Post Graduate, University of Bristol, England,
Corresponding author details:
Bashar Helail, Post Graduate
University of Bristol
England,
Copyright:
© 2020 Helail B. This is an
open-access article distributed under the
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Childhood malnutrition is a dietary deficiency that is caused by a lack of food, an eating disorder or a chronic health condition that hinders the absorption of the necessary nutrients required by the body. This is a threat because it contributes to the deaths of 45 percent of children below the age of 5. Addressing malnutrition requires multiple actions that can be spearheaded by the various sections of public health. Academic institutions play a role in carrying out research, but there is still a need for coordination on the part of the UN agencies and the various governments of affected countries [1]. Malnutrition manifests alongside other diseases, which may have a negative bearing on the life of a child. However, earl detection helps mitigates these negative effects but it is highly dependent on the educational levels and socio-economic status of the caregiver. The main challenge for players in the public health sector is to eradicate all causes of malnutrition, but this begins with the specific governments [2].
Objective: To examine carefully a malnutrition case
Methods: History, examination, investigation, diagnosis, and treatment
Results: The patients’ health did improve
Conclusion: Precise diagnostic measures should be carried out to identify the
symptoms of malnutrition and certain treatment measures should be applied
Malnutrition; Public Health; Diet; Access
The World Health Organization defines malnutrition as the cellular imbalance caused
between energy and nutrients and the body’s requirements to carry out growth and other
related functions. Larson-Nath and Goday state that malnutrition predisposes children to
other diseases and its treatment is made possible through the consumption of foods from
all food groups, keeping in mind to use locally available products [3]. There are preventive
measures against malnutrition, but it requires the input of both the mother and the
healthcare providers. This case study analyzes the various causes of malnutrition, treatment
options and other ways of preventing future cases. Aside from this, extreme cases of
malnutrition in children above the age of 5 are irreversible, with the effects manifesting not
only physically but mentally up to adulthood. It is therefore recommended that caregivers
not only attend clinics regularly but also check in their children at health facilities when
their level of activity is significantly lower and is characterized by sleepiness, shortness of
breath and signs of weakness [4].
This girl was brought to a health clinic in rural Jordanian by her mother and older sister
after they noticed that she had stopped concentrating on her school work and spent most
of her time sleeping in the family’s home. Her mother said that she was seven years old,
but her physique showed her to be slightly below the age of 6. Apart from this, the health
worker also noticed that the girl was extremely short for her age, she displayed fatigue
and constantly cried to her mother about her aching bones. She had little muscle mass and
weighed below the required limit for children her age. As they waited for medical attention,
the patient was irritable and showed crankiness, refusing to drink the water that her
mother offered her. The nurse collected this information, and further tests were carried out
to determine whether there were other diseases other than the apparent lack of nutrition.
F100 was then administered; this is a therapeutic milk formula that aids in the alleviation
of severe malnutrition as well as supplies the body with ions and energy before solid foods
are introduced in the course of the day. In April 2016, the UN General Assembly resolved
to adopt the UN Decade of Action on Nutrition 2016 – 2025, whose aim is to catalyze the policy commitments that would result in measurable actions that
address the issues related to malnutrition.Larson-Nath and Goday
state that malnutrition predisposes children to other diseases. The
reasons for this are multifactorial and may possibly be associated
with other underlying diseases (2019). This case study analyzes the
various causes of malnutrition, treatment options and other ways of
preventing future cases.
It was determined that this patient was not only suffering
from typhoid, but she was displaying the classic symptoms of
acute malnutrition. She was given a multivitamin tablet, and Oral
Rehydration Salt (ORS) was administered to help in the restoration
of fluid and necessary electrolytes. The on-call pediatrician also
prescribed ceftriaxone and albendazole to combat the infection
that was caused by parasites and iron to help in the restoration of
the blood quality [5]. Additionally, F100 was administered; this
is a therapeutic milk formula that aids in the alleviation of severe
malnutrition. The patient recovered and the clinic’s nutrition team
counseled her mother on her condition and she was advised to
provide a more nutritious diet. Her mother stated that her daughter
had stopped eating fish after she fell ill when she was four years old.
She also hated some fruits and vegetables which were abundant in
their locality. Her mother was advised to broaden the diet to include
as many vitamins as possible in order to replace the nutrients her
body was missing [6]. The head nutritionist also gave the mother a
list of foods that were readily available in her village; they were also
affordable. The interactions between infection and undernutrition
can create a lethal cycle of not only deteriorating nutritional status
but also worsening illnesses as the individual grows older. During
the first 1000 days, poor nutrition also leads to stunted and impaired
cognitive ability as well as a reduced performance in school.
WHO defines malnutrition as a cellular imbalance caused
between energy and nutrients and the body’s requirements to carry
growth and other related functions? A balanced diet is necessary for
a child’s development, but in their absence, the child manifests noncommunicable diseases, micronutrient deficiencies and the wasting
of body mass. This case can either refer to undernourishment or
overnutrition. Undernutrition sets in when there is an intake of
insufficient proteins and calories, while overnutrition is the excessive
intake of nutrients, more than the body requires for metabolism
and development. Nutrition levels are a determinant of both
child and maternal health and account for up to 10 percent of the
world’s disease burden and breastfeeding or pregnant women and
children under the age of 5 are more likely to develop malnutrition
[7]. Malnutrition is a problem that hinders the attainment of the
SDGs because poorly fed children lack the mental and physical
capacity to function on their own. It leads to cardiac dysfunction,
oral hygiene problems, and anaemia [4]. Lenters et al. [8] state that
the management of acute malnutrition has political and economic
contexts that has to be addressed. The predictors of malnutrition
are often in the form of illnesses, which when ignored, may result
in dire effects. The measures of child nutrition are useful in tracking
development processes, and this determines whether the Sustainable
Development Goals remain attainable or not, especially the second
goal, which is to ‘end hunger, achieve food security and improved
nutrition, and promote sustainable agriculture’.
The treatment of malnutrition needs to address all underlying conditions and to replace the nutrients which may be missing from the body. This is, however, only possible upon seeking a professional medical opinion. According to Lelijveld [9], there is an apparent absence of guidance on what form of treatment would work for moderate acute malnutrition (MAM), which is often the case in extreme clinical diagnoses (2019). It remains unclear whether counselling or using food products is effective, or the combination of both methods.
Dietary supplements and changes
The mother was placed under the guidance of dieticians. Their role was to develop a diet plan to ensure that the patient gets sufficient nutrients. A healthier, balanced diet was recommended, and this includes the consumption of fortified foods and drinks that are high in nutrients. A study conducted in Niger established that dietary diversity remains the best response to treating malnutrition. This is not only safe but also cost-effective, especially when using traditional or organic foods. This helps in minimizing medical costs and improving the child’s condition [10]. However, in third world countries that produce their own traditional foods, malnutrition is caused by the excessive consumption of one type of food, for instance, carbohydrates or vitamins, thereby leading to protein deficiency. Children under the age of five should be breastfed regularly if the mother is able to. In addition, the mother should consume foods that are high in protein when she is breastfeeding. If the baby is past weaning, protein-rich foods should be introduced.
Support and care services
Parents who have malnourished children receive care from social care officials and other visitors who can help in the preparation of food. An occupational therapist also plays a role in identifying the problems with their diets.Wherever possible, material support should be provided for these families so that they can better manage their child’s nutritional intake. Rahman [11] further states that seeking dietary support during and after pregnancy is dependent on the mother’s level of education and her socio-economic status. The patient’s mother was married off early, and this explains why she was unable to diagnose that her child was suffering from malnutrition.
Prevention
Preventing malnutrition requires the consumption of a healthy and balanced diet. This is not only vital for the body organs, but it also helps in the proper development of growing children. This involves eating foods from all the main groups, and especially plant and animal protein.
a) Improving the healthcare system: Systems that are efficient are necessary in preventing the rising cases of malnutrition in children. This can be done by making available information regarding feeding and weaning. Smita and Rathore [12] conducted a survey of 100 mothers in arural setting. It was discovered that deep-seated customs and beliefs prevented them from adequately feeding their children. The role of healthcare facilities then is to not only provide a diagnosis but to carry out sensitizations on the advantages and necessity of exclusive breastfeeding, of feeding children with nutritious foods and how to maintain proper levels of sanitation.
b) Early detection: A properly documented growth chart can help in the early detection of malnutrition. At a given time, the emphasis is placed on the velocity of growth rather than the child’s weight. The presence of a flat curve on the child’s chart is an indication of a problem and can be arrested and handled. The maintenance of this chart is done using anthropometric indices such as chest circumferences, weight, and height mid-arm circumference, among others [13].
c) Nutritional supplements: Vulnerable groups that are biologically vulnerable are the target groups for efforts made by governments to guarantee health. Providing the patient with supplements not only helped regain her balance, with the main objective being accelerated physical growth and rehabilitation [14].
Malnutrition in children is characterized by the lack of appetite
for either drink or food, low body temperature, loss of muscle and fat
and a prolonged healing time for wounds. In some cases, they have a
lower immune response to illnesses. Child malnutrition affects not
only affects their educational achievements but also their long-term
ability to be economically productive. Mental impairment that is
caused by iodine deficiency in the system is not only irreversible but
is also directly linked to loss of productivity [15]. The interactions
between infection and undernutrition can create a lethal cycle of not
only deteriorating nutritional status but also worsening illnesses as
the individual grows older. During the first 1000 days, poor nutrition
also leads to stunted and impaired cognitive ability as well as a
reduced performance in school [16]. In April 2016, the UN General
Assembly resolved to adopt the UN Decade of Action on Nutrition
2016–2025, whose aim is to catalyze the policy commitments that
would result in measurable actions that address the issues related to
malnutrition.There are preventive measures against malnutrition, but
it requires the input of both the mother and the healthcare providers.
Treating malnutrition is made possible through the consumption of
foods from all food groups, keeping in mind to use locally available
products [17].
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