Menu ENN Search

Severe malnutrition in infants aged <6 months—Outcomes and risk factors in Bangladesh: A prospective cohort study

Author: M. Munirul Islam, Yasir Arafat, Nichola Connell, Golam Mothabbir, Marie McGrath, James A. Berkley, Tahmeed Ahmed and Marko Kerac
Year: 2018
Resource type: Article

Abstract

Severe acute malnutrition (SAM) affects ~4 million infants under 6 months (u6m) worldwide, but evidence underpinning their case is "very low" quality. To inform future research and policy, the objectives of our study were to identify risk factors for infant u6m SAM and describe the clinical and anthropometric outcomes of treatment with current management strategies. We conducted a prospective cohort study in infants u6m in Barisal district, Bangladesh. One group of 77 infants had SAM (weight-for-length Z-score [WLZ] <–3 and/or bipedal oedema); 77 others were "non-SAM" (WLZ ≥–2 to <+2, no oedema, mid-upper-arm circumference ≥125mm). All were enrolles at 4-8 weeks of age and followed up at 6 months. Maternal education and satisfaction with breastfeeding were among factors associated with SAM. Duration of exclusive breastfeeding was shorter at enrolment (3·9 ± 2.1 vs. 5.7 ± 2.2 weeks, P <0.0001) and at age 6 months (13.2 ± 8.9 vs. 17.4 ± 7.9 weeks; P = 0.003) among SAM infants. Despite referral, only 13 (17%) reported for inpatient care, and at 6 months, 18 (23%) infants with SAM still had SAM, and 3 (3.9%) died. In the non-SAM group, one child developed SAM, and none died. We conclude that current treatment strategies of outpatient-focused care for malnourished but clinically stable infants u6m need to be tested. Breastfeeding support is likely central to future treatment strategies but may be insufficient alone. Better case definitions of nutritionally at-risk infants are also needed.

Download

Islam_et_al-2018-Maternal_-26_Child_Nutrition.pdf (PDF, 238kb)

More like this

Resource: Severe malnutrition in infants aged <6 months—Outcomes and risk factors in Bangladesh: A prospective cohort study

Abstract Severe acute malnutrition (SAM) affects ~4 million infants under 6 months (u6m) worldwide, but evidence underpinning their case is "very low" quality. To...

FEX: Outcomes and risk factors for infants under six months old with severe acute malnutrition in Bangladesh

Research snapshot 1 Severe acute malnutrition (SAM) affects around four million infants under six months of age (u6m) worldwide, but evidence underpinning their care is...

FEX: Severe malnutrition in infants under six months old: outcomes and risk factors in Bangladesh

Summary of research1 Location: Bangladesh What we know: The World Health Organization (WHO) recommends that infants under six months with uncomplicated severe acute...

FEX: Risk factors for severe acute malnutrition in infants <6 months old in semi-urban Bangladesh: A prospective cohort study to inform future assessment/treatment tools

Summary of conference abstract1 Presented at the ACF research conference, November 9th, 2016. By M Munirul Islam, Yasir Arafat, Nicki Connell, Golam Mothabbir, Marie...

FEX: Diagnostic criteria for severe acute malnutrition among infants under six months of age

Summary of research1 Location: Kenya What we know: Diagnosis of acute malnutrition in infants under six months old (U6M) is currently based on weight-for-length z score...

FEX: Management of acute malnutrition in infants less than six months in a South Sudanese refugee population in Ethiopia

By Mary T Murphy, Kassahun Abebe, Sinead O'Mahony, Hatty Barthorp & Chris Andert View this article as a pdf Lisez cet article en français ici Sinead O'Mahony is a...

Resource: Anthropometry at birth and at age of routine vaccination to predict mortality in the first year of life: A birth cohort study in BukinaFaso

Abstract Background The World Health Organization currently defines severe acute malnutrition (SAM) in infants aged under 6 months of age using weight-for-length Z score...

FEX: Improving community management of uncomplicated acute malnutrition in infants under six months (C-MAMI): Developing a checklist version of the C-MAMI tool

Summary of MSc project report1 By Sonja Read Sonja Read is a public health nutritionist from the London School of Hygiene and Tropical Medicine. She has previously worked in...

FEX: Nutritional rehabilitation of infants < 6 months with severe acute malnutrition

Summary of published research1 Location: India What we know: There is a significant burden of acute malnutrition in infants under 6 months of age in nutritionally vulnerable...

FEX: Substandard discharge rules in current severe acute malnutrition management protocols: An overlooked source of ineffectiveness for programmes?

View this article as a pdf By Benjamin Guesdon and Dominique Roberfroid Benjamin Guesdon is a nutrition and health research advisor at Action Contre la Faim...

FEX: Risk factors for acutely malnourished infants aged under six months

Research snapshot 1 Acute malnutrition (wasting) in infants aged under 6 months (< 6m) is often neglected. Worldwide, some 8.5 million infants < 6m are affected, yet...

FEX: Infant feeding strategies and PMTCT - Mashi trial from Botswana

Summary of published research1 Arecently published paper compares the efficacy and safety of two infant feeding strategies for the prevention of postnatal mother-to-child HIV...

en-net: Simplified protocol - kwashiorkor cases?

There appears to be increasing interest in simplified protocols that treat all children with MUAC <125mm with an optimised dose of specialised nutrition commodity that is...

FEX: Effect of mass supplementation with RUSF during an anticipated nutritional emergency

Summary of published research1 A woman and her dauguher receive RUSF distribution in Niger Location: Niger What we know already: Ready to Use Supplementary Foods (RUSF) are...

Resource: Perceptions of Acute Malnutrition and Its Management in Infants Under 6 Months of Age: A Qualitative Study in Rural Bangladesh

ABSTRACT Background: World Health Organization guidelines advise community-based care (CBC) for “uncomplicated” severe acute malnutrition (SAM) infants <6...

FEX: Short children with a low MUAC respond to food supplementation: an observational study from Burkina Faso

By Fabiansen, C., Phelan, Kevin, P.Q., Cichon, B., Ritz, C., Briend, A., Michaelsen, K.F., Friis, H. and Shepherd, S Summary of research: Short children with a low midupper...

FEX: Follow-up of post-discharge growth and mortality after treatment for SAM in Malawi

Summary of research1 Location: Malawi What we know: There are limited data on long term outcomes following discharge from SAM treatment; what exists is largely pre-HIV....

FEX: Chronic disease outcomes after SAM in Malawian children (ChroSAM): A cohort study

Summary of research* Location: Malawi What we know: Little is known about the long-term health effects of survivors of severe acute malnutrition (SAM), particularly risk of...

FEX: Auditing the identification and inpatient management of acute malnutrition in infants under six months in Malawi

Summary of MSc thesis By Laura White Laura White is a Canadian-trained registered dietitian who recently completed an MSc in Nutrition for Global Health at the London School...

FEX: Does nutritional supplementation for two weeks prevent malnutrition in ill children?

Summary of research1 Location: DRC, Uganda and Nigeria What we know: Ill children are at increased risk of malnutrition due to the infection-malnutrition cycle. What this...

Close

Reference this page

M. Munirul Islam, Yasir Arafat, Nichola Connell, Golam Mothabbir, Marie McGrath, James A. Berkley, Tahmeed Ahmed and Marko Kerac (2018). Severe malnutrition in infants aged <6 months—Outcomes and risk factors in Bangladesh: A prospective cohort study. www.ennonline.net/resources/severmalnutbangladesh

(ENN_6046)

Close

Download to a citation manager

The below files can be imported into your preferred reference management tool, most tools will allow you to manually import the RIS file. Endnote may required a specific filter file to be used.