Estimation of serum folate and vitamin B12 levels in children with severe acute malnutrition

Anjana Murthy K.; Ashwini Malladad; Mallesh Kariyappa

doi:10.18203/2349-3291.ijcp20201512

Authors

Anjana Murthy K. Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
Ashwini Malladad Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
Mallesh Kariyappa Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20201512

Keywords:

Anemia, Folate deficiency, Severe acute malnutrition, Vitamin B12 deficiency

Abstract

Background: Severe acute malnutrition is the important health issue children affected in India. It is often associated with Iron, Vitamin B12 and Folic acid and other micronutrient deficiencies. These reports of declining trend of Iron and folic acid deficiency with implementation of national anemia control programme. Estimation of Serum Folate and Vitamin B12 levels in SAM children aged 6-60 months with anemia was the objective of the study.

Methods: A hospital based observational study on 80 children admitted to nutritional rehabilitation center were suffering from severe acute malnutrition (SAM) in the age group of 6-60 months enrolled in the study during the period November 2018 to May 2019 .Data was collected using a predesigned and pretested Proforma, containing details of feeding, socio-economic and development history. Blood samples were sent for measurement of plasma vitamin B12 and serum folate levels. Statistical analysis was done using SPSS version 20.0.

Results: Out of 80 children, majority were between the age group of 24-60 months and majority were boys (53.8%). Mean Vitamin B12 and folic acid levels being 384.61 and 8.95 respectively. 45% and 3.8% had vitamin B12 and folic acid deficiencies respectively. Majority of neurological changes and developmental delays were noted in B12 deficient group. Of the 36, B12 deficient children, majority had moderate anaemia (40.2%), normal total count (41.7%), 60% had neutropenia, 44.4% had lymphocytosis, majority had normocytic (30.9%) anemia.

Conclusions: There was a moderate to high prevalence of vitamin B12 deficiency among malnourished children. Folate deficiency was found only in few. Efforts should be directed to prevent its deficiency in pregnant and breastfeeding women and their infants with special attention on malnourished children.B12 and folate deficiency shall be considered in all cases with SAM irrespective of blood indices. Treatment will have impact on prognosis of child.

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References

Dalwai S, Choudhury P, Bavdekar SB, Dalal R, Kapil U, Dubey AP, et al. Indian academy of pediatrics. Consensus statement of the Indian academy of pediatrics on integrated management of severe acute malnutrition. Indian Pediatr. 2013;50:39-404.

Keerthiwansa J, Gajealan S, Sivaraja S, Subashini KY. Malnutrition and anaemia among hospitalised children in Vavuniya. Ceylon Med J. 2018 Apr 19;59(4).

Debnath DJ, Parulekar CV. Profile of under-five malnourished children admitted in a tertiary care teaching hospital in pune, India. Int J Prev Med 2014;5(7):882-6.

Devi RU, Krishnamurthy S, Bhat BV, Sahai A. Epidemiological and clinical profile of hospitalized children with moderate and severe acute malnutrition in South India. Indian J Pediatr 2015;82(6):504-10.

Kumar R, Singh J, Joshi K, Singh HP, Bijesh S. Comorbidities in hospitalized children with severe acute malnutrition. Ind Pediatr. 2014;51(2):125-7.

Yaikhomba T, Poswal L, Goyal S. Assessment of iron, folate and vitamin B12 status in severe acute malnutrition. Indian J Pediatr. 2015;82(6):511-4.

Girum T, Kote M, Tariku B, Bekele H. Survival status and predictors of mortality among severely acute malnourished children <5 years of age admitted to stabilization centers in Gedeo Zone: a retrospective cohort study. Ther Clin Risk Manag. 2017;13:101-10.

Jarso H, Workicho A, Alemseged F. Survival status and predictors of mortality in severely malnourished children admitted to Jimma University Specialized Hospital from 2010 to 2012, Jimma, Ethiopia: a retrospective longitudinal study. BMC Pediatr. 2015 Dec 1;15(1):76.

KE Elizabeth. Protein energy malnutrition and severe acute malnutrition. Nutrition and Child Development. 5th edition. Hyderabad: Paras Publication; 2015:200-203

Rasmussen SA, Fernhoff PM, Scanlon KS. Vitamin B12 deficiency in children and adolescents. J. Pediatr. 2001;138:10-7.

Matoth Y, Zehavi I, Topper E, Klein T. Folate nutrition and growth in infancy. Arch Dis Child. 1979;54:699-702.

Black MM. Effects of vitamin B12 and folate deficiency on brain development in children. Food Nutr Bull. 2008;29(Suppl. 1):S126-S31.

Goyal S, Tiwari K, Meena P, Malviya S, Mohd A. Cobalamin and folate status in malnourished children. Int J Contemp Pediatr. 2017;4:1480-4.

Yadav SS, Yadav ST, Mishra P, Mittal A, Kumar R, and Singh J. An epidemiological study of malnutrition among under five children of rural and urban Haryana. J Clin Diagn Res. 2016;10:LC07- LC10

Chhabra A, Chandar V, Gupta A, Chandra H. Megaloblastic anaemia in hospitalised children. JIACM. 2012;13:195-7.