Childhood diarrhea and malnutrition in Pakistan, Part I: Incidence and prevalence

Does malnutrition in clubfoot patients affect Ponseti technique and its outcome?

OBJECTIVES

Malnutrition is a crucial health problem predominantly in the developing countries. Malnutrition in children is one of the main risk factors for diseases and mortality. Club foot or congenital talipes equinovarus (CTEV) is the most common form of congenital orthopaedic abnormality. Over the past 20 years, the Ponseti method is considered the gold standard for the treatment of clubfoot. Our objective is to determine the prevalence of malnutrition in clubfoot patients, and its effects on the outcome of Ponseti technique in patients presenting to the Orthopaedic Clinic of tertiary care Hospital in Karachi, Pakistan.

METHOD

The cross-sectional study was conducted from January to December 2018. Total 153 clubfoot patients were treated and the World Health Organization (WHO) classification of weight-for-age index was used to assess the nutritional status of patients, and its impact on outcome of Ponseti technique was recorded and analysed with a P value ≤ .05 as significant.

RESULTS

Of the 153 patients, 112 (79.7%) were found in good nutritional status and 42 (20.6%) were malnourished. The average number of casts per patient and patients requiring 6+ casts in the undernutrition group was higher compared with good nutrition group (45.5% vs 21.42%, respectively). The number of Achilles tenotomy performed in the undernutrition group was also higher (76.4% vs 51.8%).

CONCLUSION

A significant correlation between patients' nutritional status and outcome of the Ponseti technique is found as it influences the number of casts, possible relapse and failure of treatment.

Prevalence of Undernutrition and Its Associated Factors among Children below Five Years of Age in Bure Town, West Gojjam Zone, Amhara National Regional State, Northwest Ethiopia

Background. Malnutrition is the major public health problem over the world. Developing countries are highly affected. Asian and Sub-Saharan African countries, including Ethiopia, contribute the highest of all. The main aim of this study was to assess the prevalence of undernutrition and its associated factors among children below five years of age.Methods. Community-based cross-sectional survey was conducted on 342 study participants. Simple random sampling technique was used to select sampling kebeles and study units. Weight and height were measured using calibrated instruments. The data were entered into EpiData version 3.1 software and calculated using SPSS version 20.0 statistical software and/or World Health Organization Anthro software with aid of Stat/Transfer.Results. Overall prevalence of undernutrition was 35.5%, of which 85 (24.9%), 38 (11.1%), and 49 (14.3%) were stunting, wasting, and underweight, respectively. Male children were more affected in both severe and moderate nutritional problems compared to female children. The finding showed that 27 (7.9%) had severe stunting, 15 (4.4%) had severe wasting, and 11 (3.2%) had severe underweight, respectively.Conclusion. Undernutrition was high in Bure town among children below five years of age. Male sex, maternal educational status, low household income, preterm babies, absence of antenatal follow-up, diarrhea, and respiratory infections within one-month duration were factors affecting undernutrition.