[Social environment in marasmic malnutrition]

Undernutrition is associated with precarious sociocultural conditions. Concerned to break the vicious circle of undernutrition and poverty, Chile has developed programs to solve this problem, among these are the Closed Nutritional Recovery Centers (CNRC), where undernourished infants are treated and their families are educated, in order to improve their quality of life and to sustain, after treatment, the nutritional status achieved by their children at the center. We have followed up for the past 9 years of 283 children who were admitted at age 9.96 +/- 4.97 (mean +/- SD) months, (weight/age 63.05 +/- 8.4% NCHS standards), for treatment in a CNRC. Only 13% of them sustained the nutritional status achieved before discharge, which proceeded at age 13.42 +/- 5.1 months, (weight/age 81.64 +/- 8.9). We also studied, in two transversal points along follow up, the socio-cultural factors that influence nutrition after discharge from the CNRC: father's alcoholism, the presence of another malnourished infant at home, and low socio-economic status at admission were significantly related to bad nutritional long term evolution, while higher educational level and marital stability favored better outcomes.