Socio-economic and environmental factors affecting the rehabilitation of children with severe malnutrition
ABSTRACT: Poor diet and high
infection rates inflicted by low socio-economic status and poor environments
among infants and young children appear to be major causes of severe
malnutrition. Objective To determine the practical and likely effectiveness in
rehabilitation of severe malnutrition. Methods A descriptive observational
study was conducted on 27 children at three different sites: (1) Five
inpatients at the Inpatient Ward, Cipto Mangunkusumo Hospital, Jakarta (IP-CM);
(2) 8 outpatients at the Metabolic and Nutrition Clinic, Cipto Mangunkusumo Hospital
(OP-CM); (3) 14 outpatients at the Nutrition Clinic, Bogor (NC). All the
patients followed were aged <60 months and suffered from severe malnutrition
(weight for length index <-3 NCHS Z-score). Subjects were followed for 12
weeks. The IP-CM group received standard treatment following the WHO
recommendation, while the OP-CM and NC group received proper medical treatment
and nutrition education for mothers. The OP-CM group underwent more extensive
laboratory investigations. Results All children generally had low
socio-economic status. Most children experienced poor feeding, child care, and
other health practices. A tendency of increased prevalence, number of episodes,
and duration of infectious diseases was noted in the majority of subjects.
However, an improvement of nutritional status was observed during treatment in
all groups, particularly in the IP-CM group. Conclusion Socio-economic status
and environmental factors must be considered in the management of severe
malnutrition. Educating parents concerning proper feeding and child care
practices appears to be of permanent nutritional benefit for the children.
Author: Felliyani, MD; Sri S
Nasar, MD; Taralan Tambunan, MD
Journal Code: jpkedokterangg050070
