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Indian Journal of Community Medicine

A Study of Protein Energy Malnutrition (PEM) in Children (0 to 6 Year) in a Rural Population of Jhansi District (U.P.)

Author(s): S. Chakraborty, S.B. Gupta, B. Chaturvedi, S.K. Chakraborty

Vol. 31, No. 4 (2006-10 - 2006-12)

S. Chakraborty, S.B. Gupta, B. Chaturvedi, S.K. Chakraborty

Introduction

Protein Energy Malnutrition (PEM) or Protein Calorie Malnutrition (PCM) is a widespread nutritional disease in the developing countries. The present study was conducted with the objective to study the protein energy malnutrition (PEM) in children (0-6 year) in rural population of Jhansi district in the state of Uttar Pradesh

Material and Method

The study was conducted over eleven anganwari’s centers of Babina block in the Jhansi district. Multi stage sampling procedure was adopted to select approximately two hundred children (0-6 year) for the present study. The parents were interviewed to get the necessary information. A door to door survey was done and general information like name of the child, father’s name, age and sex of the child, type of family, parent’s occupation and educational status was collected from the head of each house hold. The grading of PEM was done as per the recommendations of the Nutrition Sub- Committee of Paediatrics (I.C.M.R.,1972)

Results and Discussion

The overall occurrence of PEM in under 6 year children was observed to be 67%, however it was found to be significantly higher (80.9%) in the age group of 1-3 years (Table I) as compared to other age groups. This age group also exhibited significantly higher prevalence (χ2=14.67, p<0.05) of Grade I, II, III PEM. Sen et al. also reported a higher prevalence in the age group of 1-3 years, however Saxena et al. (1997) reported a higher prevalence in the age group of 0-1 year. It was found that female had an overall higher prevalence of PEM (70.6%) as also Grade I PEM (36.6%) in comparison to males who had overall higher prevalence of PEM and Grade I PEM as 62.6 and 19.7% respectively (Table I).

Contradictory results were reported by Saxena et al. (1997) and Srivastava (1985) as overall higher prevalence among males. However, Grade II, III, and IV PEM was found to be significantly higher (χ2=1.41, p<0.05) in males (27.4, 10.9 and 4.3% respectively) than in females (23.8, 7.3 and 2.7% respectively).

The overall PEM prevalence was seen to be higher among the children of illiterate mothers whereas Grade II, III, IV PEM was higher amongst children of mothers having primary education (Table II). Significant difference (χ2=12.53, p<0.05)was found between the per cent of PEM in children of mother who are illiterate or having primary education in comparison to those of having education up to middle school and / or above. Other researchers have also reported similar observations.

The overall prevalence of PEM (Table II) was found to be maximum (77.7%) among those children whose father were labourers, while the overall prevalence of PEM was found to be minimum (50%) among those children whose father were skilled professionals. As sizeable percentage of children with Grade I and Grade II PEM was also found among the children of labourers. Grade II PEM was maximum in children of businessmen (29.4%). Significant difference (χ2=11.04, p<0.05) was found in prevalence of PEM among children of labourer / farmers in comparison to those who are in service/business/skilled profession. Srivastava (1983) also reported of higher prevalence Grade I PEM amongst children belonging to labour class.

Table I. Prevalence of PEM Amongst Under 6 Year Old Children.

Age Group
(Year)
Total
Children
Studied
Normal Malnourished
Grade-I Grade-II Grade-III Grade-IV Total
Age wise
0-1 42 20 (47.6%) 8 (19.0%) 8 (19.0%) 4 (9.5%) 2 (4.7%) 22 (52.3%)
1-3 84 16 (19.0%) 30 (35.7%) 28 (33.3%) 8 (9.5%) 2 (4.7%) 68 (80.9%)
3-6 74 30 (40.5%) 20 (27.0%) 15 (20.2%) 6 (8.1%) 3 (4.0%) 44 (59.4%)
Grand Total 200 66 (33.0%) 58 (29.0%) 51 (25.5%) 18 (9.0%) 7 (3.5 %) 134 (67.0%)
Sex wise
Male 91 34 (37.3%) 18 (19.7%) 25 (27.4%) 10 (10.9%) 4 (4.3%) 57 (62.6%)
Female 109 32 (29.3%) 40 (36.6%) 26 (23.8%) 8 (7.3%) 3 (2.7%) 77 (70.6%)
Grand Total 200 66 (33.0%) 58 (29.0%) 51 (25.5%) 18 (9.0%) 7 (3.5%) 134 (67.0%)

Table II. Prevalence of PEM in relation to educational status of mother and occupation of father

Educational
Status of
Mother
Total
Children
Studied
Normal Malnourished
Grade-I Grade-II Grade-III Grade-IV Total
Education status of mother
1lliterate 116 26 (22.4%) 37 (31.8%) 37 (31.8%) 13 (11.2%) 3 (2.5%) 90 (77.5%)
Primary 30 10 (33.3%) 6 (20.6%) 10 (33.3%) 2 (17.2%) 2 (17.2%) 20 (66.6%)
Middle School 37 20 (54%) 12 (32.4%) 2 (5.4%) 2 (5.4%) 1 (5.8%) 17 (45.9%)
Above 17 10 (58.8%) 3 (17.6%) 2 (11.7%) 1 (5.8%) 1 (5.8%) 7 (41.1%)
Grand Total 200 66 (33.0%) 58 (29.0%) 51 (25.5%) 18 (9.0%) 7 (3.5%) 134 (67.0%)
Occupation of father
Labour 81 18 (22.2%) 29 (35.8%) 22 (27.1%) 10 (12.3%) 2 (2.4%) 63 (77.7%)
Farmer 45 14 (37.1%) 15 (33.3%) 12 (26.6%) 3 (6.6%) 1 (2.2%) 31 (68.8%)
Service 37 18 (48.6%) 7 (18.9%) 8 (21.6%) 2 (5.4%) 2 (5.4%) 19 (51.3%)
Business 17 6 (35.2%) 4 (23.5%) 5 (29.4%) 1 (5.8%) 1 (5.8%) 11 64.7%)
Skilled 20 10 (50.0%) 3 (15.0%) 4 (20.0%) 2 (10.0%) 1 (5.0%) 10 (50.0%)
Professional
Grand Total 200 66 (33.0%) 58 (29.0%) 51 (25.5%) 18 (9.0%) 7 (3.5%) 134 (67.0%)

c2 =12.53, df—3,p<0,05 for educational status of mother c2 =11.04, df-4, p<0.05 for occupation of father

Conclusions

The occurrence of overall and Grade I, II, III PEM was highest amongst the age group 1-3 year. Female child had a higher percentage occurrence of overall and Grade I PEM. This may be because of the lack of attention that a girl child receives. The prevalence of overall and Grade I, II, III PEM was highest among children of illiterate mothers. Improper education and dearth of awareness among mothers results in poor health of a child. The children of labourers were affected most with overall and Grade I, II, III PEM. It is quite often seen that in labour class both the parents work through the day, resulting in the child receiving almost no attention.

The extent of malnutrition can be countered by educating the parents with respect to basic nutritional requirements of their children and encouraging them to consume locally available low cost nutritious foods.

References

  1. Sen V. Purohit B.K. Jain T.P. Weight/Height ratio in assessment of protein calorie malnutrition, Ind. Paediatrics, 2: 135-138.
  2. Srivastava V.K. Thesis for M.D. (S.P.M.), 1983. Kanpur University.
  3. Indian Academy of Paediatrics, Classification of Protein Calories Malnutrition, Ind. Paediatrics, 1972, 9:369.
  4. Ray S. K. Biswas A. B. Kumar S. A study of dietary pattern house hold food security and nutritional profile of under-five children of a communitv in West Bengal. Journal of Indian Medical Association. Sep. 1998(9):517-519,522-523.
  5. Swami H.M. Thakur J.S. Bhatia S.P. Bhatia V. Nutritional status of pre school children in an integrated child development service (ICDS) block of Chandigarh. Journal of Indian Medical Association. Oct: 99(10):554-556.

Foods and Nutrition, Inst. of Home Science, Bundelkhand University, Jhansi-284128 (U.P).
E-mail : [email protected]
Received : 29.3.05

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