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Objective: To find out the etiological spectrum of secondary malnutrition in children with severe acute malnutrition. Study Design: Descriptive study Duration and Place of Study: 01.01.2018 to 31.12.2018at Nutritional Stabilization Centre at CHC&ICH, Multan. Material and Methods: All children admitted with severe acute malnutrition, aged 1-59 months during the study period were included. Written consent was obtained from parents. Relevant data, detailed history and systemic examination were done in each child at the time of admission. Clinical and laboratory evaluation was also performed. The children were observed and evaluated daily during hospital admission to identify the common etiological factors including acute/chronic diarrhea, pneumonia, urinary infection, celiac disease, cerebral palsy and other respiratory illnesses like bronchiolitis, asthma and other underlining diseases. Results: Among 835 patients, 703 (84.2%) had weight for height <-3SD, 60 (7.18%) had bilateral edema and 349 (41.79%) with severe wasting (Z-score <-4SD). The analysis of etiological factors in these children identified nephrological problems in 383 cases (45.87%), gastroenterological problems in 331 (39.64%), Infectious diseases in 265 cases (31.74%), Hematological problems in 256cases (30.66%), and neurological problems in 97cases (11.62%). Conclusion: A wide range of diseases were identified as the etiological factors of secondary severe acute malnutrition including nephrological problems, gastroenterological problems and Infectious diseases being the three most frequent in this study. These diseases cannot be reversed without treatment and will worsen the degree of malnutrition, so these need to be identified at the earliest, thus decreasing the associated morbidity and mortality.

SAADIA KHAN, IBAD ALI, AYESHA FAYYAZ, Sumaira Nazeer, Reema Arshad. (2021) Etiological Spectrum of Secondary Malnutrition in Children (Under Five Years of Age) With Severe Acute Malnutrition Admitted At Nutritional Rehabilitation Center Stabilization Centre at CHC& ICH Multan, Pakistan Pediatric Journal, Volume 45, Issue 1.
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