PROTEIN ENERGY MALNUTRITION

Dr. Pardeep Kumar Patidar, Dr. Nilesh Jain

Abstract


Background: Protein energy malnutrition a major public health problem in children under 5 years causing nearly 50 lakh deaths annually. Malnutrition affects the cell mediated immunity, a principal host defence against tuberculosis. Diagnosis of tuberculosis in these children is a challenge and with inadequate availability of good sputum specimen.

 

Objectives: To diagnose tuberculosis in children age less than 5 years with severe acute malnutrition using CBNAAT and also correlation between positive cases (diagnosed by Gene Xpert) and their past BCG vaccination and HIV status.

 

Material & methods: Study carried out on 106 children of age 1 to 5 years with severe acute malnutrition from June 2017 to September 2018. CBNAAT and Gene Xpert done for diagnosing tuberculosis. HIV testing was done at ICTC. Study done with prior approval of Institutional Ethics committee. Being a government hospital, there was no financial burden on the patient’s legally acceptable representatives.

 

Results: 53.77% children were females. 91.5% had received BCG vaccination. No HIV case was seen. Presumptive tuberculosis was seen in 13 cases (12.3%).  Significant association was seen between cough >2 weeks and chest X-ray; fever >2 weeks and chest X-ray; history of contact with chest X-ray; TST and CBNAAT; BCG scar mark and chest X-ray and chest X-ray and CBNAAT (p<0.05).

 

Conclusion: CBNAAT has not proved very effective in diagnosing tuberculosis, hence we recommend this to be used as a confirmatory diagnostic tool.

 


Keywords


CBNAAT, Severe acute malnutrition, tuberculosis, Gene Xpert, BCG vaccination

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