INVESTIGATING THE PREVALENCE OF PROTEIN ENERGY MALNUTRITION AMONG THE CHILDREN UNDER FIVE YEARS IN OBA-ILE COMMUNITY

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ABSTRACT

This study was conducted to investigating the prevalence of protein energy malnutrition among the children under five years in Oba-Ile community. This study descriptive study design was used for this research and questionnaires were used to collect data. Twenty illiterate mothers were interviewed orally, one hundred and twenty (120) questionnaires were administered and one hundred and ten (100) were retrieved for analysis. This study shows that 52 representing 52% of the respondents which was the majority were civil servant, civil servants do not always have much time for their children due to the nature of their work, they will not be able to feed their children well, because of their lack of time, hence tends to have housemaid which will not be able to give the child proper care especially if their principal were not around. The research has shown that quiet a lot of factors which are supposed to contribute to the prevalence of protein energy malnutrition in Oba-Ile actually went negative to the assertion. Health worker should health educate the mothers on the prevention of factors that could lead to protein energy malnutrition. Mothers should ensure that they always make use of available resources since protein are usually expensive.

 

 

 


 

TABLE OF CONTENTS

Title                                                                                                                      Page

Certification                                                                                                               ii         

Dedication                                                                                                            iii

Acknowledge                                                                                                               iv-v

Abstract                                                                                                                  vi                                                

Table of contents                                                                                                 vii-ix

List of tables                                                                                                           x-xi           

Abstract                                                                                                                                                                               

CHAPTER ONE

Introduction                                                                                                                1-2

Background of the study                                                                                            2-4

Statement of the problem                                                                                         4

Aim of the study                                                                                                5

Objectives of the study                                                                                            5

Significance of the study                                                                                     5

Assumptions                                                                                                        5

Definition of terms                                                                                             6


CHAPTER TWO

Literature review                                                                                             8

Definition                                                                                                        9

Types of protein energy malnutrition (PEM)                                                            9

Assessment of malnutrition among children                                                         12

Determinants of PEM                                                                                          14

Prevention of protein energy malnutrition                                                            19

Symptoms of malnutrition in children                                                                      20

Balance diet                                                                                                     20

Health benefits of a balanced diet                                                                    20-21

7 factors of a balanced diet                                                                          21-24


CHAPTER THREE

Research methodology                                                                                          25

Study design                                                                                                    25

Study area                                                                                                       25-26

Study population                                                                                             26

Sample size determination                                                                               26

Sampling technique                                                                                           27

Method of data collection                                                                           27

Data Analysis                                                                                                     27

Ethical consideration                                                                                          27


CHAPTER FOUR

Data presentation and analysis                                                                            28-42


CHAPTER FIVE

Discussion, conclusion and recommendation

Discussion of findings                                                                                          43-46

Conclusion                                                                                                      46

Recommendation                                                                                             47

REFERENCE                                                                                                  48-53

APPENDIX                                                                                                     54

 



 

LIST OF TABLES

Table 1: Age range of the mothers                                                                  28

Table 2: Age range of the children                                                                  29

Table 3: Mother’s educational status                                                               29

Table 4: Mother’s occupation status                                                               30

Table 5: Marital status of the respondents                                                  30

Table 6: Religious status of the respondents                                                          31

Table 7: Tribe of the respondents                                                                     31

Table 8: Respondent understanding about balance diet                                   32

Table 9: How many times do you breast feed your child in 24 hours?             33

Table 10: At what age do you start introducing other foods?                            33

Table 11: What is your monthly income?                                                          34

Table 12: Do you think your child receives enough food?                                 34

Table 13: Respondents’ response for not given their child enough food?           35

Table 14: Does your child eats at least any of the following everyday: egg, beans, milk, fish, meat?                                                                                                    35

Table 15: If no, why?                                                                                             36

Table 16: Is your child sick presently?                                                                  36

Table 17: Do you know the current weight of your child?                                    37

Table 18: Showing the response of 20 illiterate mothers that were interviewed.  38

Table 19: Review MUAC of under 5 children in Oba-Ile community between Jan-Dec 2019                                                                                                                39

Table 20: Review MUAC of under 5 children in Oba-Ile community between Jan-Dec 2020                                                                                                                 40

Table 21: Review MUAC of under 5 children in Oba-Ile community between Jan-Dec 2021                                                                                                                 41

Table 22: Review MUAC of under 5 children in Oba-Ile community between Jan-Jun 2022                                                                                                                  42

 

 

 

 

 

CHAPTER ONE

INTRODUCTION

Protein-energy malnutrition (PEM), is an energy deficit due to deficiency of all macronutrients. It commonly includes deficiencies of many micronutrients. PEM can be sudden and total (starvation) or gradual. Severity ranges from subclinical deficiencies to obvious wasting (with edema, hair loss, and skin atrophy) to starvation. Multiple organ systems are often impaired (John, 2021). Protein–energy malnutrition (PEM) is composed of a spectrum of biological disorders caused by the lack of food. Despite the name, it is not necessary for affected individuals to be experiencing a lack of protein, but rather a deficiency of total energy. Dietary proteins that would normally be used for tissue repair or growth are also used as fuel. PEM is rare in the developed world and is generally associated with children suffering from neglect or solitary malnourished elderly patients. (Prabhakar, 2017). PEM may result in reductions in muscular size and strength, as well as in functional changes such as reduced work capacity or endurance. Muscle wasting as well as loss of subcutaneous fat may be observed by inspection of the temporalis muscles and the shoulder girdle and by interosseus wasting between the bones of the dorsum of the hand and the muscles of the extremities. (Edward and Kris, 2013).

Eating a balanced diet is vital for our health and well-being. Food provides our bodies with the energy, proteins, vitamins, and minerals to live, grow, and stay active. We need a wide variety of different foods to provide the right amounts of nutrients to live healthy and productive lives (Global Alliance for Improved Nutrition, 2020). A decrease in the intake of micronutrients or macronutrients in relation to the body's requirements. Diseases associated with undernutrition include marasmus (energy deficiency), kwashiorkor (protein deficiency), vitamin deficiencies, and mineral deficiencies. Malnutrition is a significant cause of morbidity and mortality worldwide, leading to 45% of all deaths in children under the age of five. Approximately 52 million children have wasting with one-third (17 million) suffering from severe acute malnutrition Even more children ( 154.8 million) have stunted growth, indicating widespread chronic malnutrition (Amboss, 2021). Undernutrition occurs when not enough essential nutrients are consumed or when they are excreted more rapidly than they can be replaced. Overnutrition occurs in people who eat too much, eat the wrong things, don't exercise enough or take too many vitamins or other dietary replacements. Risk of overnutrition is increased by being more than 20 percent overweight or consuming a diet high in fat and salt (John, 2020).


BACKGROUND OF THE STUDY

Malnutrition, in all its forms, includes undernutrition (wasting, stunting, underweight), inadequate vitamins or minerals, overweight, obesity, and resulting diet-related noncommunicable diseases. 1.9 billion adults are overweight or obese, while 462 million are underweight. Globally in 2020, 149 million children under 5 were estimated to be stunted (too short for age), 45 million were estimated to be wasted (too thin for height), and 38.9 million were overweight or obese. Around 45% of deaths among children under 5 years of age are linked to undernutrition. These mostly occur in low- and middle-income countries. At the same time, in these same countries, rates of childhood overweight and obesity are rising. (WHO, 2021). Global rates of malnutrition, in its various forms, are difficult to measure. A recent report estimated that 925 million people, more than ever, are malnourished worldwide. Malnutrition is attributable to >2.6 million child deaths every year. It is widely accepted that a child with ongoing malnutrition will most certainly suffer from developmental impairment affecting their cognitive and physical abilities. (Hood, 2013). Protein energy malnutrition (PEM) is a common problem worldwide and occurs in both developing and industrialized nations. In the developing world, it is frequently a result of socioeconomic, political, or environmental factors.( Grover, 2009). Malnutrition affects people in every country. Around 1.9 billion adults worldwide are overweight, while 462 million are underweight. An estimated 41 million children under the age of 5 years are overweight or obese, while some 159 million are stunted and 50 million are wasted. Adding to this burden are the 528 million or 29% of women of reproductive age around the world affected by anaemia, for which approximately half would be amenable to iron supplementation. (WHO, 2020). The European population is estimated at 515 million inhabitants, of which 19% is currently aged 65 years and older. This is expected to increase to 29% in 2060, Longevity is one of the main causes for the increasing number of people aged 65 years and older in Europe. Ageing is both wonderful and problematic, the latter because increased longevity often brings health-related issues, among which protein energy malnutrition (PEM) is frequently observed.

PEM is associated with delayed recovery from disease, poorer quality of life and increased risk of morbidity and mortality. The condition appears to be more prevalent among fragile elderly and in those having higher care needs, with prevalence rates dependent on age, the functional and marital status of participants, the health care setting and the tools or parameters used to determine malnutrition risk (Susanne, 2019). Six million children are affected by life-threatening severe acute malnutrition in West and Central Africa. Multiple factors including land and crop degradation, periodic droughts and weather-related shocks, poverty, limited access to basic food staples and essential services, and population growth, contribute to emergency levels of malnutrition in the region (UNICEF, 2021). Sub-saharan Africa bears the brunt of PEM in the world. On the average, the PEM associated mortality in sub-Saharan Africa is between 25 and 35%. In Nigeria, 22 to 40% of under-five mortality has been attributed to PEM. PEM is also associated with a number of co-morbidities such as lower respiratory tract infections including tuberculosis, diarrhea diseases, malaria and anaemia. These co-morbidities may prolong the duration of hospital stay and death among affected children (Agozie et al., 2012).

Studies in Nigeria found that protein-energy malnutrition was the second cause of death in children under six years. (Nweze, 2020).  In Nigeria, 22 to 40% of under-five mortality has been attributed to PEM (Ibekwe, et al., 2019).PEM is also associated with a number of co-morbidities such as lower respiratory tract infections including tuberculosis, diarrhea diseases, malaria and anaemia (le et al., 2010,  Ejaz et al., 2010). These co-morbidities may prolong the duration of hospital stay and death among affected children.


STATEMENT OF PROBLEM

Protein energy malnutrition (PEM) is defined as an unintentional loss of 10% or more of body weight in a period of six months or less and/or serum albumin levels of less than 3.5 grams per decilitre (g/dl) (Hudson et al., 2000). Getting to Oba-Ile I discovered that some of the children are malnourished. Malnutrition has been the major health challenges of the children of 0-5 years of age, and this has made them to be susceptible to many diseases, many has lost their life due to lack of adequate diet. The reason why the some of children in Oba-ile are malnourished is yet to be discovered, Could it be as a result of lack of knowledge about adequate diet and its preparation. Therefore this topic aim to investigate the prevalent of protein energy malnutrition among 0-5 years of age in Oba-Ile Community Akure North Local Government, Ondo State.

 

AIM OF THE STUDY

The aim of this study is to investigate the prevalence of protein energy malnutrition among the children under five years in Oba-Ile community.


OBJECTIVES OF THE STUDY

·       Determine the level of knowledge of mothers on balance diet

·       Review the existing records on PEM to determine gravity of the malnutrition

·       Evaluate possible factors that could lead to the prevalence of PEM at Oba-Ile


RESEARCH QUESTION

·       What is their level of knowledge on balance diet?

·       Are there existing records on PEM to determine the gravity of Malnutrition?

·       Are there possible factors that lead to the prevalence of PEM at Oba-Ile?


SIGNIFICANCE OF THE STUDY

This study will help the nursing mothers to increase their level of knowledge about malnutrition and Balance diet. It will also help to reduce morbidity and mortality rate due to poor feeding. This will also help to lower the factors the causes the prevalence of PEM. It will also increase the level of knowledge of the health worker on how to communicated effectively to the nursing mothers. This will also serve as a body of knowledge to other researchers.


ASSUMPTIONS

·       Some people assumed that they can eat what and when they like to eat it.

·       Some people believed that children that eat egg, fish and meat will steal.

·       Some people assume that meals do not necessarily need to be balance hence they focus on the satisfaction only.


DEFINITION OF TERMS

Balanced diet: Is a diet that contains differing kinds of foods in certain quantities and proportions so that the requirement for calories, proteins, minerals, vitamins and alternative nutrients is adequate and a small provision is reserved for additional nutrients to endure the short length of leanness

Disease: Refers to any harmful deviation from the normal structural or functional state of an organism, generally associated with certain signs and symptoms and differing in nature from physical injury.

Health: According to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity.

Infection is the process or the state wherein an infectious agent (such as pathogenic microorganisms, viruses, prions, viroids, nematodes and helminths) invade and multiple in the body tissues of the host.

Macronutrients: Are essential nutrients the body needs in large quantities to remain healthy.

Malnutrition: Is the lack of proper nutrition, caused by not having enough to eat, not eating enough of the right things, or being unable to use the food that one does eat.

Prevalence: is the proportion of a population who have a specific characteristic in a given time period.

Protein Energy Malnutrition: Protein-energy malnutrition (PEM) is a potentially fatal body-depletion disorder

Protein: Proteins are large, complex molecules that play many critical roles in the body.

Susceptible : Mean likely or liable to be influenced or harmed by a particular thing.



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