ABSTRACTS: Oral Presentation Abstracts
Introduction: Severe malnutrition of childhood not only results in impaired physical growth but also poor mental development, which can be permanent if not treated at an appropriate time by means of psychosocial stimulation.Objective of the study was to compare mental and psychomotor development, and behaviour of severely malnourished children admitted to an urban, hospital-based nutrition rehabilitation unit (NRU) and those attending rural community nutrition centres (CNC) under the Bangladesh Integrated Nutrition Program (BINP).
Methods: Thirty severely malnourished children (Wt/Age <-3SD) aged 6–24 months admitted to the NRU of Dhaka Hospital, ICDDR,B were compared with 30 severely malnourished, age-and sex-matched children attending CNCs of BINP in Monohordi Upazila. Children’s development was assessed using the revised version of Bayley Scales of Infant Development, and behaviour rated on a five, 9-pointed scale by Wolke, and mothers asked about temperament of their children.
Results: The study groups did not differ in parental years of schooling, fathers’ occupation, and presence of sanitary latrine. NRU children lived in significantly less crowded houses (p=0.03), were significantly more wasted, had smaller heads, and thinner arms, and all had recovered from diarrhoea along with pneumonia, septicaemia, and dyselectrolytaemia while the community children had minor illnesses. The mean±SD Mental Development Index (MDI) and Psychomotor Development Index (PDI) of the NRU children were 68.67± 16.44 and 56.57± 11.09 respectively; and of the CNCs children were 83.40± 14.37 and 78.97± 19.23 respectively (p <0.001 for both comparisons). NRU children were significantly less active, less cooperative and less vocal, and their mothers also assessed them to be less fussy (p=0.03), less active (p=0.005) and less oriented (p=0.05) although more sooth-able (p=0.002) than the community children.
Conclusion: Severe malnutrition associated with serious illnesses adversely affects development and behaviour of malnourished children. In addition to treatment of underlying diseases and nutritional supplementation, management of severely mal-nourished children should include psychosocial stimulation to improve their development.