Mishra Kirtisudha, Kumar Praveen, Basu Srikanta, Rai Kiran, Aneja Satinder
Department of Pediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi, 110001, India.
Indian J Pediatr. 2014 Aug;81(8):762-5. doi: 10.1007/s12098-013-1127-3. Epub 2013 Jul 20.
To determine the possible risk factors for severe acute malnutrition (SAM) in children below 5 y admitted in a hospital in north India.
This case-control study was conducted in a medical college hospital in children below 5 y of age. All cases of SAM (diagnosed as per WHO definition) between 6 and 59 mo of age were compared with age-matched controls with weight for height above -2SD of WHO 2006 growth standards. Data regarding socio-demographic parameters, feeding practices and immunization were compared between the groups by univariable and multivariable logistic regression models.
A total of 76 cases and 115 controls were enrolled. Among the 14 factors compared, maternal illiteracy, daily family income less than Rs. 200, large family size, lack of exclusive breast feeding in first 6 mo, bottle feeding, administration of pre-lacteals, deprivation of colostrum and incomplete immunization were significant risk factors for SAM. Regarding complementary feeding, it was the consistency, rather than the age of initiation, frequency and variety which showed a significant influence on occurrence of SAM. Multivariate analysis revealed that the risk of SAM was independently associated with 6 factors, namely, illiteracy among mothers, incomplete immunization, practice of bottle feeding, consistency of complementary feeding, deprivation of colostrum and receipt of pre-lacteals at birth.
The present study identifies certain risk factors which need to be focused on during health planning and policy making related to children with SAM in India.
确定印度北部一家医院收治的5岁以下儿童重度急性营养不良（SAM）的可能危险因素。
本病例对照研究在一家医学院附属医院针对5岁以下儿童开展。将所有年龄在6至59个月的SAM病例（根据世界卫生组织定义诊断）与年龄匹配的对照进行比较，对照的身高别体重高于世界卫生组织2006年生长标准的-2标准差。通过单变量和多变量逻辑回归模型比较两组之间有关社会人口统计学参数、喂养方式和免疫接种的数据。
共纳入76例病例和115例对照。在比较的14个因素中，母亲文盲、家庭日收入低于200卢比、家庭规模大、前6个月未纯母乳喂养、奶瓶喂养、给予代乳品、未喂初乳和免疫接种不完整是SAM的重要危险因素。关于辅食添加，对SAM发生有显著影响的是辅食的稠度，而非开始添加的年龄、频率和种类。多变量分析显示，SAM风险与6个因素独立相关即母亲文盲、免疫接种不完整、奶瓶喂养方式、辅食添加的稠度、未喂初乳和出生时接受代乳品。
本研究确定了印度在制定与SAM儿童相关的卫生规划和政策时需要关注的某些危险因素。
