Global Child Health by Krishnan Subrahmanian & Padma Swamy

Author:Krishnan Subrahmanian & Padma Swamy
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Malnutrition

Malnutrition is defined by the WHO defines as “deficiencies, excesses, or imbalances” in a person’s diet (World Health Organization 2016). There can be under-nutrition which includes stunting, wasting, and micronutrient deficiency . There is also over-nutrition which is obesity and overweight. The obesity and overweight conditions will be discussed in more detail in the Non-communicable disease part of this section.

Health Impacts of Undernutrition

Forty-five percent of all childhood deaths in 2011 was attributable to undernutrition (Black et al. 2013).This is a public health issue with children dying from severe acute malnutrition or not reaching their full developmental potential due to undernutrition. Another significant issue related to undernutrition, is the risk that it places for children for developing pneumonia and diarrheal disease . While a causal pathway has not been surmised for malnutrition and immunity , there has been an association (Black et al. 2013). There have been several studies that have looked at the impact of malnutrition on the lymphatic and hematopoietic system , also studies have shown that there are malnutrition associated changes to the intestinal flora causing for inflammation and immune dysregulation (Black et al. 2013).

The presentation of a child with severe acute malnutrition can vary. According the WHO, severe acute malnutrition (SAM ) is defined as weight less than the 3 standard deviations below the mean (−3z score), or less than 70% of ideal body weight based on WHO/National Health Center Statistics references , or presenting with edema (World Health Organization 1999). Once a child with SAM is identified then the WHO has a clear set of guidelines that recommend admission based upon certain criteria, management during hospitalization, discharge criteria, and management in the outpatient setting (World Health Organization 2013).

Micronutrient deficiencies can also cause significant pathology and can co-exist with SAM or may present without SAM. According to a report from WHO, USAID, World Bank etc, an approximate two billion people suffer from micronutrient deficiency (World Health Organization 2013). That means that more than 1 in 4 people suffer from micronutrient deficiency when a population of 7.5 billion is used (US Census Bureau 2017). Micronutrient deficiencies that are targeted by the CDC and other organizations include Vitamin A, Folate, Zinc, iodine and iron (Micronutrient Initiative 2009; Centers for Disease Control 2015). The table below discusses each of these nutrients and the clinical symptoms associated with each.Micronutrient

Health impact

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