Published: 2020-04-24

Clinicoepidemiological and laboratory profile of children with severe acute malnutrition admitted to a tertiary care centre

Abdus Sami Bhat, Umer Amin Qureshi, Waseeqa Nigeen, Iram Bashir, Shagufta Khursheed


Background: Severe Acute Malnutrituon (SAM) is a form of malnutrition where there is an imminent threat of death to the child. The chances of complications are very high and in most case child requires hospitalization for stabilization and rehabiliatation. Objective of study the clinicoepidemiological and laboratory profile of children with severe acute malnutrition (SAM) admitted to a Nutritional Rehabilitation Centre (NRC) of our hospital.

Methods: A retrospective chart review of admitted patients. Nutritional Rehabilitation centre (NRC) at GB Pant Hospital Government Medical College Srinagar over a one year period between June 2017 and June 2018.

Results: Total of 187 patients of SAM was admitted in NRC during the study period. One hundred and eight (57.7%) were males and 79(42.3%) were females .Patients were equally among various districts. Infants (<12months) constituted the majority of admissions (54.5%). Marasmus was by far the commonest phenotype presenting as SAM (85.5%).Respiratory comorbidity was the commonest present in about  41 (26.3%) followed by daiarrhea in  32(20.5%). Delayed initiation of complimentary feeding was found in 75(40.1%) while early weaning was found in another 55 children (29.4%). Birth order more than three was present in 92 children (49%). Mother’s literacy status had a direct bearing on the prevalence of SAM. Most of the children were from rural background (75%).Most belonged to low economic and income class as around 65.2% had a very meager  family income.

Conclusions: SAM is more common in Infants and in children from rural background. It is highly associated with faulty feeding practices including lack of breast feeding and presence of mixed and faulty feeding. It is also associated with increasing birth order, low maternal education and low family income Pneumonia and diarrhea are leading comorbidities. Hypoglycemia and hypothermia are leading complications.  Marasmus is the commonest phenotype.


Complications, Risk factors, Severe acute malnutrition

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National Family Health Survey (NFHS) I Report (2015-2016). Infant feeding and child nutrition. Ministry of Health and Family Welfare India. Available at: Accessed 10 December 2019.

UNICEF, WHO, World Bank Group joint malnutrition estimates 2018 ed. Available at: Accessed 04 March 2020.

Pal I, Chaudhuri RN. Gender inequalities while rearing of children under 5 years in a rural area of West Bengal. Indian J Com Med. 2007;32:215-6.

National Nutrition Monitoring Bureau (NNMB). Diet and nutritional status of rural population, Technical report 21, India, 2002. Available at:‑web.pdf. Accessed 03 December 2019.

Sharma ML. A study of malnutrition and associated infectionin children in an urban private hospital in India. Malnutrition and Infection, 2001. Available at: http://www.capgan. org/malinf.htm. Accessed 03 December 2019.

Kumar D, Goel NK, Mittal PC, Misra P. Influence of infant-feeding practices on nutritional status of under-five children. Indian J Pediatr. 2006 May 1;73(5):417-21.

Deshpande JD, Giri PA, Phalke DB, Phalke VD, Kalakoti P, Syed M. Socio-cultural practices in relation to breast feeding, weaning and child rearing among Indian mothers and assessment of nutritional status of children under five in rural India. Australas Med J. 2010;3:618-24.

Harishankar, Dwivedi S, Dabral SB, Walia DK. Nutritional status of children under 6 years of age. Indian J Prev Soc Med. 2004;35:156-62.

Jha R, Gaiha R, Kulkarni VS. Child undernutrition in India. ASARC working paper, 2010. Available at: Accessed 16 October 2019.

Christian P. Maternal height and risk of child mortality and undernutrition. JAMA. 2010 Apr 21; 303(15):1539-40.