malnutrition ppt

7/28/2019 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
http://upload.wikimedia.org/wikipedia/commons/b/bb/Zinc_Sulfate.jpg


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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
http://en.wikipedia.org/wiki/Image:1GZX_Haemoglobin.png


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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/

malnutrition ppt

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