Morphological Patterns of Severe Acute Malnutrition in Children on the Basis of Clinical or Anthropometric Assessment

Background: Malnutrition is a widespread problem, affecting the global population at some life stage. Malnutrition includes both undernutrition (wasting, stunting, underweight, and mineral- and vitamin-related malnutrition) and over nutrition (overweight, obesity, and diet-related noncommunicable diseases. The best-targeted age for addressing malnutrition is the first 1000 days of life as this window period is ideal for intervention implementation and tracking for the improvement of child growth and development. Therefore, it was a genuine necessity to find out the burden of all three categories of malnutrition such as Kwashiorkor, Marasmus, Marasmic kwashiorkor and also to find out age wise distribution of the PEM, so that these findings could help to design Nutritional Rehabilitation Policies by considering the category and age groups. Methods: All the patients in the age group 6 months to 59 months of either gender were screened for malnutrition by anthropometry using standard techniques, and SAM was diagnosed as per WHO guidelines, all were clinically classified into marasmus, kwashiorkar and mixed type. Results: During this study 60 children were enrolled, 31 cases and 29 controls with maximum no of cases between 12- 24 months of age with male predominance & M: F 1.9:1, mostly belonged to urban habituation. Most common type of clinical diagnosis was mixed type as marasmic- kwashiorkar followed by marasmus & kwashiorkar. Stunting, was seen in 30.70% cases, wasting in 29.03% and 33.27% were underweight. Conclusion: Our data on age distribution underlies the importance of early intervention to ward off short- and long-term morbidity caused by severe acute malnutrition. Our findings show that the patterns of malnutrition can differ according to nutritional assessment method. They suggest the importance of applying a mix of clinical and anthropometric methods for assessing malnutrition instead of just one method. Functional validity of characterization of aspects of individual nutritional status by single anthropometric scores or by simple clinical classification remain issues for further investigation