Clinicoepidemiological study of PEM among Axomiya children

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Clinico-epidemiological study of PEM among
Axomiya children

• Tanushree R Peters Dr.(Mrs.) P Kalita
• DNB student Associate Professor
• Department of Paediatrics Department of
  Paediatrics
• Gauhati Medical College Gauhati Medical
  College

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Introduction

• Undernutrition and malnutrition most serious
  human health hazard
• Requires prevention, early recognition and prompt
  treatment
• 3 clinical syndromes constituting severe PEM ---
• - Kwashiorkor
• - Marasmus
• - Marasmic-kwashiorkor

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Aims Objectives

• To study the epidemiology of PEM
• To detect the incidence of various grades of PEM
• To study its varied clinical features
• To study its associated complications, mortality
  and morbidity

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Materials Methods

• Carried out on Axomiya children attending OPD of
  GMCH
• Also includes 5 nearby villages
• Period of 1 year from Dec 2003

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Materials Methods

• Eligibility criteria -
• Children upto the age of 6 years
• With various grades of malnutrition (according
  to IAP)
• Attending Paediatric OPD and 5 villages
• Exclusion criteria -
• Children suffering from chronic illness

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Materials Methods

• Anthropometry used to classify grades of
  malnutrition
• were weight, height and mid-arm circumference
• Thorough clinical examination
• Classification of social class based on modified
  Kupuswamy scale

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Results ObservationsAge Incidence-
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Results ObservationsSex Incidence -

• Sex No. Percentage
  
• Male 220 44
• Female 280 56
•  

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Results ObservationsSex distribution in
severe PEM -
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Results ObservationsDistribution according to
Religion -

• Religion Number Percentage
• Hindu 316 63.2
• Muslim 180 36
• Others 4 0.8

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Results ObservationsAge incidence in relation
to Grades of Malnutrition -
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Results ObservationsGrades of Malnutrition -
31
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Results Observations PEM in relation to Birth
Order -

• Birth Order No. Percentage
• 1 100 20.0
• 2 113 22.6
• 3 127 25.4
• gt 4 160 32.0

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Results ObservationsPEM in relation to
Family Size -

• Family Size No. Percentage
• 3 100 20.0
• 4 113 22.6
• 5 127 25.4
• gt 6 160 32.0

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Results ObservationsPEM in relation to
Parents occupation -

• Occupation No. Percentage
• DWE 320 64.0
• Farmer 120 24.0
• Carpenter 25 5.0
• Driver 10 2.0
• Tailor 10 2.0
• Shopkeeper 11 2.2
• Grade IV 4 0.8

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Results ObservationsPEM in relation to
Educational qualification of parents -

• Edu Qual No. Percentage
• Illiterate 340 68
• Literate 100 20
• Primary 45 9
• Secondary 10 2
• High 5 1

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Results observationsPEM in relation to
Immunization status -
   
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Results ObservationsPEM in relation to
Immunization status -
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Results ObservationsPEM in relation to age of
cessation of Breast feeding
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Results ObservationsPEM in relation to
introduction of complementary feeding -
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Results ObservationsPEM in relation to
Socio-economic status -
     
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Results observationsDiseases associated with
PEM -
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Results ObservationsClinical signs with
severe PEM -
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Results ObservationsClinical signs with
severe PEM -
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Results ObservationsComplications associated
with severe PEM -
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Results ObservationsMortality rate in severe
PEM -
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Conclusion

• PEM ----- an environmental disease
• Detailed epidemiological investigations must to
  plan prevention

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Thank you.