FREQUENCY OF DELAYED MILESTONES AMONG MALNOURISHED CHILDREN UNDER 5 YEARS OF AGE
Main Article Content
Keywords
Stunted development, children, malnutrition
Abstract
Background : In children who suffer from inadequate nutrition, delays in reaching developmental milestones are frequently observed. Malnutrition suppresses immunity and affects the growth negatively in addition to psychomotor and cognitive development. Delays in milestones are associated with the increased burden of disease in malnourished children and, thus, it is important to recognize this burden to determine nutritional interventions, parental education, and preventive health approaches in the developing world.
Objectives: To establish the frequency of delayed milestones in children under five years with malnutrition and the correlation between socioeconomic, demographic and maternal factors as compared with the development of the other children.
Study Design: A Descriptive Cross-Sectional Study.
Place and Duration of study . Pediatrics Department of Khyber Teaching Hospital, Peshawar form January 2021 to July 2021.
Methods: This study was descriptive, cross-sectional study in Pediatrics Department of Khyber Teaching Hospital, Peshawar, over a six month period. A total number of 155 malnourished children in the age range of 1-5 years were recruited by means of consecutive sampling. Patients were studied by socio economic factors, clinical history, and maternal teaching. Systemic and physical examination, along with laboratory (supporting) tests were conducted. Analysis of data was based on SPSS v20, and chi-square test was used during stratification. A p- value of 0.05 or less was deemed as significant.
Results
Out of 155 children, 96 (62%) were between 1 and 3 years 59 (38%) between 4 and 5 years. The average age was 3 years (SD+/-1.71). Male and female distribution was 67 (43%) and 88 (57%), respectively. Socioeconomic statistics indicated that 57 percent were families in lower, 35 percent were families in middle and 8 percent were families in upper classes. Maternal education was not very high and 37% had primary education and 3 percent were graduates or above. The delay of milestones was noted in 19 children (12%). Statistical stratification indicated that there was a significant association with age (p=0.000) and a non-significant association with gender, socioeconomic status and mothers’ education (p>.05).
Conclusion: Our study reveals that 12% of malnourished children under the age of five experience delays in developmental milestones. Notably, we found a statistically significant association between these delays and the child's age, underscoring the critical importance of early nutritional support and age-specific interventions to promote healthy development. The results emphasize the necessity of early dietary interventions, parent education, and community based-programs to manage development delays. Socioeconomic barriers can be addressed and improved motherly education would also diminish the risks. Early provisions can positively impact the progress of infants and young children and reduce the effects of the malnourishment of such at-risk populations in a lasting manner.
References
2. Bandara T, Hettiarachchi M, Liyanage C, Amarasena S. Current infant feeding practices and impact on growth in babies during the second half of infancy. Journal of human nutrition and dietetics : the official journal of the British Dietetic Association. 2015;28(4):366-74.
3. Bhargava H, Singh J. Structural changes in the brain on cranial magnetic resonance imaging in severely malnourished children before and after treatment. Nutrition (Burbank, Los Angeles County, Calif). 2020;74:110753.
4. Buonomo E, Scarcella P, Tembo D, Giuliano M, Moramarco S, Palombi L, et al. Malnutrition decreases the odds of attaining motor milestones in HIV exposed children: results from a paediatric DREAM cohort. Epidemiologia e prevenzione. 2015;39(4 Suppl 1):108-12.
5. Dodamani MH, Sehemby M, Memon SS, Sarathi V, Lila AR, Chapla A, et al. Genotype and phenotypic spectrum of vitamin D dependent rickets type 1A: our experience and systematic review. Journal of pediatric endocrinology & metabolism : JPEM. 2021;34(12):1505-13.
6. Essabar L, Meskini T, Ettair S, Erreimi N, Mouane N. Malignant infantile osteopetrosis: case report with review of literature. The Pan African medical journal. 2014;17:63.
7. Gardner A, Ruch A. Not All Stridor Is Croup. Pediatric emergency care. 2020;36(1):e14-e7.
8. Goraya JS, Kaur S, Mehra B. Neurology of Nutritional Vitamin B12 Deficiency in Infants: Case Series From India and Literature Review. Journal of child neurology. 2015;30(13):1831-7.
9. Gudu E, Obonyo M, Omballa V, Oyugi E, Kiilu C, Githuku J, et al. Factors associated with malnutrition in children < 5 years in western Kenya: a hospital-based unmatched case control study. BMC nutrition. 2020;6:33.
10. Guez S, Chiarelli G, Menni F, Salera S, Principi N, Esposito S. Severe vitamin B12 deficiency in an exclusively breastfed 5-month-old Italian infant born to a mother receiving multivitamin supplementation during pregnancy. BMC pediatrics. 2012;12:85.
11. Kulkarni S, Ramakrishnan U, Dearden KA, Marsh DR, Ha TT, Tran TD, et al. Greater length-for-age increases the odds of attaining motor milestones in Vietnamese children aged 5-18 months. Asia Pacific journal of clinical nutrition. 2012;21(2):241-6.
12. Masuda K, Chitundu M. Multiple micronutrient supplementation using spirulina platensis and infant growth, morbidity, and motor development: Evidence from a randomized trial in Zambia. PloS one. 2019;14(2):e0211693.
13. Prado EL, Abubakar AA, Abbeddou S, Jimenez EY, Somé JW, Ouédraogo JB. Extending the Developmental Milestones Checklist for use in a different context in Sub-Saharan Africa. Acta paediatrica (Oslo, Norway : 1992). 2014;103(4):447-54.
14. Ramani VK, Pattankar J, Puttahonnappa SK. Acute Respiratory Infections among Under-Five Age Group Children at Urban Slums of Gulbarga City: A Longitudinal Study. Journal of clinical and diagnostic research : JCDR. 2016;10(5):Lc08-13.
15. Rupérez M, González R, Mombo-Ngoma G, Kabanywanyi AM, Sevene E, Ouédraogo S, et al. Mortality, Morbidity, and Developmental Outcomes in Infants Born to Women Who Received Either Mefloquine or Sulfadoxine-Pyrimethamine as Intermittent Preventive Treatment of Malaria in Pregnancy: A Cohort Study. PLoS medicine. 2016;13(2):e1001964.
16. Sobczyńska-Malefora A, Ramachandran R, Cregeen D, Green E, Bennett P, Harrington DJ, et al. An infant and mother with severe B(12) deficiency: vitamin B(12) status assessment should be determined in pregnant women with anaemia. European journal of clinical nutrition. 2017;71(8):1013-5.
17. Soliman A, De Sanctis V, Adel A, El Awwa A, Bedair S. Clinical, biochemical and radiological manifestations of severe vitamin d deficiency in adolescents versus children: response to therapy. Georgian medical news. 2012(210):58-64.
18. Wadhwani M, Beri S, Saili A, Garg S. Homocystinuria masquerading as vitamin B12 deficiency. Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH. 2012;4(2):326-8.
19. Zhou J, Tan J, Ma D, Zhang J, Cheng J, Luo C, et al. Identification of Two Novel LAMA2 Mutations in a Chinese Patient with Congenital Muscular Dystrophy. Frontiers in genetics. 2018;9:43.
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Laila Nazir
Registrar Pediatrics, Khyber Teaching Hospital, Peshawar, Pakistan.
Benish Hira
Registrar Pediatrics, Khyber Teaching Hospital, Peshawar, Pakistan.
Zaid Jawaid
Registrar Anesthesia, Khyber Teaching Hospital, Peshawar, Pakistan.