Stunting and micronutrient deficiencies in malnourished children.

OBJECTIVE To determine the frequency of stunting and micronutrient deficiencies in malnourished children admitted in a tertiary care hospital. METHODS It was a cross-sectional study conducted at Paediatric department of Civil Hospital Karachi from January 2007 to December 2008. Patients aged 6 to 60 months, admitted in the ward were assessed for nutritional status and stunting according to the WHO classification of malnutrition, mild (weight for height ratio between -1SD to -2SD) moderate (-2SD TO-3SD) and severe (less than -3SD of NCHS/WHO reference values) malnourished children were included in the study. All the patients were subjected to clinical examination, which included height/length, weight and clinical signs of micronutrient deficiencies. Laboratory investigations were done to confirm the clinical diagnosis of iron deficiency anaemia and rickets. The collected data was analyzed by Statistical Program SPSS version 15. Frequencies and percentages were computed to present all categorical variables. Quantitative variables such as age was presented by mean +/- SD. RESULTS A total of 150 patients were enrolled in this study. Their mean age was 24.4 +/- 13.8 months (range 6 to 60 months). Of all, 63 (44%) patients were severely stunted, 44 (29%) had moderate stunting, 27 (18%) had mild stunting while only 16 (10.7%) had normal stature. Severely malnourished (< -3SD) were 119 (79%) patients, 30 (20%) patients had moderate malnutrition (-2SD to -3SD). Forty two percent severely malnourished children also had severe stunting. Anaemia was the most common micronutrient deficiency seen in 117 (78%) patients, out of these 88% had iron deficiency anaemia, Rickets was found in 54(36%) patients. Vitamin A deficiency was present in 21 (14%) cases. Other miscellaneous micronutrient deficiencies were zinc and B-complex deficiency in 42 (28%). CONCLUSION Malnutrition and associated micronutrient deficiencies were frequently found in children between 13 to 24 months of age. Stunting was commonly present between 25 to 36 months of age, it was associated with severe malnutrition in 42% cases. Anaemia is the most common micronutrient deficiency in malnourished patients, it was observed in 78% of cases whereas 44% of severely stunted patients had coexisting rickets.