 (36.79%) children had weight gain as per the standard criteria (8 gm/kg/day). Diarrhoea was found to be the associated medical condition in majority of the children. Out of total 184 children without medical complications, 97 (52.72%) children had weight gain as per the standard criteria. Conclusions: Present study reflected that Nutritional Rehabilitation Centers have been playing a key role to cope with malnutrition as demonstrated by high weight gain rate as well as high recovery rate.
RESUMO
Objective: To study the output indicators of a nutritional rehabilitation center to assess its performance. Methods: Data of 182 children aged between 6-59 months with severe acute malnutrition in a nutritional rehabilitation center were analyzed retrospectively. Identification and treatment of severe acute malnutrition was done according to World Health Organization recommendations. Results: The recovery rate, death rate, defaulter rate, mean (SD) weight gain and mean (SD) duration of stay in the nutritional rehabilitation center were 68%, 2.2%, 4.4%, 13.0 (9.0) g/kg/d, 12.7 (6.8) days, respectively. Conclusion: Nutritional rehabilitation centers are effective in management of severe malnutrition.