Indian Journal of Community Medicine Vol. 31, No.

4, October-December, 2006

A Study of Protein Energy Malnutrition (PEM) in Children (0 to 6 Year) in a Rural

Population of Jhansi District (U.P.)
S. Chakraborty, S.B. Gupta, B. Chaturvedi, S.K. Chakraborty
Introduction

reported a higher prevalence in the age group of 0-1 year. It

was found that female had an overall higher prevalence of
PEM (70.6%) as also Grade I PEM (36.6%) in comparison to
males who had overall higher prevalence of PEM and Grade
I PEM as 62.6 and 19.7% respectively (Table I).

Protein Energy Malnutrition (PEM) or Protein Calorie

Malnutrition (PCM) is a widespread nutritional disease in the
developing countries. The present study was conducted with
the objective to study the protein energy malnutrition (PEM)
in children (0-6 year) in rural population of Jhansi district in
the state of Uttar Pradesh

Contradictory results were reported by Saxena et al. (1997)

and Srivastava (1985) as overall higher prevalence among
males. However, Grade II, III, and IV PEM was found to be
significantly higher (x2=1.41, p<0.05) in males (27.4, 10.9
and 4.3% respectively) than in females (23.8, 7.3 and 2.7%
respectively).

Material and Method

The study was conducted over eleven anganwaris centers
of Babina block in the Jhansi district. Multi stage sampling
procedure was adopted to select approximately two hundred
children (0-6 year) for the present study. The parents were
interviewed to get the necessary information. A door to door
survey was done and general information like name of the
child, fathers name, age and sex of the child, type of family,
parents occupation and educational status was collected
from the head of each house hold. The grading of PEM was
done as per the recommendations of the Nutrition SubCommittee of Paediatrics (I.C.M.R.,1972)

The overall PEM prevalence was seen to be higher among

the children of illiterate mothers whereas Grade II, III,
IV PEM was higher amongst children of mothers having
primary education (Table II). Significant difference (x2=12.53,
p<0.05)was found between the per cent of PEM in children
of mother who are illiterate or having primary education in
comparison to those of having education up to middle school
and / or above. Other researchers have also reported similar
observations.
The overall prevalence of PEM (Table II) was found to be
maximum (77.7%) among those children whose father were
labourers, while the overall prevalence of PEM was found
to be minimum (50%) among those children whose father
were skilled professionals. As sizeable percentage of children
with Grade I and Grade II PEM was also found among the
children of labourers. Grade II PEM was maximum in children
of businessmen (29.4%). Significant difference (x2=11.04,
p<0.05) was found in prevalence of PEM among children

Results and Discussion

The overall occurrence of PEM in under 6 year children was
observed to be 67%, however it was found to be significantly
higher (80.9%) in the age group of 1-3 years (Table I) as
compared to other age groups. This age group also exhibited
significantly higher prevalence (x2=14.67, p<0.05) of Grade
I, II, III PEM. Sen et al. also reported a higher prevalence in
the age group of 1-3 years, however Saxena et al. (1997)
Table I. Prevalence of PEM Amongst Under 6 Year Old Children.
Age Group
(Year)

Total
Children

Normal

Studied

Malnourished
Grade-I

Grade-II

Grade-III

Grade-IV

Total

Age wise
0-1

42

20 (47.6%)

8 (19.0%)

8 (19.0%)

4 (9.5%)

2 (4.7%)

22 (52.3%)

1-3

84

16 (19.0%)

30 (35.7%)

28 (33.3%)

8 (9.5%)

2 (4.7%)

68 (80.9%)

3-6

74

30 (40.5%)

20 (27.0%)

15 (20.2%)

6 (8.1%)

3 (4.0%)

44 (59.4%)

Grand Total

200

66 (33.0%)

58 (29.0%)

51 (25.5%)

18 (9.0%)

7 (3.5 %)

134 (67.0%)

Sex wise
Male

91

34 (37.3%)

18 (19.7%)

25 (27.4%)

10 (10.9%)

4 (4.3%)

57 (62.6%)

Female

109

32 (29.3%)

40 (36.6%)

26 (23.8%)

8 (7.3%)

3 (2.7%)

77 (70.6%)

Grand Total

200

66 (33.0%)

58 (29.0%)

51 (25.5%)

18 (9.0%)

7 (3.5%)

134 (67.0%)

c =14.67, df=2,p<0.05 for age wise

of labourer / farmers in comparison to those who are in

service/business/skilled profession. Srivastava (1983) also
reported of higher prevalence Grade I PEM amongst children
belonging to labour class.

c2 =1.41, df=1,p<0.05 for sex wise

Foods and Nutrition, Inst. of Home Science, Bundelkhand University,

Jhansi-284128 (U.P).
E-mail : shalini17576@yahoo.co.in
Received : 29.3.05

A Study of Protein Energy Malnutrition (PEM)

291

Indian Journal of Community Medicine Vol. 31, No. 4, October-December, 2006

Table II. Prevalence of PEM in relation to educational status of mother and occupation of father
Educational
Status of
Mother

Total
Children
Studied

Normal

Malnourished
Grade-I

Grade-II

Grade-III

Grade-IV

Total
90 (77.5%)

Education status of mother

1lliterate

116

26 (22.4%)

37 (31.8%)

37 (31.8%)

13 (11.2%)

3 (2.5%)

Primary

30

10 (33.3%)

6 (20.6%)

10 (33.3%)

2 (17.2%)

2 (17.2%)

20 (66.6%)

Middle School

37

20 (54%)

12 (32.4%)

2 (5.4%)

2 (5.4%)

1 (5.8%)

17 (45.9%)

Above

17

10 (58.8%)

3 (17.6%)

2 (11.7%)

1 (5.8%)

1 (5.8%)

7 (41.1%)

Grand Total

200

66 (33.0%)

58 (29.0%)

51 (25.5%)

18 (9.0%)

7 (3.5%)

134 (67.0%)

Labour

81

18 (22.2%)

29 (35.8%)

22 (27.1%)

10 (12.3%)

2 (2.4%)

63 (77.7%)

Farmer

45

14 (37.1%)

15 (33.3%)

12 (26.6%)

3 (6.6%)

1 (2.2%)

31 (68.8%)

Service

37

18 (48.6%)

7 (18.9%)

8 (21.6%)

2 (5.4%)

2 (5.4%)

19 (51.3%)

Occupation of father

Business

17

6 (35.2%)

4 (23.5%)

5 (29.4%)

1 (5.8%)

1 (5.8%)

11 64.7%)

Skilled

20

10 (50.0%)

3 (15.0%)

4 (20.0%)

2 (10.0%)

1 (5.0%)

10 (50.0%)

200

66 (33.0%)

58 (29.0%)

51 (25.5%)

18 (9.0%)

7 (3.5%)

134 (67.0%)

Professional
Grand Total

c2 =12.53, df--3,p<0,05 for educational status of mother

c2 =11.04, df-4, p<0.05 for occupation of father

Conclusions

References

The occurrence of overall and Grade I, II, III PEM was

highest amongst the age group 1-3 year. Female child had
a higher percentage occurrence of overall and Grade I PEM.
This may be because of the lack of attention that a girl child
receives. The prevalence of overall and Grade I, II, III PEM
was highest among children of illiterate mothers. Improper
education and dearth of awareness among mothers results
in poor health of a child. The children of labourers were
affected most with overall and Grade I, II, III PEM. It is
quite often seen that in labour class both the parents work
through the day, resulting in the child receiving almost no
attention.

1.

Sen V. Purohit B.K. Jain T.P. Weight/Height ratio in assessment

of protein calorie malnutrition, Ind. Paediatrics, 2: 135-138.

2.

Srivastava V.K. Thesis for M.D. (S.P.M.), 1983. Kanpur

University.

3.

Indian Academy of Paediatrics, Classification of Protein

Calories Malnutrition, Ind. Paediatrics, 1972, 9:369.

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Ray S. K. Biswas A. B. Kumar S. A study of dietary pattern

house hold food security and nutritional profile of under-five
children of a communitv in West Bengal. Journal of Indian
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Swami H.M. Thakur J.S. Bhatia S.P. Bhatia V. Nutritional status

of pre school children in an integrated child development
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The extent of malnutrition can be countered by educating

the parents with respect to basic nutritional requirements
of their children and encouraging them to consume locally
available low cost nutritious foods.

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