Malnutrition ppt
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Transcript of Malnutrition ppt
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MDG 1: Eradication of
poverty and hunger
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poverty and hunger
Definition of malnutrition
People are malnourished if their diet does
not provide adequate calories and proteinfor growth and maintenance or they areunable to fully utilize the food they eat dueto illness (undernutrition). They are alsomalnourished if they consume too many
calories (overnutrition). (Unicef)
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Malnutrition
Malnutrition is a contributing
factor in over 50% of deaths inchildren under fiveWorldBank
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Population Density of UnderweightChildren(UN)
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MUACMid Upper ArmCircumferance
SAM
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Measure of acutemalnutrition
W/H
WASTINGSAM
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Measuring ChronicMalnutrition
H/ASTUNTING
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Growth of Children
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NCHS 1978Child Growth References
Measures made 1960-75 American Children- geographically
restricted area.
With formula milk High socioeconomic background
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WHO 2006Child Growth Standards 1997-2003
de Onis et al. 2004 MDGR
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Causes of Malnutrition
Malnutrition/Death
Inadequate dietary intake Disesase
InsufficientHousehold food
MANIFESTATIONS
IMMEDIATECAUSES
UNDERLYINGCAUSES
BASICCAUSES
Political and Economical powers
Inadequate MaternalChildcare
Insufficient HealthServices/Unhealthy
Environment
Modified from UNICEF 1998
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Severe MalnutritionW/H
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Kwashiorkor
2-4yrs Comes suddenly after some time
of Moderate Malnutrition Low protein intake
HG MORTALITET!
http://www.asnom.org/image/510_nutrition/116_327_kwashiorkor.jpg
Symtoms: Bilateral OedemaApathy
Depigmented corse hair, easy to pull. Skin lesionsPoor aptetiteDiarrhoea
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Marasmus
1st year of life, often failure tobreastfeed.
Lack of proteins and calories.
Body creates energy by dissolvingits own tissues Loss ofsubcutanous fat and muscles.
Symtoms:
Wasting W/H
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The evil cycle of Malnutrition
Adapted from Andrew Tomkins and Fiona Watson, Malnutrition and Infection, ACC/SCN, Geneva, 1989 , State of the Worlds Children 1998
Apetite lossNutrient LossMalabsorbtion
Altered metabolism
Disease:IncidenceSeverityDuration
InadequateDietary Intake
Weight lossImmunity loweredGrowth faltering
Mucosa damaged
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Iodine Deficiency-Most important cause of brain damage and
mental retardation, 760milj have goitre Deficiency giveshypothyreosis and goitre.
Stillbirth and miscarriage Cretinism: mental retardation,
stunted, hypothyroidis, deaf-mutism. Lower IQ by 10-15% Iodising salt
SOURCE: UNICEF
Source:Sea fish, sea weed,Iodized salt
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Zinc Deficiency Active in >80 enzymes Protects skin and mucosa.
Increases leucocyteacticity.
Zinc supplement reducesthe length and severity ofdiarrhoea by 1/3.
Decreases incidence ofpneumonia with 12%.
Deficiency gives growthfailure and increasedsusceptibility to infections
Source:Whole-grain cereals
Legumes Meat Chicken and fish
SOURCE: UNICEF
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Iron Deficiency-Most common micronutrient deficiency in the
world affecting 40-50% of children
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Folate deficiency
Vit B9 helps in the formationof red blood cells.
Regulates the nerve cells ofthe embryonic development.
Neural tube defect, ifdeficiency during pregnancy.
Low birthweight
Preterm delivery
Anemia
Spina Bifida
Source:Liver KidneyFish,Green leafy vegetables
Beans and groundnutsSOURCE: UNICEF
B h dli h M l t iti (MSF)
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Dag 1 2 3 4 5 6 7 8 9 10Vit A XZink Sulfat X X X X X X X X X X
Folsyra X
Msslingvacc XAmoxicillin X X X X X
Albendazol X
F-75 X X ... ... ... ... ...F-100 X X ...
F-100+PPN X X
PPN X X X X
Behandlingsschema Malnutrition (MSF)
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Infant feeding
Breast feedingshould be initiatedafter delivery.
Exclusivebreastfeeding isrecommended to 6
months of age.
Source: WHO
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Breast milk advantages
Immunoglobulins (IgA)Macrophages
Iron, omega 3-Fatty acidsProtects against allergies
(eczema, cow milk protein).Sterile, warm!Mother-child bonding
Nelson 2002
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Other advantages to Breastfeeding
Cost effective foodsecurity
Enough calories, reducesunderweight
Increases child spacingby reducing fertillity
Empowerement ofwomen
Decreased maternal postpartum blood loss
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Baby Friendly Hospital Initiative
WHO and UNICEF 1991 20 000 facilities 152 countries Promoting breastfeeding
through 10 strategies.-Written policies-Educating staff and mothers-Initiate breastfeeding within 30min
from delivery, skin to skin.-Exclusive breastfeeding-Rooming in: mothers and babies
together 24 hrs after delivery-Breastfeeding support groups
UNICEF and WHO report BFHI, Jan 2006
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Should HIV positive motherbreastfeed?
10-20% risk of HIVtransmission bybreastmilk during one
year of breast feeding. Must be weighed
against the risk of childdying from diarrhoea
or other diseases
Pneumonia
Iron deficiency
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Swedish supplementation
Vit K injektion till allanyfdda barn,skyddar mot
hjrnbldning Vit A+D i AD-
droppar frn 1 mn-2 r samt alla
skolbarn undermrkavinterhalvret.
Lkemedelsboken 2007/2008
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Vad har detta barn fr diagnos?
http://upload.wikimedia.org/wikipedia/commons/4/47/Starved_girl.jpg
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References UN Millennium Project 2005, Halving Hunger http://devdata.worldbank.org/atlas-mdg/ http://upload.wikimedia.org/wikipedia/commons/4/47/Starved_girl.jpg de Onis M, Garza C, Victora CG, Bhan MK, Norum KR, guest editors.
The WHO Multicentre Growh Reference Study (MGRS): Rationale,planning and implementation. Food and Nutrition Bulletin, Volume 25,Number 1, Supplement 1, March 2004 .http://www.unu.edu/unupress/food/fnb25-1s-WHO-1.pdf
Growth Chart :http://www.who.int/nutrition/media_page/growthchart/en/
Refugee Health: An approach to Emergency Sitations, MSF 1997 http://www.asnom.org/image/510_nutrition/116_327_kwashiorkor.jpg State of the Worlds Children 1998, UNICEF http://www.milesresearch.com/main/eyesigns.asp#bitotspots Micronutrient deficiencies: Bringing science to bear. Global Strategy for Infant and young Child feeding, WHO, Geneva Essentials of Pediatrics, Nelson 4th edition 2002. http://encarta.msn.com/media_461516710_761575681_-
1_1/macrophage_engulfing_bacterium.html http://www.avert.org/aids-picture.php?photo_id=1703, Photo of
antibody. Global Health and introductory text book, Lindstrand et.al. 2006. (cost
of iodizing salt) The revised BFHI package includes: Section 1: Background and
Implementation [pdf 359kb], 2006,
http://www.who.int/nutrition/topics/bfhi/en/index.html http://upload.wikimedia.org/wikipedia/commons/b/bb/Zinc_Sulfat
e.jpg
http://devdata.worldbank.org/atlas-mdg/http://upload.wikimedia.org/wikipedia/commons/4/47/Starved_girl.jpghttp://www.unu.edu/unupress/food/fnb25-1s-WHO-1.pdfhttp://www.who.int/nutrition/media_page/growthchart/en/http://www.who.int/nutrition/media_page/growthchart/en/http://www.asnom.org/image/510_nutrition/116_327_kwashiorkor.jpghttp://www.milesresearch.com/main/eyesigns.asphttp://encarta.msn.com/media_461516710_761575681_-1_1/macrophage_engulfing_bacterium.htmlhttp://encarta.msn.com/media_461516710_761575681_-1_1/macrophage_engulfing_bacterium.htmlhttp://www.avert.org/aids-picture.php?photo_id=1703http://www.who.int/entity/nutrition/topics/BFHI_Revised_Section1.pdfhttp://www.who.int/entity/nutrition/topics/BFHI_Revised_Section1.pdfhttp://www.who.int/nutrition/topics/bfhi/en/index.htmlhttp://www.who.int/nutrition/topics/bfhi/en/index.htmlhttp://www.who.int/nutrition/topics/bfhi/en/index.htmlhttp://www.who.int/nutrition/topics/bfhi/en/index.htmlhttp://www.who.int/entity/nutrition/topics/BFHI_Revised_Section1.pdfhttp://www.who.int/entity/nutrition/topics/BFHI_Revised_Section1.pdfhttp://www.avert.org/aids-picture.php?photo_id=1703http://www.avert.org/aids-picture.php?photo_id=1703http://www.avert.org/aids-picture.php?photo_id=1703http://encarta.msn.com/media_461516710_761575681_-1_1/macrophage_engulfing_bacterium.htmlhttp://encarta.msn.com/media_461516710_761575681_-1_1/macrophage_engulfing_bacterium.htmlhttp://encarta.msn.com/media_461516710_761575681_-1_1/macrophage_engulfing_bacterium.htmlhttp://www.milesresearch.com/main/eyesigns.asphttp://www.asnom.org/image/510_nutrition/116_327_kwashiorkor.jpghttp://www.who.int/nutrition/media_page/growthchart/en/http://www.unu.edu/unupress/food/fnb25-1s-WHO-1.pdfhttp://www.unu.edu/unupress/food/fnb25-1s-WHO-1.pdfhttp://www.unu.edu/unupress/food/fnb25-1s-WHO-1.pdfhttp://www.unu.edu/unupress/food/fnb25-1s-WHO-1.pdfhttp://www.unu.edu/unupress/food/fnb25-1s-WHO-1.pdfhttp://www.unu.edu/unupress/food/fnb25-1s-WHO-1.pdfhttp://www.unu.edu/unupress/food/fnb25-1s-WHO-1.pdfhttp://upload.wikimedia.org/wikipedia/commons/4/47/Starved_girl.jpghttp://devdata.worldbank.org/atlas-mdg/http://devdata.worldbank.org/atlas-mdg/http://devdata.worldbank.org/atlas-mdg/