Anaemia and Haematological Profile in Children with Moderate and Severe Acute Malnutrition at a Tertiary Care Centre in Karnataka, India: A Cross-sectional Study

1. Postgraduate Student, Department of Paediatrics, Karwar Institute of Medical Sciences, KRIMS, Karwar, Karnataka, India. 2. Associate Professor, Department of Paediatrics, Karwar Institute of Medical Sciences, KRIMS, Karwar, Karnataka, India. 3. Professor, Department of Paediatrics, Karwar Institute of Medical Sciences, KRIMS, Karwar, Karnataka, India. 4. Associate Professor, Department of Pathology, Karwar Institute of Medical Sciences, KRIMS, Karwar, Karnataka, India. 5. Statistician, Department of PSM, Karwar Institute of Medical Sciences, KRIMS, Karwar, Karnataka, India.

Abstract

Introduction: Protein-Energy Malnutrition (PEM) remains a significant contributor to childhood morbidity and mortality worldwide, with anaemia being one of its most common and serious complications. Understanding the haematological profile of malnourished children is essential for early diagnosis and effective management.

Aim: To assess the prevalence of anaemia and evaluate haematological profiles among children with Moderate Acute Malnutrition (MAM) and Severe Acute Malnutrition (SAM).

Materials and Methods: A cross-sectional study was conducted at the Department of Paediatrics at Karwar Institute of Medical Sciences, Karwar, Karnataka, India, over six months from January 2025 to June 2025. A total of children aged 6 months to 5 years, diagnosed with MAM or SAM according to World Health Organisation (WHO) criteria, were enrolled. Children with primary haematological disorders, critical illness, or those outside the age criteria were excluded. Demographic details, anthropometric measurements, and haematological parameters including complete blood count, peripheral smear and serum ferritin were assessed. Data were analysed using descriptive statistics, the Chi-square test, and the Student’s t-test.

Results: Of the 81 children, 59 (72.8%) had MAM and 22 (27.2%) had SAM. There were no significant differences between the groups in age, gender, or socio-economic status. However, children with SAM demonstrated significantly lower Body Mass Index (BMI), Haemoglobin (Hb), Packed Cell Volume (PCV), Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin Concentration (MCHC), platelet count, and serum ferritin levels than children with MAM (p-value <0.05). Pneumonia (32.9%) was the most common associated diagnosis. Peripheral smear examination revealed a predominance of microcytic hypochromic anaemia, with a significant difference between the groups (p-value=0.0093). Overall, the prevalence of anaemia was high and its severity correlated strongly with the degree of malnutrition (p-value=0.0001).

Conclusion: Anaemia was highly prevalent among children with PEM and was more severe in those with SAM. Routine haematological screening and early nutritional intervention are vital to improving clinical outcomes.

Erythrocyte indices, Haemoglobin, Iron deficiency anaemia, Protein energy malnutrition, Under-5 children