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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