DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20163051

An epidemiological study of protein energy malnutrition among children below six years’ age in an urban slum of Gurgaon, Haryana, India

Tarun Kumar, Balbir Singh Deswal

Abstract


Background: Poorly nourished child grows less rapidly during first 6 years of age.  In India, around 43% of fewer than five children were underweight. Child protein energy malnutrition reflects a number of intermediately processes such as household access to food, access to health service and caring practices.  The present study was undertaken to assess prevalence of PEM as well as the nutritional status of children below six years’ age group and to explore most probable risk factors influencing PEM.

Methods: The study was a community based cross-sectional study carried out in 500 randomly selected households in a slum area of Gurgaon among the children below 6 years of age using pretested Performa which contained details regarding socio-demographic, nutritional conditions and utilization of health care services. Nutritional status was assessed by Physical examination, anthropometric measurement, haemoglobin and parasitological (stool) tests. Nutritional grading was done according to by physical and anthropometric examination of child using Indian Academy of Pediatrics (IAP) classification and supplemented by WHO growth chart. Data was entered in the MS Excel sheet and analyzed using Epi info Ver 7.

Results: During survey acute illness detected among 0.25% children and chronic illness prevalence was 25%. Prevalence of PEM was found to be 43.86% (37.73% among males, 50.0 % among females). Clinical signs of nutritional deficiency were detected among 31.48 % of children. Common types of nutrition deficiency were anemia, PEM, and vitamin A and B complex deficiencies. Main reasons of PEM were attributed to female sex, poor literacy of parents, low socioeconomic status, higher No. siblings and large family, recurrent diarrhea and other infections, prolonged breast feeding with delayed introduction of supplements particularly semisolid and poor quality of supplements.  Intestinal parasite detected among 38.43% of children, commonest parasite being giardia, ascariasis and thread worms; existing health services utilized in 30.72% of total illness. This was identified not due to lack of knowledge but other domestic problems.

Conclusions: Prevalence of PEM was attributed to poor living conditions, poor literacy status of parents, higher No. of siblings, poor utilization of health services, poor nutritional services of children and faulty breast feeding and weaning practices in the family. Public health specialists should plan interventions focusing on these issues.

Keywords


Protein energy malnutrition, Preschool children, Morbidity, Poor weaning practices

Full Text:

PDF

References


Millennium Development Goals (MDG) report 2012. Available at: http://www.un.org/ millenniumgoals/ reports.shtml (accessed on 10/06/2016).

National Family Health Survey (NFHS-3), India, 2005-06. Ministry of Health and Family Welfare, Govt. of India, International Institute for Population Sciences Deonar, Mumbai. Available at: http://www.indiahealthstat.com. (Accessed on 11/06/2016).

UNICEF India. The Children - Nutrition. (Pb) .New Delhi 2014 Available at: http://www.unicef.org/ india/ children_2356.htm (accessed on 10/06/016)

Levels and trends in child mortality report 2011. Estimates developed by the UN inter-agency group for child mortality estimation. Available at: http://www.unicef.org/ media/ files/ Child_Mortality_Report_2011_Final.pdf (accessed on 11/06/2016).

Reddy SD, Arlappa N. An updated Prasad’s socio economic status classification. Int J Res Dev Health. 2013;1:2-4.

Singh AK, Jain S, Bhatnagar M, Singh JV, Garg SK, Chopra H, et al. Socio-demographic determinants of malnutrition among children of 1-6 Years of age in rural Meerut. IOSR Journal of Dental and Medical Sciences. 2012;3:37-40.

Freedom from hunger for children under six. An outline for save the children and civil society involvement in childhood under nutrition in India, April 2009; 4th Floor, Farm Bhavan, Nehru Place New Delhi.

Chakraborty S, Gupta SB, Chaturvedi B, Chakraborty SK. A Study of Protein Energy Malnutrition (PEM) in Children (0 to 6 years) in a Rural Population of Jhansi District (U.P.) Indian J Community Medicine. 2006;31:1-4.

Stalin P, Roy JB, Dimri D, Singh Z, Senthilvel S, Sathyanarayanan S. Prevalence of underweight and its risk factors among under five children in a rural area of Kancheepuram district in Tamil Nadu. IOSR Journal of Dental and Medical Sciences. 2013;3:71-4.

Sengupta P, Philip N, Benjamin AI. Epidemiological correlates of under-nutrition in under-5years children in an urban slum of Ludhiana. Health and Population: Perspectives and Issues 2010;33:1-9.

Bhavsar S, Mahajan H, Kulkarni R. Maternal & environmental factors affecting the nutritional status of children in Mumbai urban slum. International J Scientific and Research Publications. 2012;2:11-4.

Joshi HS, Gupta R, Joshi MC, Mahajan V. Determinants of nutritional status of school children, western region of Nepal. NJIRM. 2011;2:10-2.

Prasoti RM, Verma SK, Kashyp S, Khanaujiya MK. An epidemiological study of Protein Energy Malnutrition (PEM) among 1-6 years children in rural Lucknow, Uttar Pradesh, India. IOSR Journal of Dental and Medical Sciences. 2014;4:10-4.