A Study on the Prevalance of Infections and Infestations in Protein Energy Malnourished Children in a Tertiary Care Hospital.

Pavenden, K M (2010) A Study on the Prevalance of Infections and Infestations in Protein Energy Malnourished Children in a Tertiary Care Hospital. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION: PEM is a spectrum of conditions caused by varying levels of protein and calorie deficiencies. Primary PEM is caused by social or economic factors that result in a Lack of food. Secondary PEM occurs in children with various conditions associated with increased caloric requirements (infection, trauma, cancer), increased caloric loss (malabsorption), reduced caloric intake (anorexia,Cancer, oral intake restriction, social factors), or a combination of these Three variables. Malnourished children are more susceptible to infection, especially Sepsis, pneumonia, and gastroenteritis. Hypoglycemia is common after periods of severe fasting, but also may be a sign of sepsis. Hypothermia may signify infection or, with bradycardia, may signify a decreased Metabolic rate to conserve energy. Bradycardia and poor cardiac output predispose the malnourished child to heart failure, which is exacerbated by Acute fluid or solute loads Micronutrient deficiencies also can complicate malnutrition. Vitamin A and zinc deficiencies are common in the developing world and are an important cause of altered immune response and increased morbidity and mortality. Depending on the age at onset and the duration of the malnutrition, malnourished children may have permanent growth stunting (from malnutrition in utero, infancy, or adolescence) and delayed Development (from malnutrition in infancy or adolescence). Environmental (social) deprivation may interact with the effects of the malnutrition to Impair further development and cognitive function. AIMS AND OBJECTIVES : Analysis of infections (bacterial) and infestations (Parasitic) in babies attending outpatient and inpatient department of Institute of Child health with the symptoms of Protein Energy Malnutrition. Correlating symptoms associated with Protein Energy Malnutrition and Microbial infections and Infestations. Comparison of incidence of infections with general pediatric population attending Institute of Child Health for other diseases. MATERIALS AND METHODS : 100 children less than age of five months with symptoms of bacterial or parasitic infection and infestation and falling into criteria of Indian Association of Pediatrics classification of Protein Energy Malnutrition were included in the prospective study. A detailed prenatal and postnatal history, socioeconomic histoty, history of weaning practices with special emphasis on any predisposing factors for infection and thorough clinical assessment were carried out. Inclusion criteria: PEM – IAP classification, Age of less than five years, Suspicion of bacterial or parasitic disease, Attending OP or admitted IP in ICH. Exclusion criteria : Babies with weight more than standard, PEM babies without suspicion of any disease. CONCLUSION : Protein energy malnutrition increases the chances of a baby to get infections more than nonPEM babies and these infections tend to follow severe course in these babies, important factor being decrease in immunity. This forms a vicious cycle, infections increasing the severity of Protein energy malnutrition. In this study group, most common infection seen was pneumonia followed by skin infections, urinary tract infections and diarhoea. This is as against the control group, where most common infection seem to be skin infections followed by minor respiratory infections. Antibiotic sensitivity pattern in both the study and control group does not change in a large way showing increase incidence of infections in the malnourished babies than normal babies.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Prevalance ; Infections ; Infestations ; Protein Energy Malnourished Children ; Tertiary Care Hospital.
Subjects: MEDICAL > Microbiology
Depositing User: Subramani R
Date Deposited: 03 Aug 2017 01:45
Last Modified: 03 Aug 2017 01:45
URI: http://repository-tnmgrmu.ac.in/id/eprint/1755

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