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The present day epidemiology of severe protein-energy malnutrition in Nigeria
Insights
Severe protein-energy malnutrition (PEM) now affects younger children (6-18 months) in Nigeria, driven by poverty and early cessation of breastfeeding. Measles and gastroenteritis are significant precipitating factors.
Area of Science:
- Pediatrics
- Public Health
- Nutrition Science
Background:
- Severe protein-energy malnutrition (PEM) remains a critical health issue in developing regions.
- Understanding current demographic and etiological patterns of PEM is essential for effective intervention.
Purpose of the Study:
- To define the current patterns and contributing factors of severe protein-energy malnutrition (PEM) in Nigerian children.
- To identify demographic, socioeconomic, and clinical characteristics associated with severe PEM.
Main Methods:
- Retrospective study of 88 pediatric patients admitted with severe PEM over a 9-month period.
- Data collection included patient demographics, parental socioeconomic status, family structure, and preceding illnesses or feeding practices.
Main Results:
- Severe PEM predominantly affects infants aged 6-18 months, an earlier onset than previously reported.
- Poverty (54.5%) and parental separation (72.7%) were significant socioeconomic factors.
- Measles (30.7%) and gastroenteritis (33%) were common preceding illnesses; early cessation of breastfeeding or use of cow's milk was frequent.
Conclusions:
- Current severe PEM in this Nigerian cohort presents earlier, linked to poverty and suboptimal infant feeding practices.
- Public health strategies should address poverty, promote sustained breastfeeding, and manage childhood infections to prevent severe PEM.
Abstract:
Eighty-eight patients with severe protein-energy malnutrition (PEM) admitted into the Wesley Guild Hospital, Ilesa, Nigeria over a 9-month period were studied to define the patterns and factors encountered currently in PEM. Severe PEM now occurs predominantly in the 6- to 18-month age group, which is earlier than was reported previously. The majority of the parents were Yoruba Christians and were low-income workers or unemployed. Poverty was a factor in 54.5 percent. Most of the parents were literate. About half of the families were polygamous. The prevalence of social problems was high, with 72.7 percent of the parents living apart. Attacks of measles and recurrent or prolonged gastroenteritis were preceding precipitating factors in 30.7 percent and 33 percent of the patients, respectively. Failure or cessation of breast-feeding or bottle-feeding with cow's milk from the first month of life preceded the development of PEM in a large percentage of patients. The implications of these findings are discussed.