Assessment of Nutritional Deficiency Diseases among Children of an Urban Slum

Rathi H.B.¹, Singh Khileswar², Bansal A.K.³, Mohan R. S.¹, Shrivastava P. K.¹and Sinha T. ¹

¹Dept. of Community Medicine, Govt. Medical College, Jagdalpur (Bastar)

²Dept. of Medicine, Govt. Medical College, Jagdalpur (Bastar)

³Prof. and HOD, Department of Community Medicine, Govt. Medical College Jagdalpur (Bastar)

ABSTRACT:

On analysis of the data collected 4.6 % children were suffering from protein energy malnutrition, 11.5 % vitamin “A” deficiency, 13.3 % Vitamin “B” complex deficiency and 11.1 % from anaemia These various nutritional deficiency diseases are not just due to poor hygiene conditions and lack of nutritional food but also because the mother herself is suffering from anaemia and malnutrition during adolescence and child bearing age. They become trapped in an intergenerational cycle of ill health and poverty.

KEYWORDS: Intergenerational cycle, Protein Energy Malnutrition

INTRODUCTION:

India is a party to the United Nations declarations of the rights of the child which gives all children, without any exception, the right to enjoy special protection, opportunities and facilities to enable them to develop physically, mentally, spiritually and socially in healthy and normal manner in conditions of freedom and dignity. Keeping in view the United Nations declaration and constitution of India, the Government of India adopted a national policy of the children which declares that children are “supremely impact asset” of the Nation, whose nurture is therefore a National responsibility. It affirms that it shall be the duty of the state to provide adequate services to children both before and after birth and through the period of growth to ensure their full physical, mental and social development for correct perspective in health planning. In 1957 as per recommendation of the study group of World Health Organization (WHO) has expressed the view that in order to get a comprehensive picture of disease (any health problem) more and more studies should be carried out, Garg Narendra K (1), so, this study has been carried out.

MATERIAL AND METHODS:

The present study was conducted in an urban slum Bhande Plot, Nagpur. During the study all children of zero to five years of age were included. Thus data of 555 children were collected in a pre drawn proforma. Each child was examined clinically and the findings were recorded as per standard nutritional assessment schedule.

OBSERVATIONS AND DISCUSSIONS:

On analysis of the collected data, it has been revealed that 226 (41.08 %) children out of 555 were suffering from one or the other type of nutritional deficiency diseases. 26 (4.6 %) of children had signs of PEM. Table further (3.9, 0.5 and 0.1 % children were suffering from marasmus, Kawashiorkar, Marasmus and Kwashiorkor, respectively) reveals that 12 to < 36 months of children were worst sufferers of PEM in comparison to

other age groups. Common signs observed were muscle wasting and hair changes. Bansal et. al. in his study found 0.67 % marasmic children, which is low in comparison to the larger sample size in the present study.

11.5 % children had Vit. “A” deficiency Conjunctiva Xerosis (8.3 %) was the common of manifestation of Vit.

“A” deficiency followed by Bitot’s spot (2.5 %) far as age group 24 to 60 months of age children were most sufferers. None of the children had active corneal manifestations. Bansal et. al. (2). Signs of Vit. “B” complex deficiency were observed in 13.3 % of children (Table - I) 5.2% children were affected by angular stomatitis which is more or less similar to the findings (5.84 %) Bansal A.K.et al, followed by stomatitis (3.8%). 2.3 and 1.9 % children also had signs of glossitis and cheilosis respectively.

TABLE – I: NUTRITIONAL DEFICIENCY DISEASES BY CLINICAL EXAMINATION (n = 226)

Deficiency Disease

No.

Percentage

Protein Energy Malnutrition

Marasmus

Kwashiorkar

Marsmic Kwashiorkar

4.6

3.9

0.5

0.1

Vitamin “A” Deficiency

Night Blindness

Conjuctival Xerosis

Bitot’s Spot

11.5

0.7

8.3

2.5

Vitamin “B” Complex Deficiency

Angular Stomatitis

Stomatitis

Glossitis

Chielosis

13.3

5.2

3.8

2.3

1.9

Anemia

11.1

Authors further observed that 12-60 months of age children were most sufferers of vit. “B” complex deficiency diseases. Bansal A.K. et. al. Reported that 13.74 % children had signs of anemia viz conjunctiva pallor.

Higher percentage of nutritional deficiency was also reported by different authors data Banik, Kamble, Bansal, in their studies conducted from time to time across the country. These various nutritional deficiency diseases are not just due to poor hygiene conditions and lack of nutritional food but also because the mother herself is suffering from anaemia and malnutrition during adolescence and child bearing. They become trapped in an intergenerational cycle of ill health and poverty.

Exclusive breast feeding for the first six months together with nutritionally adequate food from six months onward personal hygiene etc. can have a significant impact on child survival, potentially reducing the under five child mortality by 19 % in developing countries along with breast feeding up to two years of age.

Global aid is being spent on diseases like HIV, TB and malaria rather than addressing malnutrition and sanitation in the 30 high burden countries that have the worst statistics relating to maternal and child health (Himanshi Dhawan - 2010).

An independent study said “mismatch” between global aid and demands from worst affected countries could be one of the primary reasons for missing the millennium development goals for maternal mortality and child health.

In a report released on 18th March 2010, NGO World Vision said aid was not being directed to the countries with the greatest need. Three countries – India, Nigeria and Congo – together contributed 40 % of total child deaths, yet received 17 % of aid for health between 2006 and 2007.

Also, the aid currently given to health was not just poorly targeted but was “insufficiently focused on child and maternal health: in recent years aid for child and maternal health has accounted for only around 3 % of overall developmental assistance”.

The ‘Child Health Now – Together we can end Preventable Deaths’ report pointed out that 30 high burden countries including India were spending less than $ 10 on maternal and newborn health per birth. Incidentally, principal diseases and underlying causes of child death are not receiving the “lion’s share of aid for health”.

“A lot of political energy and donor funding in recent years has been directed towards vertical programmes to address specific diseases – particularly HIV, TB and malaria – at the expense of key causes of death like malnutrition and lack of hygiene and sanitation,” the report said.

Globally, a child under five dies every 3.5 seconds which amounts to 24,000 deaths a day and almost 9 million a year. India shares the highest burden with 1.95 million under five deaths according to the Child Health report.

Launching its five year campaign to bring down under five deaths that occur due to preventable causes, World Vision global ambassador Dean Hirsch said, “We want to focus on reducing preventable deaths for children under five. Maternal and child health are missing the target the most. The campaign is our Contribution to the growing chorus of leaders from UN, NGOs and other organizations calling for urgent action to save mothers and children from preventable deaths”.

There are hundreds of deaths and many more costly illnesses each year from health problems that breastfeeding may help to prevent. This includes stomach viruses, ear infections, asthma, juvenile diabetes, Sudden infant death Syndrome and even childhood leukemia. Among the benefits: Breast milk contains antibodies that help babies to fight against infections; it also can affect insulin levels in the blood, which may make breast-fed babies less likely to develop diabetes and obesity (12).

Light exercise during pregnancy may improve the future health of child by controlling weight in the womb, Regular moderate intensity aerobic exercise leads to a modest reduction in offspring birth weight without restricting the development of maternal insulin resistance, by altering the maternal environment in some way that has an impact on nutrient stimulation of foetal growth, resulting in a reduction in offspring birth weight. Given that large birth size is associated with an increased risk of obesity, a modest reduction in birth weight may have long-term health benefits for offspring by lowering this risk in later life. Regular exercise during pregnancy does not cause the same reduction in insulin resistance that occurs in exercising non-pregnant individuals (13).

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Received on 30.08.2010

Accepted on 20.09.2010

Research J. Science and Tech. 2(5): Sept –Oct. 2010: 95-97