Relationship Of Plasma Zinc Levels With Severe Acute Malnutrition Among Children Under Five Years In Nowshera, Khyber Pakhtunkhwa

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Irfan Ullah,Shah Nawaz, Qiam Ud Din, Saifoor Ahmad Khan, Muhammad Ibrahim, Zahid Irfan Marwat

Abstract

Background: Zinc (Zn) is regarded as a trace element/mineral but forms an integral part of several enzymes (metallo-enzymes) in the body including carbonic anhydrase, lactate dehydrogenase, alkaline phosphatase, carboxypeptidase & superoxide dismutase. Predisposing factors for Zn deficiency include malabsorption and intake of high phytates. Zn supplementation improves the condition dramatically. Apart from the deficiencies of other trace elements, Zn deficiency is highly prevalent in undernourished children. However, the prevalence & relationship of Zn deficiency with severe acute malnutrition (SAM) in children has not been studied in this part of the province. The objective was to determine plasma zinc level in severely malnourished children belonging to Nowshera, Khyber Pakhtunkhwa and to find its relationship with three forms of SAM.


Methods: Ninety children with SAM of both sexes, in the age range of 6 months to 59 months, categorized in three groups, 30 in each (Marasmus, Group I, Marasmic Kwashiorkor, Group II & Kwashiorkor, Group III) were randomly selected in a cross-sectional study. Anthropometric parameters like weight & height (or length) were recorded. Blood samples were taken for determination of plasma Zn levels. 

Results: Plasma Zn levels of all 90 severely malnourished children were below normal. Using the independent “student-t test”, Zn levels of children among all the three groups were compared: In Group I children with marasmus, Zn level was 64.71±2.05, in Group II children with marasmic-kwashiorkor, the level was 64.05±4.24 and in group III children with kwashiorkor, it was 57.85±3.90 irrespective of age and sex. Plasma zinc levels were significantly low in kwashiorkor, followed by marasmic kwashiorkor and marasmus. Children in different age groups revealed no significant difference in Plasma zinc levels. Zinc deficiency was equally prevalent in both sexes.


Conclusion: Plasma Zn concentration is decreased in children with all three types of SAM. It also concludes that out of all the three, marked Hypozincemia is the feature of kwashiorkor.

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