Early detection of protein energy malnutrition in Sharkia Governorate.
The objective of this cross-sectional study was to assess the nutritional status of children, aged 6 to 36 months, in Sharkia Governorate aiming for early detection of malnourished cases.


METHODS
the present study was carried out on 1000 children aged 6 to 36 months, selected by a multistage random sample from 6 villages in two districts in Sharkia Governorate. Data were gathered by an interview questionnaire to the child's mother or care giver at their homes. Anthropometric measurements as height, weight, mid-arm, head circumference and skin fold thickness were assessed. Body mass index was calculated. Dietary evaluation was done by a 24 hours recall for amounts and frequencies of food and was transferred to their recommended daily allowance (RDA). The studied children were classified into three groups according to their weight for age percentiles, underweight children, borderline malnourished children and normal weight children. Serum hemoglobin, pre-albumin and albumin were assessed for a randomly selected number of the studied group.


RESULTS
the study showed that all anthropometric measurements were lower than normal in underweight and borderline subjects. The prevalence rates of wasting, stunting and underweight were 15%, 24.4% and 15.4% in the studied infants in Sharkia Governorate, respectively. The study revealed that nutrient intake of the study subjects was lower than the RDA for the energy intake from carbohydrates, vitamin D, and iron, while it was higher than the RDA for the energy intake from lipids and vitamin A and equal to the lower level of the normal range of RDA for the energy intake from proteins. Most of the protein intake was of plant origin. Caloric intake was less than RDA in underweight and border line children, but more than RDA in normal children (86%, 90% and 102%). The ratios of caloric intake to the required calories according to weight were 90%, 98% and 108% in the three groups respectively. Chronic cough and chronic and recurrent diarrhea were more complained by underweight and borderline children. Underweight children were more infested with oxyurius and entamoeba histolitica than the other 2 groups. Serum hemoglobin, albumin and plasma pre-albumin levels were within normal range with significantly lower values in underweight and borderline infants compared to normal children. By multiple linear regression analysis, the most important factors affecting BMI were carbohydrate, lipid and caloric intake, serum albumin, plasma pre-albumin, vitamin A and D intake and protein intake.


CONCLUSIONS
There is a high prevalence of wasting ,stunting and underweight among infants and children of the studied sample in Sharkia governorate explained by the low socioeconomic status, unbalanced diet. Early changes of protein energy malnutrition were detected, in spite of the fact that serum hemoglobin, albumin and plasma pre-albumin levels were within normal range, they were significantly lower in underweight and borderline infants compared to normal children.
Shaaban
Sanaa Y
SY
Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Marzouk
Diaa
D
Nassar
May F
MF
Ezzat
Nermine I
NI
Mohamed
Ibrahim
I
D000328:Adult; D001837:Body Weights and Measures; D002675:Child, Preschool; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D008297:Male; D009752:Nutritional Status; D010290:Parents; D011203:Poverty; D011228:Prealbumin / Q000032:analysis; D011502:Protein-Energy Malnutrition / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D012709:Serum Albumin / Q000032:analysis
D006454:Hemoglobins; D011228:Prealbumin; D012709:Serum Albumin