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Combating protein-energy-malnutrition in a rural/peri-urban southern African black population
U E MacIntyre1, M Bac, P M Kuzwayo
1Department of Human Nutrition, Medical University of Southern Africa, Medunsa.
Insights
Protein-energy malnutrition (PEM) in young children is a critical issue in Africa. A South African nutrition unit improved outcomes through education on local food preparation and sustainable practices, significantly reducing child mortality.
Area of Science:
- Public Health
- Pediatrics
- Nutrition Science
Background:
- Protein-energy malnutrition (PEM) poses a significant threat to child health in Africa, contributing to high morbidity and mortality rates.
- The Gold Fields Nutrition Unit was established in South Africa in 1987 to address PEM in rural populations.
Purpose of the Study:
- To combat and prevent Protein-energy malnutrition (PEM) in young children in rural South Africa.
- To improve rehabilitation outcomes for children suffering from PEM through community-based interventions.
Main Methods:
- Admitted and treated 442 pediatric patients with PEM and managed 406 outpatients from 1987-1989.
- Educated mothers and carers on meal preparation using local foods, vegetable gardening, orchard maintenance, and improved hygiene.
- Established satellite nutrition clinics to extend care and support.
Main Results:
- Average patient age was 15.4 months, with an average hospital stay of 12 days.
- Daily weight gain during treatment averaged 31g.
- A 1990 follow-up of 73 patients showed no deaths within a 12-month period, indicating improved outcomes.
Conclusions:
- Community-based nutritional education and practical skill-building significantly improve outcomes for children with PEM.
- The intervention model, including satellite clinics, demonstrates a sustainable approach to reducing PEM-related mortality and morbidity.
Abstract:
PROTEIN-ENERGY-malnutrition (PEM) is a major cause of morbidity and mortality in young children in Africa. In South Africa, in 1987, to help combating and preventing PEM in the rural black population, the Gold Fields Nutrition Unit was inaugurated at the Medical University of Southern Africa. In 1987-9, 442 patients (rural/peri-urban) plus their mothers or child carers were admitted, and 406 attended as outpatients. Average age was 15.4 +/- 7.6 months, weight 7.0 +/- 1.6kg, stay in hospital, 12 +/- 10.8 days, and daily weight gain during treatment was 31 +/- 48g. Mothers mainly were young and unmarried. Primary causative factors were infections, ignorance, and insufficiency of food. Since results from rehabilitation are usually poor, mothers and carers were taught how best to prepare meals using local foodstuffs. The interventions included teaching and demonstrations of how to grow vegetables, maintain an orchard, a fowl-run, and improve kitchen and laundry facilities. In 1990, in a follow-up of 73 patients, no deaths had occurred within a 12 month period. This far better than usual outcome is being furthered by setting up satellite nutrition clinics.