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Dr. Mohammad Hayatun Nabi MPH(Aus), MHSM(Aus), MBBS Dept. of Public Health

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The prevalence of malnutrition in Bangladesh is among the highest in the world. Millions of children and women suffer from one or more forms of malnutrition including low birth weight, wasting, stunting, underweight, Vitamin A deficiencies, iodine deficiency disorders and anemia. Globally, malnutrition is attributed to almost one-half of all child deaths. 2Dr. Mohammad Hayatun Nabi

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Bangladesh has made good progress in the past decade to achieve Millennium Development Goal 1, the eradication of extreme poverty and hunger, more needs to be done. Malnutrition rates have seen a marked decline in Bangladesh throughout the 1990s, but remained high at the turn of the decade. Nationally, 41% of children under five years are moderately to severely underweight and 43.2% suffer from moderate to severe stunting, an indicator for chronic malnutrition. 3Dr. Mohammad Hayatun Nabi

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Protein energy malnutrition Low birth weight Nutritional anemia Nutritional blindness Iodine deficiency disorders Seasonal vitamin deficiency 4Dr. Mohammad Hayatun Nabi

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Protein Energy Malnutrition (PEM) continues to be a major public health problem in many developing countries. It affects mostly children under 5 years of age belonging to the poor underprivileged communities. The condition is particularly serious during the post weaning stage and is often associated with infection. 5Dr. Mohammad Hayatun Nabi

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Respiratory infection and diarrhea are the common diseases that precipitate severe PEM and death. Apart from contributing to high mortality, severe malnutrition can lead to permanent squeal in those who survive. These include stunted growth, poor learning ability and reduced work efficiency. 6Dr. Mohammad Hayatun Nabi

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Protein: deficit in amino acids needed for cell structure, function Energy: calories (or joules) derived from macronutrients: protein, carbohydrate and fat Micronutrients: vitamin A, B-complex, iron, zinc, calcium, others 7Dr. Mohammad Hayatun Nabi

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Several methods have been suggested for the classification of PEM. The choice of classification depends on the purpose for which it is used. In clinical studies, patients with severe PEM are classified into 3 groups- kwashiorkor, marasmus and marasmic kwashiorkor. 1. WHO classification 2. Gomez classification 3. Wellcome classification 8Dr. Mohammad Hayatun Nabi

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MalnutritionBody weight (% of standard*) Grade 176-90 Grade 260-75 Grade 3