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

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...

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: 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...

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...

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...

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: 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...

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: Relapse after treatment for moderate acute malnutrition: Risk factors and interventions to prevent it

Summary of presentation1 based on published research2 View this article as a pdf By Heather Stobaugh and Mark Manary Dr Heather Stobaugh has a PhD in Food Policy and Applied...

FEX: Risk factors associated with severe acute malnutrition in infants under six months in India: a cross sectional analysis

By Susan Thurstans Susan is a registered nurse and midwife with over 12 years' experience in maternal and child health and nutrition programmes in both development and...

FEX: The Paediatric Development Clinic: A model to improve medical, nutritional and developmental outcomes for high-risk children aged under-five in rural Rwanda

By Kathryn Beck, Catherine M Kirk, Jessica Bradford, Christine Mutaganzwa, Evrard Nahimana and Olivier Bigirumwami View this article as a pdf Kathryn Beck is the Nutrition...

FEX: Weight-for-height and mid-upper-arm circumference should be used independently to diagnose acute malnutrition: policy implications

Summary of research1 Location: Global What we know: Overlap between mid-upper-arm circumference (MUAC) and weight-for-height Z-scores (WHZ) when assessing acute malnutrition...

FEX: Efficacy of three feeding regimens for home-based management of children with uncomplicated severe acute malnutrition

Summary of research Bhandari N, Mohan SB, Bose A, et al. Efficacy of three feeding regimens for home-based management of children with uncomplicated severe acute malnutrition:...

FEX: Admission profile and discharge outcomes for infants aged less than six months admitted to inpatient therapeutic care in ten countries

Summary of research* Location: Global (Burundi, DRC, Kenya, Liberia, Myanmar, Niger, Somalia, Sudan, Tajikistan, Uganda) What we know: The burden of acute malnutrition in...

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