Risk factors for severe malnutrition in under five children admitted to nutritional rehabilitation centre: a case-control study from Central India

Abstract

Background: Protein energy malnutrition is a major public health problem in India with maximum prevalence in central part of country known as Madhya Pradesh (60.3%). It is one of the leading causes of morbidity and mortality in under five children. The objective of the study if the study was to identify the risk factors for severe malnutrition in under five children admitted to Nutritional Rehabilitation Centre as compared to normal nourished children in the community.

Methods:This was a case control study design. 350 cases were selected from N.R.C. of N.S.C.B Medical College Jabalpur and 350 neighbourhood controls were selected from same community. The chi-square test, student t test and binary logistic regression were used for data analysis using spss-17.0 software.

Results: In logistic regression age 0-2 years, female sex, low birth weight, rural locality, S.T caste, illiterate paternal education, early marriage of mother, partially or unimmunized children, kaccha house, lack of hygiene, open field defecation, inadequate calorie, infectious diseases ARI, diarrhoea, and fever were significantly associated with severe malnutrition. The overall Prediction of model was R² = 92.9%. The mean time gap between first identification of children as malnourished and their admission to N.R.C. is 4.38 months.

Conclusions:There is evidence of strong association between severe malnutrition and some of the risk factors. Long delay in referral and admission of severe malnourished children is a major challenge.