Study of biochemical and nutritional indicators in severe acute malnutrition: A prospective observational study

Background: Malnutrition in children is widely prevalent in developing countries including India. More than 33% of thedeaths in 0-5 years are associated with malnutrition. Children with severe acute malnutrition (SAM) are in danger of death fromhypoglycemia, hypothermia, fluid overload, electrolyte mismanagement, and undetected infections. Hence, biochemical andnutritional indicators in these children are important for management. Objectives: To study the biochemical and nutritional indicatorsin children with SAM. Methods: This hospital based prospective study was conducted on children aged 6-59 months admitted atNutrition Rehabilitation Center attached to a tertiary care teaching institution. 100 consecutive SAM children admitted during2013-2015 were studied. Children were tested for biochemical and nutritional status like complete blood picture with peripheralsmear, liver function tests, renal function tests, serum electrolytes, calcium, phosphorus, and alkaline phosphatase. Results: A totalof 100 cases were included, of these 57 were male and female were 43. Mean age of presentation was 18.45±2.37 months. A lack ofexclusive breastfeeding was seen in 67% of these children and in 78% children complimentary feeds were initiated either early orlater than 6 months. Hypoglycemia was seen in 15% cases, hypokalemia in 22%, and hypocalcemia in 35% of cases. Hyponatremiawas seen in 14% and hypernatremia in 19% of the children. The most common type of anemia was microcytic hypochromictype (55%). Conclusion: The observations in this study confirm a significant association between SAM and faulty feeding andearly introduction of complementary feeds. It was observed that these children have significant alterations in nutritional indicatorsat admission