title: Epidemiological and clinical profile of hospitalized children with moderate and severe acute malnutrition in South India.
abstract: OBJECTIVE
  To evaluate the clinico-epidemiological profile, pattern of infections, feeding practices, socio-demographic risk factors and outcome of hospitalized children with moderate acute malnutrition (MAM) and severe acute malnutrition (SAM).
  
  
  METHODS
  Cases (children aged 1-60 mo with SAM or MAM) and controls (children with weight for height z score more than -1 SD) were recruited from November 2011 through July 2013. Overall, 126 cases and 126 controls were included.
  
  
  RESULTS
  Only 33 % of malnourished children (cases) were exclusively breast fed. Among controls, 71 % were exclusively breast fed for the first 6 mo after birth. Most cases had associated infections (p 0.004) and anemia (p < 0.001). ROC curve revealed 120 mm mid upper arm circumference (MUAC) as the best cut off for predicting SAM. Mothers' education, pre-lacteal feeds and co-morbidities were independent predictors of malnutrition (R(2) = 22.1 %) by logistic regression.
  
  
  CONCLUSIONS
  Though 11.5 cm MUAC has been mentioned by WHO as the cut off for identifying SAM, a higher cut off (12 cm) may be required to use it as a screening tool. Mothers' education, pre-lacteal feeds and co-morbidities were found to be independent determinants for malnutrition in the present patient population, indicating the need towards a targeted approach for modifying these factors.
authors.affiliation: Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605006, India.
authors.forename: R Usha
authors.initials: RU
authors.lastname: Devi
authors.forename: Sriram
authors.initials: S
authors.lastname: Krishnamurthy
authors.forename: B Vishnu
authors.initials: BV
authors.lastname: Bhat
authors.forename: Ajit
authors.initials: A
authors.lastname: Sahai
mesh_terms: D000740:Anemia / Q000453:epidemiology*; D000886:Anthropometry / Q000379:methods; D001827:Body Height; D001835:Body Weight; D001942:Breast Feeding / Q000706:statistics & numerical data; D016022:Case-Control Studies; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007239:Infections / Q000453:epidemiology*; D008297:Male; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D000067011:Severe Acute Malnutrition / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D012720:Severity of Illness Index