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Developmental performance of hospitalized severely acutely malnourished under-six children in low- income setting
Teklu Gemechu Abessa1,2, Liesbeth Bruckers3, Patrick Kolsteren4
1Department of Special Needs and Inclusive Education, College of Behavioral Sciences and Education, Jimma University, Jimma, Ethiopia. teklugemechu.abessa@uhasselt.be.
Insights
Severe acute malnutrition (SAM) significantly hinders child development, with younger children experiencing greater delays in gross motor, fine motor, personal social, and language skills. These developmental delays generally decrease with age, though social-emotional issues persist across age groups.
Area of Science:
- Child Development
- Pediatric Nutrition
- Global Health
Background:
- Retrospective studies indicate severe acute malnutrition (SAM) impacts child development.
- The specific age-related effects of SAM during its acute phase on child development are not well-documented.
- This study aimed to compare developmental performance in young children with SAM against healthy, age- and gender-matched controls.
Purpose of the Study:
- To compare the developmental performance of severely acutely malnourished children under six years of age with that of non-malnourished healthy children.
- To investigate the differential age-related effects of SAM on various developmental domains.
- To identify specific skills most affected by SAM across different age groups.
Main Methods:
- A comparative study involving 310 children with SAM and 310 matched healthy controls (mean age 30.7 vs. 29.6 months).
- Utilized culturally adapted tools: Denver II-Jimma (assessing personal social, fine motor, language, gross motor skills) and Ages and Stages Questionnaires: Social-Emotional (ASQ:SE).
- Employed multivariable Poisson regression analysis to compare developmental performance scores between the two groups.
Main Results:
- SAM caused significant developmental delays: 1-year-olds showed 300% delay in gross motor, 200% in fine motor, 140% in personal social, and 71.4% in language skills.
- 3-year-olds experienced delays of 80% in gross motor, 50% in fine motor and language, and 28.6% in personal social skills.
- Gross motor skills were most affected, personal social least. Younger children with SAM exhibited more severe delays across all domains, with delays decreasing with age. Social-emotional problems were pronounced in very young and older children.
Conclusions:
- Severe acute malnutrition (SAM) exerts a differential impact on various developmental dimensions in children under six years.
- The age of the child significantly moderates the extent of developmental delay caused by SAM.
- Gross motor and fine motor skills are particularly vulnerable to the effects of SAM in early childhood.
Background:
Retrospective studies show that severe acute malnutrition (SAM) affects child development. However, to what extent SAM affects children of different ages at its acute stage is not well documented. This study was aimed at comparing the developmental performance of severely acutely malnourished children under six with that of age and gender-matched non-malnourished healthy children.
Methods:
The developmental performances of 310 children with SAM (male = 155, female = 155); mean age = 30.7 mo; SD = 15.2 mo) admitted to the nutritional rehabilitation unit (NRU) at Jimma University's Hospital was compared with that of 310 age and gender-matched, non-malnourished healthy children (male = 155, female = 155; mean age = 29.6 mo; SD = 15.4 mo) living in Jimma Town in Ethiopia. Two culturally adapted tools were used: (1) the Denver II-Jimma, to assess the children's performance on personal social (PS), fine motor (FM) language (LA), gross motor (GM) skills, and (2) the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE), to assess social-emotional (SE) skills. Multivariable Poisson regression analysis was conducted to compare the developmental performance scores of SAM and non-malnourished children.
Results:
For one-year-old children, SAM delays their developmental performance on GM, FM, PS and LA by 300%, 200%, 140% and 71.4% respectively. For three-years-old children, SAM delays their developmental performance on GM by 80%, on FM and LA by 50% each, and on PS by 28.6%. Of the skills assessed on Denver II-Jimma, GM is the most, and PS is the least affected. Younger SAM children are more affected than older ones on all the domains of development. The delay in FM, GM, LA and PS generally decreases with an increase in age. Social-emotional behavior problems seem to be most pronounced in the very young and older age ranges.
Conclusions:
SAM has a differential age effect on the different dimensions of development in children under 6 years of age.
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