Erum Afzal, Saadia Khan, Ibad Ali, Kausar Aftab, Reema Arshad, Asad Abbas.
Developmental Status in Children with Severe Acute Malnutrition.
J Islamic Int Med Coll Jan ;15(4):245-9.

Objective: To access the developmental status in children with severe acute malnutrition (SAM). Study Design: Hospital based observational cross sectional study. Place and Duration of Study: Department of Pediatrics, The children's hospital and the institute of child health Multan from 1 January 2019 to 15 July 2019. Material and Methods: A total of 72 patients aged 6-36 months, diagnosed as severely acute malnourished according to World Health Organization criteria, were included in study. Permission was taken from the IRB ethical committee of the hospital. Prior to study a Performa was designed by trained staff and after the permission of parents complete data were collected from patients. All the children were assessed by using Portage Early Education Plan by a trained and expert clinical nurse to evaluate for the specific areas of development affected by malnutrition. Portage Early Education Plan has five development key areas applied up to 5 years. These are self-help, motor skills, cognition, social skills and language. Complete data was analyzed by using SPSS version.21.0. Mean comparison test was applied and Chi square test was applied and P value less than 0.05 were considered as statistically significant (MUAC). Results: Out of 72 patients, 38(52.78%) were male and 34(47.22%) were female. Male to female ratio was 1.11:1. Mean comparison of mid upper arm circumference (MUAC) was correlated with developmental quotient (DQ). Mid upper arm circumference was found to be significant correlation with Motor developmental quotient (DQ) (p-value 0.005), cognition developmental quotient (DQ) (p-value 0.048) and mean developmental quotient (DQ) (p-value 0.03). It was found that significant association with low Motor 2 2 developmental quotient (DQ) (Chi = 4.2, P-value= 0.032), low Cognition developmental quotient (DQ) (Chi = 2 3.0, P-value= 0.042) and low Mean developmental quotient (DQ) (Chi = 3.1, P-value= 0.038). Conclusion: Children with severe acute malnutrition have extreme developmental delay in all five domains i.e. Self-help, motor skills, cognition, social skills and language. This highlights the importance of developmental therapy with management of malnutrition as recommended by WHO manifest of severe acute malnutrition after development therapy. To improve potential outcome of children with severe acute malnutrition, developmental assessment and therapy should be part of severe acute malnutrition program to timely identify and manage neuro disabilities in severe acute malnutrition.

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