Nutritional and hematological profile of children with severe acute malnutrition rehabilitated with or without vitamin B12

Authors

  • Siddharth Khanna Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India
  • Praveen Kumar Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India
  • Sunita Sharma Department of Pathology, Lady Hardinge Medical College, New Delhi, India
  • Jagdish Chandra Department of Pediatrics, ESI Hospital, Basaidarapur, New Delhi, India
  • Rajesh Sinha Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20220257

Keywords:

Severe wasting, Anemia, Vitamin B12 supplementation, Micronutrients

Abstract

Background: Aim of the study was to study the effect of vitamin B12 supplementation in children with severe acute malnutrition (SAM).

Methods: A total of 100 children were enrolled in the study in two different time frames.  Group A consisted of 50 children with SAM enrolled from November 2016 to May 2017 and managed as per existing national protocol for facility-based SAM management while group B consisted of 50 children enrolled from June 2017 to Dec 2017 who were tested for vitamin B12 deficiency on admission and supplemented with vitamin B12 in presence of vitamin B12 deficiency hematological and anthropometric parameters of both groups were compared at 12 weeks of rehabilitation

Results: At 12±1 weeks, 38% children from group A and 24% from group B were still anemic (p=0.13). No one from either group had folic acid deficiency while deficiency of vitamin B12 was present in 14% and 6% cases in group A and group B respectively (p>0.05). Mean weight gain at 12±1 weeks, in group A and non-supplemented sub-group of group B was comparable (p>0.59). However, mean weight gain in supplemented sub-group of group B was significantly higher compared to group A (p>0.05) and non-supplemented sub-group of group B (p<0.05).

Conclusions: Significant number of SAM children remain anemic when treated with current guidelines. Additional vitamin B12 supplementation in vitamin B12 deficient group showed improvement in weight gain among SAM children.

Metrics

Metrics Loading ...

References

International Institute for Population Sciences (IIPS) and ICF.2017. National Family Health Survey (NFHS-4), 2015-16: India. Mumbai: IIPS. Available at: http://rchiips.org/NFHS/factsheet_NFHS-4.shtml. Accessed 20 February 2018.

Awasthi S, Das R, Verma T, Sheila. Anemia and undernutrition among preschool children in Uttar Pradesh. Indian J Pediatr. 2003;40(10):985-90.

Poulten J, Kapila M, Poddar R, Cameron D. A nutritional survey in Santhal Parganas, India. J trop pediatr. 1987;33:346-8.

Thakur N, Chandra J, Pemde H, Singh V. Anemia in severe acute malnutrition. Nutrition. 2014;30(4):440-2.

Ray S, Chandra J, Bhattacharjee J, Sunita S, Agarwala A. Determinants of nutritional anaemia in children less than five years age. Int J Contemp Pediatr. 2016;3:403-8.

Yaikhomba T, Poswal L, Goyal S. Assessment of iron, folate and vitamin B12status in severe acute malnutrition. Indian J Pediatr. 2015;82(6):511-4.

Goyal S, Tewari K, Meena P, Malviya S, Asif M. Cobalamin and folate status in malnourished children. Int J Contemp Pediatr. 2017;4(4):1480-4.

Strand TA, Taneja S, Kumar T, Manger MS, Refsum H, Yajnik CS et al. Vitamin B-12, folic acid, and growth in 6- to 30-month-old children: a randomized controlled trial. Pediatrics. 2015;135(4):e918.

Ministry of Health and Family Welfare, Government of India. Facilitator guide for facility-based management of severe acute malnutrition. 2013.

Osei AK, Rosenberg IH, Houser RF, Bulusu S, Methews M, Hamer DH. Community-level Micronutrient Fortification of School Lunch Mealimproved vitamin A, Folate, and iron status in schoolchildren of Himalayan Villages of India. J Nutr. 2019;140:1146-54.

WHO Guideline: Updates on the management of severe acute malnutrition in infants and children. Geneva: World Health Organization; 2013. Available at: http://apps.who.int/iris/bitstream/handle/ 10665/95584/9789241506328_eng.pdf?sequence=1. Accessed 20 February 2021.

Khairnar MR, Wadgave U. Shimpi PV. Kuppuswamy’s Socio-Economic Status Scale: A Revision of Occupation and Income Criteria for 2016. Indian J Pediatr. 2017;84:3-6.

World Health Organisation. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Available at https://www.who.int/vmnis/indicators/haemoglobin.pdf. Accessed 20 February 2020.

Yewale VN, Dewan B. Treatment of iron deficiency anemia in children: a comparative study of ferrous ascorbate and colloidal iron. Indian J Pediatr. 2013;80:385-90.

Ankar A, Kumar A. Vitamin B12 Deficiency. In: Stat Pearls. Treasure Island (FL): Stat Pearls Publishing; 2020. Available at: https://www.ncbi.nlm.nih.gov/ books/NBK441923/. Accessed 20 February 2018.

Dror DK, Allen LH. Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms. Nutr Rev. 2008;66(5):250-5.

Bhatnagar S, Kumar R, Dua R, Basu S, Kumar P. Outcome of children with severe acute malnutrition and diarrhea. Pedaitr Gastroentrol Hepatol Nutr. 2019;22:242-8.

Singh P, Kumar P, Rohatgi S, Basu S, Aneja S. Experience and outcome of children with severe acute malnutrition using locally prepared therapeutic diet. Indian J Pediatr. 2016;83:3-8.

Mamidi RS, Kulkarni B, Radhakrishna KV, Shatrugna V. Hospital based nutrition rehabilitation of severely undernourished children using energy dense local foods. Indian Pediatr. 2010;47:687-93.

Downloads

Published

2022-01-28

How to Cite

Khanna, S., Kumar, P., Sharma, S., Chandra, J., & Sinha, R. (2022). Nutritional and hematological profile of children with severe acute malnutrition rehabilitated with or without vitamin B12. International Journal Of Community Medicine And Public Health, 9(2), 882–886. https://doi.org/10.18203/2394-6040.ijcmph20220257

Issue

Section

Original Research Articles