EFFECT OF PROTEIN ENERGY MALNUTRITION (PEM) AMONG

CHILDREN UNDER 0-5 YEARS IN GYADI-GYADI WARD, TARAUNI LOCAL

GOVERNMENT AREA, KANO STATE

BY

HAFSAT AHMAD HARUNA

ADCOHST/2019/CHD/087

A RESEARCH PROJECT SUBMITTED TO DEPARTMENT OF COMMUNITY

HEALTH EXTENSION WORKER AMINU DABO COLLEGE OF HEALTH

SCIENCES AND TECHNOLOGY, NO. 9C CIVIC CENTER, KANO STATE

IN PARTIAL FULFILMENT FOR THE AWARD OF DIPLOMA IN

COMMUNITY HEALTH BY COMMUNITY HEALTH PRACTITIONERS

REGISTRATION BOARD OF NIGERIA (CHPRBN) ABUJA

AUGUST, 2022

i
 APPROVAL PAGE

This research project entitled “Effect of Protein Energy Malnutrition (PEM) Among

Children Under 0-5 Years In Gyadi-Gyadi Ward, Tarauni Local Government Area,

Kano State” was conducted and carried out by me in partial fulfillment to the award of

Diploma in Community Health by Community Health Practitioners Registration Board of

Nigeria (CHPRBN), Abuja.

Sign: __________________ __________________

Mal. Aisar Sunusi Maigayya Date

(Project Supervisor)

Sign: __________________ __________________

Malama Maryam Isa Bashir Date

(H.O.D) Community Health

Sign: __________________ __________________

External Examiner Date

ii
 DECLARATION

I Hafsat Ahmad Haruna humbly declare that this project entitled “Effect of Protein

energy malnutrition among children under 0-5years in Gyadi-Gyadi ward” has been

carried out by me under the supervision of Mal. Aisar Sunusi Maigayya, for the award of

Diploma in Community Health.

iii
 CERTIFICATION

This is to certify that this project entitled: “Effect of Protein Energy Malnutrition

(PEM) Among Children Under 0-5 Years In Gyadi-Gyadi Ward, Tarauni Local

Government Area, Kano State” was carried out by Hafsat Ahmad Haruna meet the

regulation governing the award of Diploma in Community Health by Community Health

Practitioners Registration Board of Nigeria (CHPRBN), Abuja.

_____________________

Hafsat Ahmad Haruna

ADCOHST/2019/CHD/087

iv
 DEDICATION

This project work is dedicated to Almighty Allah, the creator of the universe, who in his

infinite grace granted me the opportunity to carry out this research work and to also my

parent Mr. Ahmad Tijjani Haruna and Mrs. Hajjara Usman Ahmad, I pray the good Lord

reward them bountifully (Amen).

v
 ACKNOWLEDGEMENT

In the name of ALLAH the beneficent and the merciful. Praise be to Almighty Allah and

his Prophet Muhammad (SAW) and to thank him for sparing my life from the first to the

end of my project.

Secondly, I will to show my gratitude to the moral upbringing by my parent to the present

status may Almighty Allah reward them and guide them abundantly and may he also

reward them with Aljannatul Firdaus (Ameen).

My appreciation is directed to my supervisor Mallam Aisar Sunusi Maigayya for his

immense contribution that make this project a reality, may Almighty Allah reward and

guide him and give him a special and loyal wife (amen)

I will also like to extend my sincere gratitude to my lecturers as well as my father Mr.

Ahmad Tijjani Haruna, Provost Abdullahi Yar’adua, PRO Malam Usman, Malam

Abdulwarith Isah, Malam Adam, Malam Usman and other respective lecturers that I have

not mentioned their names for their tremendious contribution and guidance given to me

during my school program, may Almighty Allah reward, assist and bless them and their

entire family (Ameen).

However, I will like to send my special vote of thanks to my brothers and sisters Usman,

Sadiq, Sulaiman, Haruna, Muhammad, Saifullah, Abdullah, Kamalu and Rafi’a

Abdulra’uf, Wasilah Kabir, may Almighty Allah guide and protect them abundantly.

(Ameen)

My special thanks also goes to my entire family and friends and the entire people of

Gyadi-Gyadi ward, my colleagues who helped me most especially Ahmad Garba

vi
K/Wambai, Fatima Nasir Baita, Fadillah Lawan Sulaiman, Fatiman Usman Garba, Aisha

Mustapha Jarumi, Nusaiba A. Sani. Maryam Abdulra’uf Danwakili, Sulaiman, Maryam

Bashir Abubakar during my programme for their support given to me toward

accomplishment of this study may Almighty Allah bless, guide, assist, protect and reward

you all abundantly (Ameen).

vii
 ABSTRACT

The effect of protein energy malnutrition. To identify the effect of protein energy

malnutrition, to identify the cause of protein energy malnutrition (PEM) in the study area,

to provide the possible ways of preventing and controlling of protein energy malnutrition

in the study area. The study design adopted in this study is descriptive survey which

described the effect of protein energy malnutrition among children under 0-5 years in

gyadi-gyadi ward, Tarauni local government area, Kano state. This involves the

description of the instrument used in collection of data such as ddescription should

include how the instrument was developed and the major features of the instrument was

developed by the researcher to use self-designed questionnaire as method of obtaining

information in the area of the study. This questionnaire was designed based on the study

objectives been mentioned already in chapter one and classify into and two section A bio-

data and section B research questions. The data collected are analyzed based on statistical

information and simple frequency distribution of the items, responses were on percentage

of the respondent carried in table form. The sample size was 100 respondent that had

been selected out of the total population 136,500 to represent the entire people of Gyadi-

Gyadi ward, Tarauni LGA, Kano state. The researcher decided to use simple random

sampling techniques to select the respondent out of the population to represent the

universe of enquiry. It’s the method in which all the members has an equal chance of

been selected. Causes of protein energy malnutrition shows that inadequate intake of

good balance diet has 25 respondents representing the percentage of 26.3% and also the

effect of protein energy malnutrition shows that children suffer most from the shortage of

viii
nutrient and affect the body weight has 20 respondent representing the percentage of 21%

while how to prevent and control protein energy malnutrition shows that through

adequate intake of good balance diet has 30 respondents with the percentage of 31.6%

respectively.

ix
 TABLE OF CONTENT

Title page - - - - - - - - - i

Approval Page - - - - - - - - - ii

Declaration - - - - - - - - - iii

Certification - - - - - - - - - iv

Dedication - - - - - - - - - v

Acknowledgement - - - - - - - - - vi

Abstract - - - - - - - - - viii

Table of content - - - - - - - - - x

Chapter One

1.1 Introduction/background of study - - - - - -

1.2 Statement of the problem - - - - - -

1.3 Aim and Objectives - - - - - - - -

1.3.1 Aim - - - - - - - - -

1.3.2 Objectives - - - - - - - - -

1.4 Research questions - - - - - - - -

1.5 Significance of the study - - - - - - -

1.6 Scope/Limitation of the study - - - - - -

Chapter Two

2.0 Introduction - - - - - - - - -

2.1 Conceptual framework - - - - - - -

2.1.1 Effect - - - - - - - - - -

x
2.1.2 Protein Energy Malnutrition - - - - - -

2.1.3 Children - - - - - - - - -

2.2 Causes of Protein energy malnutrition (PEM) - - - -

2.3 Effect of Protein energy malnutrition (PEM) - - - -

2.4 Prevention and control of Protein energy malnutrition (PEM) - -

Chapter Three

3.0 Introduction - - - - - - - - -

3.1 Area of the study - - - - - - - -

3.2 Research design - - - - - - - -

3.3 Sampling techniques- - - - - - - -

3.4 Instrument for data collection - - - - - -

3.5 Validity of the research - - - - - - -

3.6 Reliability for the instrument - - - - - -

3.7 Administration of the research instrument - - - -

3.8 method of data analysis - - - - - - -

Chapter Four

4.0 Introduction - - - - - - - - -

4.1 Data presentation and analysis - - - - - -

4.2 Discussion of major finding - - - - - -

Chapter Five

5.1 Introduction - - - - - - - -

5.2 Summary of the study - - - - - - -

xi
5.3 Conclusion - - - - - - - - -

5.4 Discussion - - - - - - - - -

5.5 Recommendation - - - - - - - -

5.6 Suggestion for further study - - - - - -

Reference - - - - - - - - - -

Appendix - - - - - - - - -- -

xii
 CHAPTER ONE

INTRODUCTION

1.1 Background of the study

The world health organization (WHO) defines malnutrition as the cellular imbalance

between the supply of nutrients and energy and the body’s demand for them to ensure

growth maintenance and specific function On is (2015). The term protein energy

malnutrition (P.E.M) applies to a group of related disorder that include marasmus

kwashiorkor and intermediate state of marasmus kwashiorkor.

Children with kwashiorkor have rational edema and metabolic disturbances including

hypoalbuminemia and hepaticsteatosis, whereas marasmus characterized by severe

wasting (J. Nutr 2016) studies suggest that marasmus represent an adaptive response to

starvation whereas kwashiorkor represents a maladaptive response to starvation.

Under-nutrition, especially among young children in low and middle income countries

(LMICS) remains widespread, particularly in sub-saharan Africa and south Asia. Its

effect include increased risk of morbidity and mortality from infection, impaired

intellectual development and a higher risk of developing obesity and chronic non-

communicable diseases in later life. The immediate determinates are intake of adequate

diets and increased disease underlying these are food insecurity, suboptimal social case

including breastfeeding and inadequate health and environmental services. These, in turn

are under pinned by combination of social and structural factors that include education of

women, lack of financial and other resources at household level, and food environment in

an increasing number of countries that remotes consumption of nutrients poor diets, such

1
social, environmental and economic factors are taking place in the context of inequitable

economic globalization. Where the opportunities among the poor accessing growing

dominance of large (operation at every point in the food supply chain). A combination of

nutrition specific, that is health and diet actions and nutrition sensitive that is

environmental, social and economic intervention is required to mitigate this situation,

ultimately however, the reduction and eventual eradication of nutrition will entail

structural reforms that address poverty inequity and the negative aspects of globalization,

including climate change (Rasmussen KM, 2010)

Uundo Ramokolo (2014) is a senior scientist at the South African Medical Research

Council. Health systems research unit she holds a master of public health epidemiology

degree from the University of Cape town and is currently completing her doctorate at the

University of Norway. PhD focuses on the growth of cohorts of HIV exposed and

unexposed children living under different PMTCT policies between 2002 and 2013 a Co

investigator in the national in several other projects. Including a study assessing the

impacts of child support grant on child wnage zembmkabile(2010) He’s a socialist at the

South African medical Research Council she is also a senior research fellow at the South

African social Policy Research and teaching in social policy especially as this creates to

poverty equality health and well-being.

Using The WHO golva database on child growth, which cover 87% of the total

population of under five years old in developing countries, we describe the worldwide

distributing based on nationality representative cross-sectional data gathered between

2010 in Africa Asia Latin America and Oceania. Defines confirm that more than a third

2
of the world children affected for all the indicator [wasting stunting and underway] the

most favorable situation low or moderate prevalence or call in Latin America in Asia

most countries and Africa a combination of both this circumstance is found a total 86%

of the Joanna affected live in Asia mainly in southern Asia 15% in Africa and 50% Latin

America approximately 43% of the children [230 millions] developing countries are

stunned. Efforts to accelerate significantly economic development we’ll be unsuccessful

unit Optima, child growth and development are ensured for the majority WHO [2016].

Protein energy malnutrition or protein calorie malnutrition. Refers to a form of

malnutrition where is inadequate of protein intake. (Sutton GM., Certain IV 2010)

In Nigeria protein energy malnutrition [PEM] is particularly serious in post wearing and

often associated with infections [donut, 2011] in Nigeria most of the data reported on

PEM I have from the southern part of the country their data indicates PEM to be one of

the major causes of child death in Nigeria.

In Kano protein energy malnutrition (PEM) is a common condition in our environment

and still associated with high morbidity and mortality.

1.2 Statement of the problem

Protein energy malnutrition (PEM) Is a pathological condition that about children zero to

five years and it has been the major contributory factor of high morbidity and mortality

on our community level local government level state level and general worldwide.

protein energy malnutrition Called lack of inadequate intake of food or protein. And

energy food as well as others nutrient the grid need to conduct research on this subject

3
matter is that to find out the actual felt need of the Gyadi-Gyadi ward, Tarauni Local

government In the prevention of protein energy malnutrition [PEM]

1.3 Aim and Objectives

1.3.1 Aims

The aim of the study is to determine the effect of protein energy malnutrition among

children from zero to five years the case study of Gyadi-Gyadi ward Kano, Tarauni local

government area, Kano state.

1.3.2 Objectives

The research topic he's trying to expose the following research objectives which include

1. To identify the effect of protein malnutrition among the children zero to five years

2. To identify the causes of protein energy malnutrition

3. To provide the possible ways of preventing and control of protein energy

malnutrition in the study area

1.4 RESEARCH QUESTION

the study will try to answer the following research questions.

 What are the effects of protein energy malnutrition among children zero to five

years?

 What are the costs of protein energy malnutrition in the study area?

 What are the possible ways or methods of prevention and control of protein

energy malnutrition in the study area?

4
1.5 SIGNIFICANCE OF THE STUDY

this project is the great value to the consideration of the health on Children because at this

age is a part of vulnerable group that effect from the problem of malnutrition. however it

will be significant to the government at both state level and local level. To evaluate and

assess the situation

it will also be benefit to the individual, family and the entire community members by the

time they become aware about the effect of protein energy malnutrition.

1.6 SCOPE/LIMITATION OF THE STUDY

The research project title us to determine the effect of protein energy malnutrition among

children from zero to five years a case study of Gyadi-Gyadi ward, Tarauni LGA Kano

state. The study was limited to identify the effect causes of PEM and possible ways for

the prevention and control of protein energy malnutrition in the study area, the research

project connect from the month of April, 2022 to August 2022.

1.7 Definition Of Term

PEM – Protein Energy Malnutrition

WHO – World Health Organization

LIMICS – Low and Middle Income Countries

KM – Kwashiorkor Marasmus

5
 CHAPTER TWO

REVIEW OF THE RELATED LITERATURE

2.1 Theoretical framework

According to World Health Organization protein energy malnutrition [PEM] refers to an

imbalance between the supply of protein and energy and the body demand for them to

shore optimal growth and function. Or is M.D (2019).

It is a major public health in India. It’s affect particularly the preschool children [Less

than six years] with its there are consequences ranging from physical to cognitive growth

and susceptible to infection. this affect the child at the most crucial period of time of

development which can lead to permanent in later life. Gragndah M. (2015)

Protein energy malnutrition (PEM) Is measured in terms of underweight [low weight

forage] and wasting [low weight for height]. the prevalence of stunting among five is

48% [moderate and severe] UNICEF 2013 it is the highest in the world. The majority of

children suffering from under nutrition [80%] add mild and moderate forms which go on

unnoticed Park K (2017) And the early ages affected more which makes the process

irreversible.

In comparison to the global reference standard, they wait for age distribution of Indian

children falls to the left of the Curve.

Under nutrition makes the child susceptible to infection and complement its effect in

contribution to child mortality. This account for 22% of the burden of diseases in India

and adversely affects the economic growth of the country with an estimated adult

productivity loss of 1.4% of gross domestic product GDP Gragnolation, (2015).

6
Protein energy malnutrition (PEM) Is defined as the range anthological Condition, arising

from coincidence lack of protein and in calories in varying reports or call most frequently

on infants and young children and commonly associated with infection. Rasmussen KM

2010

There are three effects of protein energy malnutrition include:

1. Kwashiorkor protein malnutrition predominance

2. Marasmus defiance in both calories and protein nutrition

3. Kwashiorkor Marasmus: markets protein defiance and market calories

insufficiency signs present sometimes referred to as the most severe from

all malnutrition. This may also be secondary to other conditions such as

chronic renal diseases of cancer can exist in which protein energy wasting

occurs.

Protein energy malnutrition affect children the most because they have less protein

intake. The few are cases found in the developed world are almost entirely found in small

children as a result need of children particularly in case of milk allergy.

Content of Protein energy malnutrition (PEM)

Presented monetization protein malnutrition is determined at any point in life but protein

malnutrition prenatally has been shown to significant life long effect. During pregnancy,

one should aim a diet That consists at least 20% protein For the health of the fetus, That’s

that consists of less than 60% protein intense have been linked with many difficulties

comma including decreased brain weight, increase with brain. Even diet of mild protein

malnutrition 7.2% has been shown to have casting and significant effect. The following

7
are some studies in which prenatal protein deficiency has been shown to have

unfavorable consequences.

1) Decreased brain size: protein deficiency has been shown to effect for size

and composition of brains razoos monkey, monkey whose mother has

eaten a diet with an adequate amount of protein where to show have no

deficit in brain size or composition, even end their body weight and

mounted for less than ½ of that of the control, whereas monkey whose

mother has eaten low protein diets we are shown to have smaller brain

regardless of the diet given after birth. (P) Organe (2012)

2) Impaired neorcotical long term potentiation: Mild protein deficiency in

which 72% of diets consist of protein in rat has been shown to impair

entonineskortex plasticity (viscous partial memory) noradrenergic function

in the heocortex and neocortial long term proteintiation. (Langley Evans

SC May, 2016).

3) Altered fats distribution: protein under nutrition can be averaging effect

depending on the period of fatal life during which the malnutrition

occurred. Although there were not significant differences in the food

intake, yeah we are increase among of parental fats in rats that were protein

deprived during early (quarion days 0.7)and mid (gestation days 18-14)

pregnancy And throughout the pregnancy whereas rash that we are protein

deprived only rate in gestation [gestation days 15 to 22] we are shown to

have increased gonadal fat. Rossirf (2010).

8
 4) Increased obesity: my exposed to a low protein diet prenatally weighed

4% than the control group of birth [intra Uterine growth retardation], we

were fed a high fat diet after birth, the prenatal undernourished micro we

are adequately nourished prenatally diets not shown an increase in body

weight or adipostly when fed the same high fat diet after birth. Kampiras

W. D. (2011)

5) Decreases birth weight and gestational nutrition: supplementations of

protein and energy can lead to increased duration of gestation and higher

weight been Fed is supplement containing protein, energy and

micronutrient. Pregnant women showed more successful results during

birth gestation and fewer but Tim but than women who had consumed a

supplement with micronutrient and low energy but no protein [although

this finding may be due to the increase of energy in the supplement, not the

increase of protein].

2.2 Concept of under 5 children

Children are biologically, a child [plural children] is a human being between the stages of

birth and puberty or between the development period of infancy and puberty.

Child can be defined as a young human being below the age of puberty, below the legal

age of maturity.

Children can be defined as the person you have given birth to your son or your daughter,

a person who hasn't yet grown up, someone inexperienced in a certain thing or someone

9
behaving in an immature manner. An example of a child is your 30 years old son. An

example of a child is someone who is only four years old.

2.3 concept of protein energy malnutrition [PEM]

Protein energy malnutrition is a potentially fatal body depletion disorder, it is the leading

cause of death in children in developing countries.

Protein energy malnutrition also referred to as protein calories malnutrition, it’s develops

in children and adults whose consumption of protein deficiency can occur when a person

diets provide enough but lacks the protein minimum. In most cases the deficiency will be

dual. protein energy malnutrition may also occur in person who are unable to absorb vital

nutrients or convert them to energy essential for health tissue formation and organ

functions.

Types of protein energy malnutrition

 Primary protein energy malnutrition results from a diet that lacks sufficient

sources of protein and or energy.

 Secondary protein energy malnutrition is small condition in the United states,

where they sale occurs as a complication of aids, cancer, kidney failure

inflammatory bowel diseases and other illnesses that impair the body’s ability to

absorb or use nutrients or to compensate gradually in a patient who has a chronic

illness or experiences chronic semi starvation. It’s may appear suddenly in a

patient who has an acute illness.

2.4 causes of protein energy malnutrition

The causes of protein energy malnutrition include the following:

10
1. Inadequate food intake is the most common cause of malnutrition worldwide in

developing countries, inadequate food intake is secondary to insufficient or

inappropriate food supplies early cessation of breastfeeding. In some areas cultural

and religion food customs may play a role. Inadequate sanitation further endangers

children by increasing the risk of infectious diseases that increases malnutrition

losses and alters metabolic demand.

2. In developed countries, inadequate food intake is a less common cause of

malnutrition. Instead, diseases and in particular chronic illnesses play an important

role in the etiology of my nutrition. Children with chronic illnesses are at risk for

nutritional problems for several reasons, inducing the following:

i. Children with chronic illness frequency have anorexia, Which leads to

inadequate food intake.

ii. Increase inflammatory burden and increase metabolic demands can increase

need.

iii. Any chronic illness that involves the liver or small bowel affect nutrition

adversely by impairing digestive and absorptive function.

Chronic illness that commonly associated with nutritional deficiencies include the

following:

a) Cystic fibrosis

b) Chronic renal failure

c) Childhood malignancies

d) Congenital heart diseases

11
 e) Neuromuscular diseases

f) Chronic inflammatory bowel diseases

In addition align the following plays children at significant risk for the development of

nutritional deficiencies;

 Prematurity

 Development decay

 In utero toxin exposure (i.e feral alcohol exposure)

1. Children with multiple food allergies present a special nutritional challenge

because of serve diet any restriction. Patients with active allergic symptoms may

have increased calorie and protein needs.

2. Guidelines on fruit juice intake for children by the American Academy of

Pediatrics recommend that is the evolution of children with malnutrition the

pediatric Should determine the amount of Juice being consumed as excessive Juice

consumption may be associated with malnutrition. [over nutrition and under

nutrition]. Harohilli R. Shashidhar (2017). physical finding that are associated

with protein energy malnutrition includes the following, Balint JP, (2011).

 Decrease subcutaneous tissue: Areas that are most affected are the legs,

arms Botox and face.

 Edemalareas That are mostly affected at the distal extromities and anasarca

(generalized edema)

12
  In the last four decades, protein energy malnutrition [PE M] During infancy

has been one of the main public health problem in the developing countries

Both early and very recent papers on the diseases have been devoted to causes and

various means of treating it from the health workers point of view. Among the prominent

causes listed in the interactive are faulting food habits, ignorance and poverty

unavailability of rich protein sources, large family size and unhygienic environment.

Quite Surprising, the causes of the disease from the client’s points of view have not been

well documented in the literature. A disease is not totally cured until preventive measures

are incorporated into the curative regiment. Journal of tropical pediatric 2015

The cause of protein energy malnutrition can either be direct, let us examine each of them

in details:

Direct causes of protein energy malnutrition

The direct factors which are commonly referred to as immediate factors include;

a) Inadequate food intake

b) Disease

Inadequate food intake is the result of limited access to food in terms of quality and

quantity.

Disease

Notably malaria and measles least a loss of appetite, increase Rate of metabolism due

to fevers, thereby increasing the body’s nutrient demand. Diarrhea reduces the

absorptions of food nutrient, whereas we’re meeting decreases food intake. Intestinal

parasite competes for nutrients with the body e.g hookworm Compete for iron.

13
Indirect causes of protein energy malnutrition

a) Food insecurity and limited access to food stuff;

 Families cannot acquire or produce enough food to cater for energy

needs

 Lack of or Limited access to land or agricultural input, marketing and

distribution of food.

 Lots of food through destruction by pests, fungi, rodents and wild

animals.

 Soil erosion often resulting from overshooting, Deforestation and

discrimination.

 Poor farming practices often do too lack of knowledge, money, time or

equipment.

 Poor weather conditions like failure of rains, floods etc.

 Lack of time to gather food, prepare it properly and provide special

dishes for young children. Among the time consuming and energy

experiencing activities of the rural African housewife are the fetching of

water from long distance.

 Urbanization and rapid migration to the larger towns resulting in

unemployment and low income.

b) Poor water/sanitation and adequate health service

14
  Health services may be low quality expensive non existence or

unfriendly.

 Lack of prenatal and child health care.

 Inadequate management of sick children.

 Inadequate water and sanitation facilities.

c) Inadequate maternal and child care practices

 Families do not give adequate time and resources for women and

children health.

 Poor caring and practices including the inappropriate care of sick

children.

 Not utilizing health care facilities for pregnant mothers or adolescent

girls.

 Not supporting mothers to breastfeed adequately.

 Inadequate diets for women including food taboos during and after

pregnancy. MC Latham. (2017)

2.5 Effect of protein energy malnutrition

Protein energy malnutrition countries to affect millions of human beings in

developing countries children suffer most from the shortage of nutrients because at

early ages malnutrition has an important impact on the central nervous system. The

change that malnutrition triggers in the brain of these children will have severe

consequences on their developing and learning abilities. Odabas (2017)

15
Development reports of important alternation in the head circumference and brain

growth of malnourished children have been published in the literature, Together with

accounts of charges in bold are the dendritic position And the morphology of the

dendritic spines as well as in myelination. Computerized tomography brain scans and

magnetic resonance Imagine in children suffering from malnutrition worsen the

damage to the central nervous system. All the alternation that are observed in such

cases give rise to important compromise of the child higher brain function, which may

well lead to permanent neuropsychological damage. Rev neural (2017)

2.2.3 Types of protein energy malnutrition

1. Kwashiorkor (Protein malnutrition on predominant)

2. Marasmus (deficiency in calories intake)

3. Marasmus Kwashiorkor (Marked protein deficiency and marked calories

insufficiency signs present sometimes referred to as the most severe of normal

of malnutrition’s)

Kwashiorkor (Protein Malnutrition predominant)

a. Definition of kwashiorkor

Kwashiorkor Is a form of severe protein malnutrition Characterized by

edema and an enlarged liver with fatty infiltrates. Sufficient calories intake,

but with insufficient protein consumption, distinguishes it from marasmus,

kwashiorkor Causes or call in areas of famine or poor food supply.

Cambridge k 2011 causes in the developed world are rare.

16
Signs and symptoms of kwashiorkor

The defining sign of kwashiorkor in a malnourished child is pitting edema (swelling of

the ankles and feet) other signs include:

 A Sites ended abdomen

 An enlarged liver with fatty infiltrates

 Thinning of hair

 Loss of teeth

 Skin depigmentation and dermatitis

Causes of kwashiorkor

The precise etiology of kwashiorkor remains unclear Brined A (2014) Several hypothesis

have been proposed that are associated with the explanation Some but not all aspects of

the pathophysiology of kwashiorkor. They include but are not limited to protein

deficiency causing hypoalbuminemia, amino acid, deficiency, oidative stress and gut

microbiome change. Brined A (2014)

Complications of kwashiorkor

There can be serious complication when treatment is delayed, including coma, sick and

permanent mental and physical disabilities. Kwashiorkor Can be life threatening if the

left it’s untreated. It can cause major organ failure and eventually death.

Treatment of kwashiorkor

17
WHO guidelines ten general principles for the inpatient management of several

malnourished children. Ashworth A (2013)

 Treats or prevent hypoglycemia

 Treats or prevent hypothermia

 Threats or prevent dehydration

 Correct micronutrient deficiencies

 Stats cautious feeding

 Correct electrolyte imbalance

 Treat or prevent infection

 Actively catch up growth

 Provide sensory stimulation and emotional support

 Prepare for follow up after recovery.

Both clinical subtypes of severe acid malnutrition (kwashiorkor and marasmus) A

treated similarly.

Definition of marasmus [deficiency in calorie intake]

Marasmus is a form of malnutrition. It happens when the intake of nutrients and

energy is too low or a person need. It’s list to wasting or the loss of body fat and

muscle. A child sign and symptoms of marasmus.

Other symptoms include:

 Persistent dizziness

 Lack of energy

18
  Dry skin

 Brittle hair

Causes of marasmus

 Not having enough nutrition or having too little food.

 Consuming the wrong nutrients or too much of one and not enough of another

 Having a health condition that makes it difficult to absorb or process nutrient

correctly.

Complication causes

Diarrhea, measles or a respiratory infection a serious complication that can be total in a

child with marasmus. Diarrhea can also be a contributing causes of marasmus. Other

complications include bradycardia, hypertension and hypothermia.

Treatment of marasmus

Initial treatment of management often includes dry skin milk powder mixed with Boiled

water. Later, the mixture can also include vegetable oil such as sesame, caseins and

sugar, caseins are Milk proteins. The oil increases the energy content and density of the

mixture.

C. Definition of Marasmus and Kwashiorkor

Marasmus KwashiorkorIs the third form of protein energy malnutrition that combines

features and symptoms of both marasmus and kwashiorkor.

A person with both marasmus kwashiorkor may

A. The extremely thin

19
 B. Show signs of wasting in areas of the body

C. Have excessive fluid buildup in other parts.

Children with marasmus kwashiorkor, the wait will be less than 60% of the standard

weight for their age.

Causes of marasmus kwashiorkor

Marasmus kwashiorkor causes by activates or chronic protein deficiency and chronic

energy deficit and it's characterized by edema.

Complication of marasmus kwashiorkor

medical complication

If there is a serious medical complication then the patient should be referred for inpatient

treatment this complication include the following;

 Bilateral pitting oedema. Grade 3 (+++)

 Marasmus kwashiorkor (W/U < 70%)

Resources for MUAC straps

 Severe vomiting/intractable vomiting.

 Hypothermia – auxiliary temperature < 35°c rectal < 35°c

 Fever 39°c

 Number of breath per minutes – 60 resp/min. For under 2min

Treatment of marasmus kwashiorkor

20
A child may not necessarily need fluid delivered intravenously. Only hydration may be

sufficient, infections are common among children with marasmus, so treatment with

antibiotics other medication is standard treating infections and any other health.

2.6 Prevention and control of protein energy malnutrition

b. Health and educational Education

c. Promotion of education and literacy in the community

d. Growth monitoring

2.6.1 Health and educational education

Health education interventions aimed at changing children’s diets often target their

mother.

However, little is known about what factors influence mother, For themselves and how

this is related to their choice of food for their children. The present study aimed to

examine the types of food mothers eat themselves in comparison with their choice for

their primary school age children. In addition the study aimed to assess whether the

mothers dieting behaviors affected their differences.

A questionnaire was completed by 218 [responses rates 52%] mothers of children age

between five and is asking them about their children in a less healthy way then they feed

their children in a less healthy way than they feed themselves, specifically, they feed their

children more sweet products and more unhealthy breads and dairy products. Health

educate mother on taking more healthy food like fruit and vegetables (fresh oranges,

boiled/streamed carrots, boiled cottage cheese, natural yoghurt), Meat, fish, poultry, eggs

21
(Roasted chicken, grilled fish, boiled eggs), Sweets, biscuits, soft drinks [orange or fruit

drink, digestive biscuits]. These were Submitted to produce a total health food score

(mother themselves a=0.6 mother for children a =0.6)

2.6.2 Promotion of Education and literacy in the community

The community strategies for promoting literacy flipbook provides simple activities that

parents and children can do to build the skills that help to strengthen children reading

ability even everyday activities singing, talking, play shopping and doing chores around

the house Have the potential to boost children literacy by strengthening both children oral

language development and their knowledge of the world around them. Although the flip

book was initially designed as part of a safe the children literacy boost programming

framework, others working on education or community mobilization efforts could easily

use this flip book as a resources for enhancing children learning or for children education.

Because the flip book supports children’s language and learning in a broad sense, it is a

resources that could easily cut across other education sectors, including early childhood

development basic education and even emergency education context.

2.6.3 Growth monitoring

Growth monitoring is widely accepted and strongly supported by health professionals,

and is standard component of community pediatric services throughout the world. We

sought to evaluate research evidence of its impact. This requires definition, consideration

of the setting and discussion of the intended effect of this activity. In this review, we

define goods monitoring as the regular recording of a child’s weight, coupled with some

22
specified remedial actions. If the weight is abnormal in some way, although the causes of

growth faltering and the responses to it may be region specific the process and the same

and we consider here growth monitoring in both the deprived and richer populations of

the world.

Growth monitoring consists of routine measurement of detect abnormal growth,

combined with some action when there is detected. As primary care workers worldwide

invest time in these activities, we sought evidence of this benefits and harms. The review

objectives are to evaluate the effect of routine growth monitoring on.

And also we use MAVAC, measuring weight and Tamowa in The prevention and control

of protein energy malnutrition.

MVAC –interpretation of mid upper arm circumference. MUAC indicators.

MUAC Less than 110 mm (11.0cm), RED color Indicates severe acute malnutrition

(SAM). The child should be immediately referred for treatment.

MUA C of between 110MM [11.0 CM] and 125 [12.5 CM], red color (3- color tape)

Orange color [4 color tape] Indicates moderate acute malnutrition [M AM]. The children

should be immediately referred for supplementations.

MUAC of between 125mm (12.5cm) and 135mm (13.5cm) Yellow color, indicate that

the child is at risk for acute malnutrition I should be counseled and followed up for

growth promotion and monitoring (GPM).

MUAC over 135mm (13.5cm) Green color indicates that a child is well known.

2.7 Summary

23
Summary protein energy malnutrition It’s a common childhood disorder and is primarily

caused by deficiency of energy, protein and micronutrients. Protein energy malnutrition

manifest as underweight, [low body weight compared with healthy peers] stunting [Poly

near growth], wasting [acute weight loss], or edematous malnutrition (kwashiorkor).

World Health Organization (WHO) Guidelines, management of most forms of PEM can

be done in the community setting by improving household food security, promoting

appropriate complementary food, providing micronutrients, providing antihelminthic

treatment and preventing (e.g by vaccine) And treating infections illnesses.

24
 CHAPTER 3

RESEARCH METHODOLOGY

3.0 Introduction

This Doctor continues description of methods and procedures to be employed in carrying

out this research works, it also comprises the following subheading:

3.1 the area of the study

3.2 Research design

3.3 Population of the study

3.4 sample size

3.5 Sample techniques

3.6 instrument for data collection

3.7 Validity of the instrument

3.8 reliability of the instrument

3.9 Administration of the research instrument

3.10 Method of data analysis

3.1 THE AREA OF THE STUDY

Gyadi-Gyadi ward in Tarauni local government area. It has an area of about 3-4 km and

has a population of about 136,500 people based on 2016 population projection. The

postal code of the area is 700, although postal codes are usually assigned as sometimes

assigned to individual addresses or to institution that receives a large volume of meals

such as government agencies and large commercial companies.

25
According to the spatial and attribute data [coordinate] Tarauni Local government area

allocated in longitude 115317 N and latitude 83010 E. Gyadi-Gyadi Population census of

1991, 2006, 2016.

By the North Gyadi-Gyadi ward was bound Buy farm center word, by the east Gyadi-

Gyadi ward was bounded by Hausawa ward, by the south Gyadi-Gyadi ward was

bounded by Aminu Kano ward, by the west Gyadi-Gyadi was bounded by Gyadi-Gyadi

area ward, Gyadi-Gyadi is endowed by schools (nursing, primary and secondary school)

e.g government Gyadi-Gyadi school, Albasar International school, Hafsat Ganduje

Science Academy, Hausawa government secondary school etc.

Hence Gyadi-Gyadi ward is both endowed with market both daily and periodical market

as follows, Gyadi-Gyadi farm center market (daily) cikin Gyadi-Gyadi farm center

market.

It is also endowed with hospitals both PHC and other hospitals.

Gyadi-Gyadi ward Has several tribes due to closeness to Tamburawa industrial area

which lead to massive gravity models of attraction to that area which many people come

and settle in Gyadi-Gyadi ward in order to search for jobs and life well-being.

This push and full function into Gyadi-Gyadi ward attract several tribes settling in Gyadi-

Gyadi, this Tribes are as follows; Yoruba Hausa fulani

3.2 RESEARCH DESIGN

The study design adopted in this study is case study which describe the effect of protein

energy malnutrition among children under 0-5 years of age in Gyadi-Gyadi ward, Tarauni

26
local government, Kano state. The method has been used by various research over the

years.

3.3 RESEARCH POPULATION

The population of this comprises the people resident in Gyadi-Gyadi Including the civil

servant, housewives and business people around the area.

3.4 SAMPLE SIZE

The sample size was 100 respondents that being selected out of a total population of

136,300 to represent the entire people of Gyadi-Gyadi ward in Tarauni local government

area Kano state.

3.5 SAMPLING TECHNIQUES

Research here decided to use simple random sampling techniques to select the respondent

out of the population period to represent the universe of inquiry it is a method in which

all the members has an equal chance of being selected.

3.6 INSTRUMENTS FOR DATA COLLECTION

This involves a description of the instruments used in collection of data such as

description should include, how the instrument developed and major features of the

instrument and whether the instrument was developed by the researcher to use self

designed questionnaire as a instrument of obtaining information in the area of the study.

This questionnaire was designed based on the study objectives been mentioned already in

chapter one and classified into two section a bio data and section B research question.

27
3.7 VALIDITY OF THE INSTRUMENT

They drafted question Was validated by projects supervisor and two other lecturers in the

department for appropriateness in which necessary corrections were made and amended.

3.8 RELIABILITY OF THE INSTRUMENT

To make the instrument reliable the point of the study was conducted out of the actual

area of the study to test conducted 2 weeks before the actual data of review of date.

3.9 ADMINISTRATION OF THE RESEARCH INSTRUMENT

A letter of introduction was given to the head of Gyadi-Gyadi ward For permission

before the actual date of collection of data and permission granted to get access to the

respondent. The researcher distributed the 100 question near by herself and allowed the

maximum of 1 after the other which she went back personally to Select the filled

questionnaire. There is such a distributed the questionnaire in some area of Gyadi-Gyadi

ward in area around cikin unguwar Gyadi-Gyadi (old Gyadi-Gyadi), farm center,

Hausawa, dangi.

3.10 Methods of data analysis

The data collection are analyzed based on statistical information and simple frequency

distribution of the items, responses were on percentage of the respondent carried in a

table form.

28
 CHAPTER FOUR

DATA PRESENTATION, ANALYSIS AND DISCUSSION

4.0 Introduction

This chapter contains statistical analysis result of the findings obtained from the

respondent in Gyadi-Gyadi ward of Tarauni local government area, Kano state.

100 questionnaire Were distributed to the respondent from Gyadi-Gyadi ward And out of

100, ninety-five (95) questionnaire were retrieved back fully completed by respondent,

therefore the result of the findings are presented in the following table.

4.1 Data presentation of demographic data

This section presents the demographic data of the respondents based on gender, age,

occupation and educational level of respondents.

Table 1: Age of Respondent

S/N Range of Age No. of Respondent Percentage %

A. < 30 years 55 57.8%
B. 31-50years 25 26.3%
C. 51 + years 15 15.8%
TOTAL 95 100%
Source: Field work 2022

This table above shows that below 30 years have 55 respondents with the percentage of

57.8% and 31 to 50 years has 25 respondents which is 26.3% and 51 and above years has

the respondent number of 15 and the percentage of 15.7% the highest is less than 30

years respondent which percentage of 57.8%.

29
Table 2: Gender of respondent

S/N GENDER No. of Respondent Percentage %

A. MALE 60 63.1%
B. FEMALE 35 36.9%
TOTAL 95 100%
Source: Field work 2022

The above table shows that mail has the respondent number of 63 percentage of 63.1%

and the female has 35 respondents with the percentage of 36.9%. The highest add emails

with the respondent number of 60 that has the percentage of 63.1%..

Table 3: Occupation of the respondent

S/N OCCUPATION No. of Respondent Percentage %

A. Student 40 42.1%
B. Civil Servant 35 36.8%
C. House wife 20 21.1%
TOTAL 95 100%
Source: Field work 2022

The above table shows that the student has the respondent number of folks with the

percentage of 42.1% and the civil servant has respondent number of 35 with the

percentage of 36.8% and the housewife half the respondent number of 20 with the

percentage of 21.1%. The highest is students that has 40 respondents with the percentage

of 42.1%.

30
Table 4: Marital status of respondent

S/N MARITAL STATUS No. of Respondent Percentage %

A. Married 40 42.1%
B. Single 40 42.1%
C. Divorce 5 5.2%
D. Widower 10 10.5%
TOTAL 95 100%
Source: Field work 2022

The above table shows that married people has 40 respondents and representing the

percentage of 42.1% where single people has 40 respondents with the percentage of

42.1% and diversity has five respondent resenting 5.2% and widower has 10 responded

with the percentage of 10.5%. There’s add married and single people their house for sale

respondent to the percentage of 42.1% respectively.

Table 5: Educational qualification of the respondent

S/N Educational Level No. of Respondent Percentage %

A. Primary 10 10.6%
B. Secondary 35 36.8%
C. Tertiary 50 52.6%
TOTAL 95 100%
Source: Field work 2022

The above table shows that Primary has ten respondents with the percentage of 10.5%

and the secondary has 35 respondent with the percentage of 36.8% and it actually has 50

31
respondents with representing the percentage of 52.6%. The highest is the tertiary with 50

respondents representing the percentage of 52.6%.

Table 6: Responses of respondent on causes of protein energy malnutrition (PEM)

S/N STATEMENT OF ITEMS No. of Respondent Percentage %

A. Inadequate or good balance diet 25 26.3%
B. Loss of food through destruction by pest, 10 10.5%
fungi, rodents, birth and wild animals
C. Food insecurity and limited access to food 16 16.7%
stuff
D. Lack of prenatal and child health care 12 12.5%
E. Lack of immunization 23 24.2%
F. Lack of nutritional knowledge 9 9.6%
TOTAL 95 100%
Source: Field work 2022

The above table shows that 25 respondents 26.3% believe that inadequate intake of good

balanced diet caused the effect of protein energy malnutrition and lots of food through

destruction by pest,fungi,Rodents, bats and wild animals has 15 respondents with the

percentage of 15.7% we have food insecurity and limited access to food stuff has 18

respondents representing the percentage of 18.9% and lack of prenatal and child

healthcare has 14 respondents representing the percentage of 14.7% and lack of

immunization has to end trip respondents the percentage of 24.2%. The highest are the

inadequate intake of good balanced diet that has turn 5 respondents with percentage of

32
26.3% and lack of immunization that house 23 respondents with their percentage of

24.2% respectively.

Table 7: Responses of the respondents on effects of protein energy malnutrition

S/N STATEMENT OF ITEMS No. of Respondent Percentage %

A. Children suffer most from the shortage of 20 21.1%
nutrients
B. It damages the central nervous system 30 31.5%
C. It produce notable morphological changes 10 10.5%
in the brain of children
D. It affect the weight of the body 15 15.8%
E. It affect the early childhood on intellectual 15 15.8%
and motor abilities
F. It can result to death 5 5.3%
TOTAL 95 100%
Source: Field work 2022

The above table shows that children suffer most from the shortage of nutrients with 20

respondents and has the percentage of 21.1% and it damages to the central nervous

system representative respondents with the percentage of 31.5% and it’s produce notable

morphological changes in the brain of children has 30 respondents with the percentage of

10.5% and its effects of the weights of the body with ten respondents representing and

percentage of 15.8% And it’s effect through the early childhood on intellectual and motor

abilities has 15 respondent to the percentage of 15.8% and it’s can result to death 5

respondents with the percentage of 5.3%.

33
The highest are the children that suffer most from the damages to the central nervous

system that has 30 respondent to the percentage of 31.5% respectively.

Table 8: Responses of the respondents based on possible ways of the prevention and

control of protein energy malnutrition

S/N STATEMENT OF ITEMS No. of Respondent Percentage %

A. Through adequate intake of good balance 25 28.6%
diet
B. By growth monitoring 21 22.3%
C. Health education 16 16.8%
D. By promotion of education and literacy in 10 10.5%
the community
E. Taking your child to health facility for 15 15.7%
immunization
F. Through nutritional counseling 8 6.1%
TOTAL 95 100%
Source: Field work 2022

The table above shows that protein energy malnutrition can be prevented through

adequate intake of good balanced diet that has 25 respondents representing the percentage

of 28.6% and true growth monitoring has 21 Respondent to the percentage of 22.3% and

through health education has 16 respondents representing the percentage of 16.8% and

also promotion of education and literacy in the community has 10 respondents with

percentage of 10.5% and by taking your child of health facility for immunization has 15

34
respondent representing the percentage of 15.7% and through nutritional counseling 8

respondent with percentage of 6.1%.

4.3 Summary of the findings

Based on the percentage frequency on the causes of protein energy malnutrition, majority

of the respondents believe on inadequate intake of balance diet as one of the leading

causes of protein energy malnutrition with the tween 6.3% and based on effect of protein

energy malnutrition, majority of the respondents with the total percentage of 36% believe

that it’s gone damage the central nervous system and based on the possible ways of

prevention and control the majority of respondents believe that proper intake of good

balance with the percentage of 28.6%.

35
 CHAPTER FIVE

SUMMARY CONCLUSION RECOMMENDATION AND DISCUSSION

5.0 Introduction

This chapter deals with summary of the study discussion of major findings, conclusion

and recommendation based on the findings from the study.

5.1 Summary

The case study is overview on the effect of protein energy malnutrition (PEM) Among

children under five years in Gyadi-Gyadi ward Tarauni local government Kano state,

Which comprises five chapters.

Jumped on these with the background of the study, aim and objectives, research

questions, statements of the problem and significance of the study, scope/imitation of the

study and definition of terms. While chapter two deals with the conceptual framework

that is the meaning off protein energy malnutrition and children types of protein energy

malnutrition effect of protein energy malnutrition and how to prevent and control protein

energy malnutrition.

While the chapter three deals with the research methodology, the study area, research

design, research population, sample size, sampling techniques, instrumentadministration

of the research instrument and method of data collection and methods analysis. While

chapter four deals with data presentation analysis and interpretation and discussion of

major findings it’s up to five days with the summary conclusion recommendation

discussion of major findings based on the result found in the study.

36
5.2 Conclusion

From Basra chapters it has been expressed the effect of protein energy malnutrition

among children under zero to five years in third world countries most especially Nigeria

in particular. There are syndromes that is kwashiorkor and marasmus, Which costs due to

the inadequate intake of protein [calories] finally concluded that the protein energy

malnutrition problem in Gyadi-Gyadi ward.

5.3 Discussion of major finding

the research questions we are answered in this section in chapter 4 represent the database

on the research question of the study using a percentage and analysis in a tabular form.

Table 6: what are the causes of protein energy malnutrition [PEM]

Shows that 25 respondents representing 26.3% believe that inadequate intake of good

balanced diet of cause the effect of protein energy malnutrition and lots of food through

destruction by pest, fungi, rodents, birds and wild animals has ten respondents with

percentage of 10.5% on the food insecurity and limited access to food stuff has 16

respondents with the percentage of 16.7% respondents A lack of prenatal and child health

care has 12 respondents with percentage 12.5% while lack of Immunization has to

increase pendant with the percentage to end 4.2%.

The highest is lack of immunization that has nine respondents with percentage of 9.6%

Therefore all the responding believe that the above mentioned items can lead to the

sensation of protein energy malnutrition in one way or the other meanwhile all the factors

must be addressed in controlling and preventing protein energy malnutrition.

37
Table: what effect of protein energy malnutrition shows that children suffer most from

the shortage of nutrient with 20 respondents and how’s the percentage of 21.1% and it

damages to the central nervous system represents 30 respondents and with percentage of

31.5% and it's produces notable morphological changes in the brain of children has time

responding to the percentage of 10.5% I need affect the early childhood in intellectual

and Motor Abilities has 15 and respondents with the percentage of 15.7% and it affects

the weight of the body 10 respondent with the percentage of 15.1% and it can result to

death five respondents with a percentage of 6.1%.

Table 8: possible ways of the prevention and control of protein energy malnutrition

shows that through adequate intake of good balanced diet has been to have respondents

with the percentage of 28.6% on growth monitoring house 21 responding to the

percentage 22.3% and through health education has 16 respondents with the percentage

of 16.8% I’m promotion of education and literacy in the community turn respondent for

the percentage 10.5% and taking your child to health facilities for immunization has 15

respondents with the percentage of 15.7%.

The highest is true adequate intake of good balanced diet that has 20 5 respondents

representing 28.6% respectively. So, the majority believes that proper intake of good

balanced diet can be the solution and prevention of major problems in controlling the

Protein Energy malnutrition.

38
5.4 Recommendations

Based on these findings of the study I would like to make the following recommendations

so as to solve the problems of the effectual energy malnutrition in Gyadi-Gyadi ward

Tarauni local government Kano state. These are as follows:

1. There would be a special training to the health practitioners on this effect of

protein energy malnutrition.

2. Therefore government should educate the public to know the effects of protein

energy malnutrition to the public health.

A – On government organization also embark on enlightenment to the general

public on the effect of protein energy malnutrition

B - Government should educate the general public to know the effect of protein

energy malnutrition to public health.

3. Community leaders should embark on enlightenment to general public on the

effect of protein energy malnutrition

4. Qualitative and quantitative related items is being provided

5. International organization for example UNICEF, Red Cross etc also participate in

the public campaign on the protein energy malnutrition so as to minimize the

problem.

6. Finally the Commission is being established on protein energy malnutrition by

federal and state government in order to take care of the issue efficiently and

effectively.

39
5.5 Suggestions for further study

My further suggestion is nursing management of protein energy malnutrition [PEM]

Should be considered to the next researcher.

40
 REFERENCES

Alleyer G.A.O and Young, V.H (2017) Andrenal function in malnutrition

Ashenoff MT, and Loveil, H.G (2015). The highest and weight of Jumaican children of

various racial origin

Christopher O.H (2013). WHO Organization

Federal ministry of Health (FMoH) (2013). Nigerian guiding and training manual for the

development of PHC system in Nigeria

D. Nutri (2016) Dietry fiber and our nutrition in childhood. 3rd edition

Onis GAO and Young (2015). Guide to child health management

Omoludu, CB (2014). Epidemiology and disease control

Rasmussen KM (2010). Epidemiology and disease control, 1st edition

Ross and Wilson, anatomy and physiology in health illness

Sulton GM, Certain IV (2010) child health on the C 2nd edition

Sanchez R.E (2012). Nutrition and implication of the tropical pediatrics

UNICEF (2013) Comparison on antripometric, method for assessing nutrition status.

Preschool children.

Vundu Ramokolo PHC developing countries, 1st edition.

41
 APPENDIX
Aminu Dabo College of Health Science
and Technology,
School of Community Health,
Department of Community Health Science
No. 9C Civic Centre, Kano,
Kano State
17th May, 2022.

Dear Respondent,

ACADEMIC RESEARCH QUESTIONNAIRE

The researcher is a final year students of Professional Diploma in Community Health of

the above named institution conducting a research on the topic "EFFECT OF PROTEIN

ENERGY MALNUTRITION (PEM) AMONG CHILDREN UNDER 0 -5YEARS IN GYADI

GYADI WARD" your responses are basically for research purpose, you are requested to

participate in this study and the information you provide will be in strictly used.

Therefore, you are kindly requested to honestly provide the required information to the

best of your ability.

Thank you.

Yours faithfully,

Hafsat Ahmad Haruna

Researcher

42
 SECTION A: BIO DATA

1. Age
(a) < 30 years [ ] (b) 31 - 50 [ ] (c) 51 and Above [ ]
2. Gender
(a )Male [ ] (b) Female [ ]
3. Occupation: ____________________________________________
4. Marital Status
(a) Married [ ] (c) Divorce [ ]
(b) Single [ ] (d) Widower [ ]
5. Educational Qualification
(a) Primary [ ] (c) Tertiary [ ]
(b) Secondary [ ] (d) Other (Specify): _______________
SECTION B: RESEARCH QUESTION 1

1. What are the causes of protein energy malnutrition?

A) Inadequate intake of good balance diet.
YES [ ] NO [ ]
B) Loss of food through destruction by pest, fungi, rodents, births, and wild animal.
YES [ ] NO [ ]
C) Food insecurity and limited access to food stuff
YES [ ] NO [ ]
D) Lack of pre-natal and child healthcare.
YES [ ] NO [ ]
E) Lack of immunization
YES [ ] NO [ ]
F) Lack of nutritional knowledge
YES [ ] NO [ ]
SECTION C: RESEARCH QUESTION 2
2. What are the effects of protein energy malnutrition?

A) Children suffer most from the shortage of nutrients:

YES [ ] NO [ ]

B) B. It damage to the control nervous system

YES [ ] NO [ ]

43
 C) It produces notable morphological change in the brain of children.
YES [ ] NO [ ]
D) It affects the weight of the body
YES [ ] NO [ ]
E) It affect the early childhood on intellectual and motor abilities.
YES [ ] NO [ ]
F) It can result to death
YES [ ] NO [ ]

SECTION D: RESEARCH QUESTION 3

3. Possible ways for the prevention & control of protein energy mal-nutrition

A) Through adequate intake of good balance diet

YES [ ] NO [ ]
B) By growth monitoring
YES [ ] NO [ ]
C) Health Education
YES [ ] NO [ ]
D) By Promotion of Education and literacy in the community"
YES [ ] NO [ ]
E) Taking your child to health facility for immunization.
YES [ ] NO [ ]
F) Through Nutritional counseling
YES [ ] NO [ ]

Thanks for Ticking the Questionnaire

44