Changes in Nerve Electro Physiologic Properties in Children Before and After Correction of Malnutrition
Condition: Stunting; Severe Acute Malnutrition; Wasting
MeSH terms: Malnutrition; Severe Acute Malnutrition
Study type: Interventional

Summary: 
      The goal of this clinical trail study is to measure neurophysiologic parameters to assess the
      effect of malnutrition on the peripheral nervous system and their response to treatment in
      three categories (SAM, severe wasting, and severe stunting) of childhood malnutrition. 83
      under-5 children from three categories of undernourished groups- severe stunting (n=30),
      Severe acute malnourished (n=22), wasting (n=31), and 45 age-matched healthy children from
      urban/peri-urban areas were enrolled.

      SAm were provided with appropriate nutritional therapy/treatment that include supplementation
      of a high-calorie diet; i.e., F-100 milk and khichuri-halwa for nutritional rehabilitation.
      Egg milk and micronutrient supplementation were for recovery from severe stunting. Wasted
      children were treated with suitable local nutritional management (NM), such as infant and
      young child feeding practices (IYCF), providing MNP and nutrition education. Wasted children
      with medical complications were treated with specialized therapeutic milk (F-75) and those
      without medical complications were treated with a suitable local Nutritional Management (NM)
      & routine medicines to treat simple medical conditions at community nutrition center (CNC)
      with weekly follow up. At day 60 of intervention, children were again brought to icddr,b for
      a nerve conduction test.
    

Detailed description: 
      The purpose of this study is to measure neurophysiologic parameters to assess the effect of
      malnutrition on peripheral nervous system and their response to treatment in three categories
      (SAM, severe wasting and severe stunting) of childhood malnutrition. The electrophysiological
      properties of peripheral nerves in malnourished under-5 children before and after correction
      of severe malnutrition were assed.

      This is an exploratory study conducted in icddr,b, Dhaka, Bangladesh. 83 under-5 children
      from three categories of undernourished groups- severe stunting (length-for-age Z-scores
      <-3), SAM (weight-for-length Z-scores <-3, and/or mid-upper-arm circumference <11.5 cm, with
      or without nutritional edema) and wasting (weight-for-length Z-scores (WLZ) <-2) were
      enrolled. A total of 45 age-matched healthy children selected as controls. Participants were
      identified from urban/peri-urban areas of Dhaka city. After enrolment, participants were
      brought to icddr,b Dhaka Hospital and data on socio-economic status, weaning practice,
      morbidity, and dietary intake were collected. Nerve electro physiologic parameters assessed
      by motor (median, ulnar, fibular and tibial) and sensory (median, ulnar and sural) nerve
      conduction studies (NCS) on enrollment.

      SAM were treated with appropriate nutritional therapy/treatment that included supplementation
      of high calorie diet; i.e., F-100 milk and khichuri-halwa for nutritional rehabilitation.
      Egg-milk and micronutrient supplementation were provided for 2 months for recovery from
      severe stunting (following standard guidelines for facility based management and recently
      conducted community based nutrition intervention studies). As per national guidelines,
      children suffering from severe wasting with medical complications were treated with
      specialized therapeutic milks (F-75) and those without medical complications treated with a
      suitable local Nutritional Management (NM) & routine medicines to treat simple medical
      conditions at community nutrition center (CNC) with weekly follow up. Children were monitored
      in the community for 2 months. Monthly anthropometry had been done. On day 60 or 2 months of
      intervention, children with weight-for-length/height Z-scores ≥-1 and MUAC >115 mm were again
      brought to icddr, b for nerve conduction test.
    

Intervention name(s): Nutritional Intervention
Intervention type(s): Combination Product
Intervention description(s): Severe acute malnourished children were provided with appropriate nutritional therapy/treatment that include supplementation of a high-calorie diet; i.e., F-100 milk and khichuri-halwa for nutritional rehabilitation.
Egg milk and micronutrient supplementation for recovery from severe stunting following standard guidelines for facility based management and recently conducted community based nutrition intervention studies.
Wasted children were treated with suitable local nutritional management (NM), such as infant and young child feeding practices (IYCF), providing MNP and nutrition education.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Malnutrition; Nerve Conduction