Molluscum Contagiosum and Nutritional Level of Children Attending to a tertiary care hospital clinic in Sri Lanka
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This study aimed to determine the association between nutritional status and Molluscum contagiosum in children attending a skin clinic. The researchers found significantly higher rates of undernutrition and obesity in children with Molluscum compared to national statistics. Both undernutrition and obesity can contribute to Molluscum by causing long-term immune deregulation. The majority of children also exhibited indirect signs of neglect such as head lice or uncut hair. The study concludes that nutritional status is associated with Molluscum contagiosum in children.
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Molluscum Contagiosum and Nutritional Level of Children Attending to a tertiary care hospital clinic in Sri Lanka
- 1. A STUDY TO DETERMINE THE ASSOCIATION BETWEEN MOLLUSCUM CONTAGIOSUM (MC) AND NUTRITIONAL STATUS OF THE CHILDREN ATTENDING THE SKIN CLINIC OF THE LADY RIDGEWAY HOSPITAL Hewapathirana H.P.I. Munasinghe M.A.R.P. De Silva K.N.L. Jayamanne B.D.W. Senivirathne J.K.K. Akarawita J. SLCGP 39th th Annual Academic Sessions SLCGP 39 Annual Academic Sessions – 2013 2013 SLCGP 39th Annual Academic Sessions – 2013
- 2. Introduction • Molluscum Contagiosum(MC) - benign selflimiting contagious viral infection • Caused by a DNA poxvirus (Molluscipox virus) • Common in childhood • Epidermal disease • Painless papular eruption with multiple umbilicated cutaneous lesions • Can occur in any body area except palms and soles SLCGP 39th Annual Academic Sessions – 2013
- 3. Molluscum Contagiosum SLCGP 39th Annual Academic Sessions – 2013
- 4. Introduction… • Positively associated with – Immunodeficiency – Atopic Dermatitis – Poor personal hygiene • Current practice – frequently seen with undernurished children • No published data on the association between nutritional status of the children in local setup SLCGP 39th Annual Academic Sessions – 2013
- 5. Objective To determine the association between MC and nutritional status of the children attending to the skin clinic of a tertiary care hospital. SLCGP 39th Annual Academic Sessions – 2013
- 6. Methodology • Descriptive cross sectional study • Dermatology clinic of Lady Ridgeway Hospital for Children • Ethical approval – ERC of LRH • Sample – Children aged 0 -12yrs – Non –immunosuppressed (illness / therapy ) – Proper consent – Convenient sample • Data Collection – Over 6 months (2012) SLCGP 39th Annual Academic Sessions – 2013
- 7. • Tools Methodology… – Validated pre tested interviewer administered questionnaire (Sinhala / Tamil ) – By trained respective investigators – Followed by careful clinical evaluation • Analysis – Data entered into an electronic format – Relevant statistical tests applied – Comparison with national available data (National Nutrition and Micronutrient Survey 2012) – Comparisons done for children under 5yrs and 6 12 yrs separately SLCGP 39th Annual Academic Sessions – 2013
- 8. Results • Total of 419 children evaluated . 49% aged below 5 yrs • Age Distribution Q3 =7.5yrs M = 7.68 Median age 4.75yrs (IQR 4.67yrs) Mean 5.25yrs ( 2.83 ) Q1 =2.83yrs M = 2.92 SLCGP 39th Annual Academic Sessions – 2013
- 9. Results… • Sex Distribution 52% were males • Ethnicity •Majority were Sinhalese (46 %) • 32% Moors and 23% Tamils respectively SLCGP 39th Annual Academic Sessions – 2013
- 10. Results… • 90% with 1st episode SLCGP 39th Annual Academic Sessions – 2013
- 11. Results… • Nutritional assessments – According to current WHO standards (based on Standard Deviations) < 5yrs group Weight for age percentages National Study Group 23.50% P < 0.05 15.90 % 3.80 % 3.30 % Severe Unnderweight (< -3SD) Underweight (< -2SD) SLCGP 39th Annual Academic Sessions – 2013
- 12. Results… 5 - 12yrs group < 5yrs group Height for age percentage Height for age percentage National National Study Group Study Group 28.30 22.40 22.00 P < 0.05 13.10 P < 0.05 4.70 2.00 Severe Stunting (< -3SD) Stunting (< 2SD) National Study Group Stunting (-2SD) SLCGP 39th Annual Academic Sessions – 2013
- 13. Results… < 5yrs group 5 - 12yrs group Weight for height percentage B.M.I. National Study Group National 19.60 Study Group 19.30 P < 0.05 13.60 P < 0.05 5.60 2.30 3.30 0.70 Server Wasting ( <- Overweight ( Acute 2SD ) >+2SD) Malnutrition ( <-3SD ) 9.90 P < 0.05 3.10 <-2SD SLCGP 39th Annual Academic Sessions – 2013 P < 0.05 1.60 >+2SD
- 14. Results… • Among all 71 % showed some kind of neglected features . i.e .Head lice(15%) ,long hair(25%) ,etc SLCGP 39th Annual Academic Sessions – 2013
- 15. Results… • In summary compared to national statistics – Under 5yr group • Height for age(stunting) and Weight for height (wasting) percentages were significantly high • Overweight percentage was significantly high – 5 -12yr group • B.M.I. >+2SD (Obese) and < -2SD (Wasting) percentage was significantly high – Majority showed indirect evidence of negligence SLCGP 39th Annual Academic Sessions – 2013
- 16. Conclusions • Both undernutrition and obesity proportions were high among the study group • Both can be contributed to MC due to long term immune deregulation • Obesity reduces skin barrier function also SLCGP 39th Annual Academic Sessions – 2013
- 17. Thank you SLCGP 39th Annual Academic Sessions – 2013
- 18. Acknowledgements • Prof.J.K.K.Senivirathne • Prof.P.Wickramasinghe – Faculty of Medicine, Colombo • All the staff members of L.R.H. Dermatology unit • All the patients and guardians who participated SLCGP 39th Annual Academic Sessions – 2013
Editor's Notes
- Good afternoon everybody.My presentation title in brief is on MolluscumContagiosum and the assessment of nutritional status of children attending to 3ry care hospital in Sri Lanka
- MolluscumContagiosuma benign self limiting cutaeneous viral infection often seen in childhood.It’s a painless umbilicatedpapule often seen as multiple lesions This can occur in any part of the body except palms and soles
- Few images from our study group (not from the internet)
- It is positively associated with immunodeficiency Atopic Dermatitis and poor personal hygiene Lack of local data with the association of nutritional status in pediatric population
- Our objective was to determine the association between MolluscumContagiosumand nutritional status of the children attending to the skin clinic of a tertiary care hospital
- We conducted the study as a descriptive cross sectional study at the dermatology clinic of LRH after the ethical approval by the hospital Ethical Review committee. Children aged upto 12 ys were selected after informed consent after excluding immunosuppressive conditions .
- We used a validated pretested interviewer administered questionnaire followed by a detailed clinical evaluation. Data were compared with National Data under two main age groups. Those are under 5yr and 5 -12 yrs.
- Total of 419 children evaluated . 49% of them aged below 5 yrsMedian age of the total sample was 4.75yrs and it was 2.9 and 7.7yrs for aged below 5yrs and above 5yr groups respectively
- 52% were males and the majority were Sinhalese(46%). 32 % moors and 23% tamils were seen in the sample
- 90% presented with the 1st episode .
- Lets move on to the nutritionalassessments and comparisons. Weight for age under 5yr group was better than the national level among the study group
- But low height for age (stunting) prevalences were significantlyhigher than the national level under 5yr aged group.
- under 5yr group, wasting and over weight prevalenceswere significantly high and similar with Body Mass Index (BMI) of the other age group
- 71% showed evidence of negligence by the aspects that we looked into -which can be the main confounder to the nutritional status too
- In summary compared to national statistics , both under nutrition and overweight proportions were high in all age groups in the study. Majority showed indirect evidence of negligence
- MolluscumContagiosumassociated with both under nutrition and obese children. Both contribute to develop MC by different mechanisms .Wide spread MC is manifestation of negligence .Obesity was observed in 10-12 yr age group