Malnutrition: Ignorance remains the root cause Nutritional Assessment of Municipal High School Children, Guntur ,Andhra Pradesh

Ramya Hasini M U.G, Guntur Medical College Under guidance of Dr. Sita Rama, M.D, Professor & HOD, Community medicine, Guntur Medical College Dr. Sreedevi, M.D, Assistant Professor Community medicine, Guntur Medical College Dr. G.Sreekanth, P.G Community Medicine, Guntur Medical College

Background Malnutrition literally means bad nutrition where in some nutrients are in excess,lacking or in wrong proportion. It remains the worlds most serious health problem and the single best contributor to child mortality.

The situation is more so with the developing countries like India where 1/3rd of the child population is either stunted or underweight. Some Facts
47 percent of Indias children below the age of three years are malnourished
(underweight). The World Bank puts the number probably conservatively at 60 million. This is out of a global estimated total of 146 million. 47 percent of Indian children under five are categorised as moderately or severely malnourished.

South Asia has the highest rates and by far the largest number of malnourished
children in the world.

The UN ranks India in the bottom quartile of countries by under-1 infant mortality
(the 53 highest), and under-5 child mortality (78 deaths per 1000 live births). According to the 2008 CIA fact book, 32 babies out of every 1,000 born alive die before their first birthday.
rd

At least half of Indian infant deaths are related to malnutrition, often associated with infectious diseases.

Malnutrition impedes motor, sensory, cognitive and social development , so

malnourished children will be less likely to benefit from schooling, and will consequently have lower income as adults.

The most damaging effects of under-nutrition occur during pregnancy and the first
two years of a childs life.

These damages are irreversible, making dealing with malnutrition in the first two
year crucially important.

A close reading of available statistics shows the problem to be far from uniform.

(ikada inko slide lo facts untayi) Nutritional Assessment : First Step towards solving malnutrition Helps identify the risk groups Helps develop health care programs that meet the community needs Helps intensify the initiated nutritional programs

Three anthropometric indications to assess nutritional status during childhood: Weight for age Height for age Weight for height

Goals Assessment of the magnitude of malnourishment amongst children of 11-15 years age group in a specific locality by Studying the socio-demographic profile of children in municipal high school Studying the magnitude of malnourishment among them Studying the magnitude of micro-nutrient deficiencies and other disorders among then

And recommend the preventive measures Considerations Age during 11 to 15 yrs is characterized by an exceptionally rapid rate of growth School provides the most efficient and effective way to reach the above age population

Methodology study area: the study was done in the municipal high schools of Guntur town,Andhra Pradesh. Study population:a cross sectional randomized study was done on a total of 436 students between the ages 11 and 16 yrs belonging to classes VI,VII,VIII,IX. Method:1.the students were interviewed regarding the basic data like age,sex,socio economic class,religion,literacy status of parents 2.their general appearance was appreciated and thorough clinical examination ws done to find any signs of morbidity. 3.the anthropometric measurements have been taken for each student.height has been taken barefooted in centimeter and recorded nearest to 1cm.weight was measured b a weighing machine having precision of 0.5kg.BMI was cakcutated taking the values BMI=weight(in kgs)/height(in m2 ) 4.the haemoglobin of each student was estimated by the sahlis method and expressed in gm%. 5.the data so collected was compiled in MS Excel and analysed with? software. Slide:5 results

B oys

Girls

46.9-boys,53.1-girls - 1 46%hindus,17.4%muslims,36.6%christians - 2 Literacy :both parents illiterate-29.09%;mother illiterate-51.9% - 3 Anthropometric measurements 4, 5 62.5% underweight;32.1%over weight,5.4%normal weight(weight for age) 94.8% normal growth,5.2% stunted(height for age) Heamoglobin estimation - 6 94.2% anemic out of which severe 31.7%;moderate 50.1%,mild 12.4% General appearance - 7 94.4% normal built;5% thin built;0.6% obese Clinical examination - 8

Tongue-31% have pale tongue Teeth-36.3% mottled teeth;2.2% dental caries Gums-0.6% spongy and bleeding Conjunctiva-94%normal;5.3% pale conjunctiva;0.7% brown pigmentation Glands-0.6% thyroid enlargement Lips-1.1% chielosis Nails-0.4% koilonychia Skin-0.2% pellagra dermatosis Assessment: Anemia is the most common form of malnutrition among the children Most of them having moderate to severe anemia. Malnutrition is common when parents are ignorant especially mother

Recommendations: 8 point program Volunteers to educate people personally at their houses Educating the children of the health, nutrition and hygiene Educational workshops on child diet for parents at the meetings in schools Educating the mother at child birth Apportioning considerable amount of family expenditure towards nutritious food Providing nutritious mid day meals at schools Separate malnutrition counseling cabinets at health centers Malnutrition camps at immunizations centers for early warning

Looking Forward: The assessment in municipal schools of Guntur is just one example of a trend seen across the country where ignorance seems to be prevalent both among the literate and the illiterate parents.

If the recommended measures are effective in this one locality, then the measures can be adopted on a large scale and the process can be repeated for consistent results. References: Parks textbook of preventive and social medicine Retrieved http://www.nlm.nih.gov/medlineplus/childnutrition.html Retrieved http://www.unicef.org/progressforchildren/2006n4/photoessay/index.html Retrieved http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001441/ Retrieved http://www.cini.org.uk/child_malnutrition.html Images: http://www.hetv.org/programmes/nutrition.htm http://ruralreporter.blogspot.in/2012/01/malnourished-india.html