NUTRITIONAL RISK STRATIFICATION AMONG UNDER-FIVE CHILDREN USING THE ELIZ MODIFIED IMPACT TOOL AND ASSESSMENT OF PREDISPOSING FACTORS IN A TERTIARY CARE SETTING

Abstract

 Introduction: Malnutrition remains a critical public health challenge, contributing significantly to childhood morbidity and mortality globally and in India. Early identification and risk stratification are essential for effective intervention. The study aimed to classify malnourished children in a tertiary care hospital using the ELIZ Modified IMPACT Tool and to determine factors predisposing to malnutrition in children under 5 years of age. Methods: A prospective observational study was conducted over 18 months involving 200 children aged 1 month to 5 years. Participants included those with underweight, stunting, or wasting. The ELIZ Modified IMPACT Tool, a comprehensive scoring system covering anthropometry, clinical signs, dietary history, ecological factors, and functional status, was used to stratify children into risk categories (No, Low, Medium, High Risk). Results: Of the 200 participants, 54.5% were classified as Low Risk, 36% as Medium Risk, and 1% as High Risk. Poor mother’s education (p=0.029), Low birth weight (p=0.001), Lack of Exclusive Breastfeeding (p=0.003), Failure to introduce semi-solids at 6 months (p=0.016), Lack of continued breastfeeding for 2 years (p=0.013), and Lack of family pot feeding by 2 years (p=0.043) were significantly associated with high risk of malnutrition. Conclusion: The ELIZ Modified IMPACT Tool provides a structured framework for nutritional severity stratification in clinical settings. This highlights the need for early identification and targeted nutritional interventions in high-risk children. Interventions focusing on maternal nutrition education and exclusive breastfeeding are crucial.