Undernutrition and risk of infections in underfive children from urban low income groups of South Delhi

Abstract

Preschool children are the most vulnerable segment of the population. Undernourished children are more prone to morbidity due to infections. Infections aggravate undernutrition and the vicious cycle of undernutrition and morbidity continues until the cycle is interrupted by health and nutritional follow up. Analysis of NFHS-3 data showed that the relative risk of morbidity was higher in children with low BMI. The present mixed longitudinal study was taken up to assess the risk of morbidity in undernourished children and to assess the impact of morbidity on their nutritional status newlineThree thousand eight hundred and eighty eight (N=3888) children were recruited for the study. Information pertaining to socioeconomic and demographic profile were collected in all families .All children were followed up fortnightly to obtain information on morbidity due to infections (74,636 fortnightly visits with mean of 19.7 observations per child). In infants length and weight were measured every month. In the one to five year age old children, weight was measured every month and height once in three months. Data on IYCF practices and immunisation profile were obtained during the monthly visits using pre-tested and validated questionnaire. newlineGeneralised estimating equation was used to assess the risk of morbidity in undernourished children. Prevalence of underweight was observed to be 31.9 percent, stunting 43.4 percent and wasting 12 percent. Prevalence of morbidity was found to be 10.3 percent. Respiratory infection was the main cause of morbidity followed by fever and diarrhea. Children who had morbidity during the preceding fortnight had lower mean body weight and BMI. With repeated illness, deterioration in nutritional status was higher as compared to single episode of infection. Irrespective of the prior nutritional status, there is a fall in body weight during illness. All under-five children in the study were provided with the mother child protection card which provides authentic messages on health and nutrition care