Long-term Follow-up of Children Discharged from Child Malnutrition Treatment Centres in Gujarat

Background Malnutrition among children under five years of age is a pressing health concern in India, especially in the state of Gujarat. To combat this, Child Malnutrition Treatment Centres (CMTCs) have been set up to treat children suffering from Severe Acute Malnutrition (SAM) with medical complications. However, a significant number of children relapse after discharge, necessitating exploration of the factors contributing to relapse. Methods Between October and December 2024, a cross-sectional study was conducted in Devbhoomi Dwarka, Gujarat, involving 56 children discharged from two CMTCs. The research collected data through structured interviews with caregivers, anthropometric measurements, and evaluations of hygiene practices and feeding behaviors. Results Of the 56 children, discharged between June 2023 – September 2024, 10 children that is 18 per cent of the children relapsed into SAM after being discharged. The mean relapse time for females was 238.8 days, whereas for males, it was 162.8 days, indicating that male children relapse more quickly than females. The survival curves for the 11–36 months age groups showed a more rapid decline between 100 and 140 days, highlighting this period as critical. In addition, younger children aged 11–36 months were more prone to relapse than older children aged 37–62 months. Poor hygiene practices were strongly linked to higher relapse rates, with 33.3 per cent of children practicing open defecation relapsing compared to 14.9 per cent of those using toilets. Conclusion These findings highlight the importance of addressing environmental and behavioral factors, such as hygiene practices, in the post-discharge care of children with SAM. A long-term community-based follow-up of all CMTC/Nutritional Rehabilitation Centre (NRC) discharged children at risk should be incorporated. A holistic approach that includes health, nutrition, and hygiene education for caregivers is crucial to reduce relapse rates and ensure long-term recovery in these vulnerable children. The findings underscore the importance of effective monitoring of post-discharge children within 100-140 days, particularly for younger males. The findings also underscore the importance ofpractising hygiene and feeding practices to reduce relapse rates and ensure long-term recovery for these vulnerable children.