Prevalence of malnutrition and proportion of anaemia among the malnourished children aged 1-5 years in a rural tertiary care centre, South India

Abstract

Background: PEM is a disease of multiple deprivations and poverty, affecting nearly 150 million children under the age of five years in the world. Out of the 120 million children in India, over 75 million are estimated to suffer from visible PEM, which is indeed a matter of great concern. Numerous studies have been conducted time to time to know the prevalence of malnutrition, in order to target the at risk population so that effective intervention programmes can be implemented. To fight against malnutrition and PEM, we have to identify the malnourished so as to develop a target based intervention. For that, anthropometry provides the single most portable, universally applicable, inexpensive and non-invasive technique for assessing the size, proportions and composition of the human body.

Methods: A cross sectional study was done among 400 children aged 1-5 years who attended OPD, based on systematic random selection. Socio economic profile of the subjects and anthropometric values were taken by trained staff and the measured values were compared with WHO reference values and classified as underweight, stunted, thin or having wasting as per different classifications. The data was analyzed using the statistical software, SPSS version 20.

Results: Among the 400 children, 31% of the children were identified as underweight by IAP classification. Stunting was identified in 28.8% of the children. As per weight for height criteria, 27% of children were identified as having wasting. Thinness according to BMI classification was identified in 38% children. The sex wise difference in PEM and in stunting was not statistically significant. In this study 41.1% of the underweight children had anemia, 46.1% of the children who were stunted were having anemia and among the children who were having wasting, 37% of them were having anemia.  

Conclusions: The study revealed that high percentage of children aged 1-5 years were malnourished, inspite of a very high rate of literacy, employment status, vaccination and health care facilities in Kerala and has shown the relevance of anthropometry in identifying the malnourished children from population. The conventional use of underweight (low weight for age) instead of z score as the sole criterion for identifying undernourished children may underestimate the true incidence of severe undernutrition in a community, so further research has to be done in to sort out the appropriate   reference system for Indian population.