Epidemiological and Clinical Profile of Hospitalized Children with Moderate and Severe Acute Malnutrition in South India

Objective To evaluate the clinico-epidemiological profile, pattern of infections, feeding practices, socio-demographic risk factors and outcome of hospitalized children with moderate acute malnutrition (MAM) and severe acute malnutrition (SAM). Methods Cases (children aged 1-60 mo with SAM or MAM) and controls (children with weight for height z score more than -1 SD) were recruited from November 2011 through July 2013. Overall, 126 cases and 126 controls were included. Results Only 33 % of malnourished children (cases) were exclusively breast fed. Among controls, 71 % were exclusively breast fed for the first 6 mo after birth. Most cases had associated infections (p 0.004) and anemia (p<0.001). ROC curve revealed 120 mm mid upper arm circumference (MUAC) as the best cut off for predicting SAM. Mothers' education, pre-lacteal feeds and co-morbidities were independent predictors of malnutrition (R-2=22.1 %) by logistic regression. Conclusions Though 11.5 cm MUAC has been mentioned by WHO as the cut off for identifying SAM, a higher cut off (12 cm) may be required to use it as a screening tool. Mothers' education, pre-lacteal feeds and co-morbidities were found to be independent determinants for malnutrition in the present patient population, indicating the need towards a targeted approach for modifying these factors.