Comparison of anthropometrical indicators between malnourished children admitted to a nutrition rehabilitation unit and their counterparts in a community

Abstract

Objective: Relate z-scores of malnourished children treated in a Nutrition Rehabilitation Unit (NRU) with that of their counterparts in a community. Methodology: The Matlab MCH-FP Programme regularly measures mid-upper arm circumference (MUAC) to detect severe malnutrition in a community. An NRU was established to rehabilitate children detected as severely malnourished (MUAC <120 mm), and to involve mothers in the process. The z-score values (ANTHRO) of the admitted children were compared with those for their counterparts selected randomly in a community, using normal test comparisons for continuous variables. Results: During a five-year period, 548 malnourished children aged less than five years from the intervention area were admitted for a mean (SD) of 19.1 (17.1) days. Admission was highly seasonal, particularly high during the pre-harvest period; 3.3% of the children were admitted twice during the study period; 32% of the admitted patients were infants, and 75% were aged less than two years. Mean weight gain was linear over time till the 5th week of admission when it reached a plateau. The weight-for-age and weight-for-height values, but not height-for-age, improved significantly among patients at the NRU. The admitted children were both stunted and wasted. Five hundred community children from a neighbouring non-intervention area were significantly less stunted and wasted than those admitted in the NRU. The malnourished comparison children had a higher weight-for-height score (z=-11.5, p<0.0001) and weight-for-age score (z=-9.5, p<0.0001) than those recorded for children from the intervention area when admitted to the NRU, and had also a significantly higher weight-for-age score than that recorded on children when discharged from the NRU (z=-4.8, p<0.001). Conclusion: The results of the study showed that children rehabilitated in an NRU improved significantly in terms of their nutritional status, but their z-score values on discharge were still comparable to those of the malnourished children living in the community. Community-based rehabilitation programmes may be required to continue caring for the still fragile children at risk of morbidity and mortality.