Madam, malnutrition is a pathological condition resulting from deficiency of one or more nutrients and has a wide range of clinical manifestations. Children are amongst the worst-affected groups. In 2001, it was noted that malnutrition caused 54% deaths in children living in developing countries.1 The World Health Organization through the Millennium Development Goal 4 has recognized that improved nutrition is crucial in reducing the under-5-years mortality,especially in the developing countries.2
Laying its special emphasis in our part of the world, the percentage of malnourished children is highest in Asia with 70% of undernourished children living in this part of the world. In South Asia, one out of two preschoolers is underweight and has stunted growth.3 In Pakistan,33.03% (CI= 27.96-38.54)of children under the age of 5 are underweight, 53.38% of the children are stunted and wasting has been reported in 11.52% of the children,4 which clearly shows that the nutritional status in this country is poor.Goiter caused by iodine deficiency is also common with the highest cases reported in Pakistan, India and parts of Indonesia.3
Marasmus, Kwashiorkor or Marasmus Kwashiorkor will probably develop in a child who is malnourished for a prolonged period of time leading to an increased mortality. Children who are undernourished are more susceptible to the effects of infectious diseases compared to children who are adequately nourished.1 Infections can in turn lead to more undernourishment as food intake is decreased during infection and this turns into a vicious cycle.
One of the possible causes of such status could be declined production of food.1 Many landscapes that were once fertile are deemed barren due to environmental pollution caused by mankind. This in turn leads to less land that is available for farming and ultimately food production per acre is insufficient to touch base with other countries. Poverty, unawareness, population growth, political instability, loss of food stock due to poor harvest and natural calamities are some of the important factors causing malnutrition amongst children. Malnutrition in Pakistani children has been directly linked to illiteracy of mothers, low family income and larger family size.5 Maternal undernourishment is also a contributing factor to babies being born with low-birth-weight.1 The increased basal metabolic rate due to acute and chronic illnesses may also precipitate the pre-existing malnutrition.
To solve the problems causing malnutrition among Pakistani children, the following measures are suggested: Various methods like the use of fertilizers would give a better crop. Policies should be made by the government to provide food security to the masses. Educational programmes should be planned that elucidate the importance of various components in a child\\\'s diet and also inform people about cheaper food alternatives that can provide them with vital nutrients. Controlling the growth of population and providing family planning guidance will lead to more food availability.
Nava Asad, Ammara Mushtaq
Undergraduate MBBS Student, Dow Medical College, Dow University of Health Sciences, Karachi.
1.Blossner M, de Onis M. Malnutrition: quantifying the health impactat national and local levels. Geneva, Switzerland: World Health Organization; 2005. Environmental Burden of Disease Series. (Online) 2011 (Cited 2011 Sep 25). Available from URL: http://whqlibdoc.who.int/publications/ 2005/9241591870.pdf.
2.United Nations. We Can End Poverty 2015: Millennium Development Goals, United Nations, 2011. (Online) 2011 (Cited 2011 Nov 1). Available from URL: http://www.un.org/en/mdg/summit2010/.
3.Khor GL. Update on the prevalence of malnutrition among children in Asia. Nepal Med Coll J 2003; 5: 113-22.
4.Finlay JE, Ozaltin E, Canning D. The association of maternal age with infant mortality, child anthropometric failure, diarrhoea and anaemia for ?rst births: evidence from 55 low- and middle-income countries. BMJ Open 2011; 1: e000226.
5.Shah SM, Selwyn BJ, Luby S, Merchant A, Bano R.Prevalence and correlates of stunting among children in rural Pakistan. Pediatr Int 2003; 45: 49-53.