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Lai WK, Palaniveloo L, Mohd Sallehuddin S, Ganapathy SS. Double burden of malnutrition and its socio-demographic determinants among children and adolescents in Malaysia: National Health And Morbidity Survey 2019. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:94. [PMID: 38915044 PMCID: PMC11197233 DOI: 10.1186/s41043-024-00583-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 06/09/2024] [Indexed: 06/26/2024]
Abstract
INTRODUCTION Malaysia faces the threat of a double burden of malnutrition where undernutrition and overweight (including obesity) coexist in the same population. This study aimed to determine the anthropometric assessment among children and adolescents aged 5 to 17 years and its association with socio-demographic factors. METHODS Data were extracted from the National Health and Morbidity Survey conducted in 2019. This cross-sectional survey applied a two-stage stratified sampling design. Socio-demographic characteristics were obtained. Weight and height were measured, age- and sex-specific standard scores for height and BMI were calculated to establish individual's anthropometric assessment. Having either stunting or thinness was considered undernutrition, while being overweight (including obesity) was considered overnutrition. If someone had undernutrition and/or overnutrition, they were classified as having malnutrition. The prevalence was determined using complex sampling analysis, while the association was assessed through logistic regression. The analysis included a total of 3,185 respondents. RESULTS The prevalence of stunting, thinness, overweight and obesity among the respondents aged 5 to 17 years was 12.7%, 10.0%, 15.0% and 14.8%, respectively. The overall prevalence of malnutrition was 48.3%. Respondents residing in rural had 1.35 times more likelihood of experiencing undernutrition [AOR = 1.35, 95% CI (1.04, 1.77)] compared to their urban counterparts. Boys exhibited a greater likelihood of being overweight and obese than girls [AOR = 1.40, 95% CI (1.13, 1.73)]. Respondents aged 10 to 14 years were 1.37 times more likely to be overnutrition than those aged 5 to 9 years old [AOR = 1.37, 95% CI (1.09, 1.73)]. CONCLUSION There is growing evidence of the increasing prevalence of coexistence of undernutrition along with overweight and obesity among children and adolescents in Malaysia. Moving forward, greater initiatives and efforts are required to formulate strategies for planning and implementing programs and policies to expedite progress in improving nutrition.
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Affiliation(s)
- Wai Kent Lai
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia.
- Raub Health District Office, Pahang State Health Deparment, Ministry of Health, Raub, Malaysia.
| | - Lalitha Palaniveloo
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
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Mahmud MH, Baharudin UM, Md Isa Z. Diseases among Orang Asli community in Malaysia: a systematic review. BMC Public Health 2022; 22:2090. [DOI: 10.1186/s12889-022-14449-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 10/25/2022] [Indexed: 11/18/2022] Open
Abstract
AbstractOrang Asli, the indigenous people of Peninsular Malaysia, is a minority population and placed behind in terms of socioeconomy, education and health. The Malaysian government has supported Orang Asli since the second Malaysia Plan in the 1970s, resulting in changes in their living standard, access to health, education and occupation. Hence, this review aims to assess the recent prevalence of diseases among Orang Asli in Peninsular Malaysia. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) review protocol guided this systematic review. The research question was formulated based on Population, Interest, Comparison and Outcome (PICO). The selected databases include Web of Science, Scopus, Ovid and EBSCOhost. The process of identification, screening and inclusion identified 33 articles. The mixed methods appraisal tool (MMAT) was then used to rank the quality of the articles. Selangor is the most frequent state involved in this review (12 studies), followed by Perak (10 studies), Pahang (10 studies) and Kedah (one study). We categorised into four categories of diseases, namely neglected tropical disease (n = 20), non-communicable disease (n = 6), nutritional status (n = 5), and hepatic disease (n = 2). The prevalence of diseases among Orang Asli is higher than in the general population, especially for soil-transmitted helminth (STH) and malnutrition. There is increasing research on non-communicable diseases due to an increasing trend in the socioeconomic status and lifestyle of the Orang Asli. Government agencies and private organisations must work together to empower Orang Asli with a healthy lifestyle, improve their socioeconomic status, and enhance food security, all of which will improve Orang Asli's health and reduce the prevalence of diseases.
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Pandurangi R, Mummadi MK, Challa S, Reddy NS, Kaliaperumal V, Khadar Babu C, Telikicherla UR, Pullakandham R, Geddam JJB, Hemalatha R. Burden and Predictors of Malnutrition Among Indian Adolescents (10-19 Years): Insights From Comprehensive National Nutrition Survey Data. Front Public Health 2022; 10:877073. [PMID: 35784251 PMCID: PMC9240318 DOI: 10.3389/fpubh.2022.877073] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/13/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Malnutrition among adolescents is a persistent problem with a profound impact on different dimensions of health. The objective of this analysis is to assess the burden of malnutrition (Stunting, Thinness, Overweight, and Obesity) and their associated socio-demographic factors among Indian adolescents (10-19 years) from the Comprehensive National Nutritional Survey (CNNS 2016-18) data. Methods We used Individual-level data of 35,831 adolescents from the CNNS conducted in 2016-18 for this analysis. CNNS collected data on the nutritional status of adolescents along with socio-demographic variables from all states of India. Burden of stunting (Height for age Z score, HAZ < -2 SD), thinness (BMI for age Z score, BAZ < -2 SD), overweight (BAZ > 1 SD) and obesity (BAZ > 2 SD) were estimated for the entire country and individual states. A multivariable logistic regression analysis was used to assess the socio-demographic factors associated with stunting, thinness, and overweight. Results CNNS collected data from 35,831 adolescents, of which 31,941 with BAZ scores, and 32,045 with HAZ scores were included in the final analysis. The burden of stunting and thinness among Indian adolescents was 27.4% (95% CI 26.4, 28.4%) and 24.4% (23.5, 25.4%), respectively. The burden of overweight and obesity was 4.8% (4.5, 5.1%) and 1.1% (0.9, 1.3%), respectively. Adolescents in the age group of 15-19 years (AOR 1.23, 95% CI 1.11, 1.36) compared to 10-14 years, females (AOR 1.20; 1.08, 1.33) compared to males, were at increased odds of getting stunted. Adolescents from lowest wealth index families (AOR 1.66; 1.33, 2.07) were at increased odds of thinness compared to peers of higher wealth index families. Adolescents of 10-14 years (AOR 1.26, 95% CI 1.06, 1.49) compared to 15-19 years, urban residents (AOR 1.43, 95% CI 1.19, 1.71) compared to rural residents, were at increased odds of overweight. Conclusion Indian adolescents face the double burden of malnutrition that is undernutrition (stunting and thinness) alongside overnutrition (overweight and obesity) that are linked with socio-demographic factors. The National Nutritional Programs (POSHAN Abhiyan) should prioritize high-risk groups specifically older age group (15-19 years), females, and low wealth Index quintile families identified in this analysis.
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Affiliation(s)
- Raghavendra Pandurangi
- Division of Public Health Nutrition, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - Mahesh Kumar Mummadi
- Division of Clinical Epidemiology, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - Sairam Challa
- Division of Public Health Nutrition, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - N. Samarasimha Reddy
- Division of Clinical Epidemiology, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - Venkatesh Kaliaperumal
- Division of Pathology and Microbiology, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - Chinta Khadar Babu
- Division of Clinical Epidemiology, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - Usha Rani Telikicherla
- Division of Public Health Nutrition, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - Raghu Pullakandham
- Division of Drug Toxicology, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - J. J. Babu Geddam
- Division of Clinical Epidemiology, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - Rajkumar Hemalatha
- Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
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Mavinkurve M, Azriyanti AZ, Jalaludin MY. The short child: Importance of early detection and timely referrai. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2021; 16:6-15. [PMID: 34938388 PMCID: PMC8680933 DOI: 10.51866/rv1157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Stunting is a common phenomenon in Malaysian children. Optimising outcomes for children with growth disorders rests on early recognition and prompt referral. In this context, a framework for the clinical approach can help to guide appropriate growth assessment and referral. This review article aims to provide family medicine specialists with such a framework whilst raising awareness about the shortcomings of the existing growth monitoring system in Malaysia. It also invites readers to consider additional measures that could further optimise this system.
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Affiliation(s)
- Meenal Mavinkurve
- Department of Paediatrics, International Medical University, Seremban, Negeri Sembilan
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia,
| | - Anuar Zaini Azriyanti
- Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Muhammad Yazid Jalaludin
- Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia
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Berrueta M, Ciapponi A, Bardach A, Cairoli FR, Castellano FJ, Xiong X, Stergachis A, Zaraa S, Meulen AST, Buekens P. Maternal and neonatal data collection systems in low- and middle-income countries for maternal vaccines active safety surveillance systems: A scoping review. BMC Pregnancy Childbirth 2021; 21:217. [PMID: 33731029 PMCID: PMC7968860 DOI: 10.1186/s12884-021-03686-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/01/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Most post-licensure vaccine pharmacovigilance in low- and middle-income countries (LMICs) are passive reporting systems. These have limited utility for maternal immunization pharmacovigilance in LMIC settings and need to be supplemented with active surveillance. Our study's main objective was to identify existing perinatal data collection systems in LMICs that collect individual information on maternal and neonatal health outcomes and could be developed to inform active safety surveillance of novel vaccines for use during pregnancy. METHODS A scoping review was performed following the Arksey and O'Malley six-stage approach. We included studies describing electronic or mixed paper-electronic data collection systems in LMICs, including research networks, electronic medical records, and custom software platforms for health information systems. Medline PubMed, EMBASE, Global Health, Cochrane Library, LILACS, Bibliography of Asian Studies (BAS), and CINAHL were searched through August 2019. We also searched grey literature including through Google and websites of existing relevant perinatal data collection systems, as well as contacted authors of key studies and experts in the field to validate the information and identify additional sources of relevant unpublished information. RESULTS A total of 11,817 records were identified. The full texts of 264 records describing 96 data collection systems were assessed for eligibility. Eight perinatal data collection systems met our inclusion criteria: Global Network's Maternal Newborn Health Registry, International Network for the Demographic Evaluation of Populations and their Health; Perinatal Informatic System; Pregnancy Exposure Registry & Birth Defects Surveillance; SmartCare; Open Medical Record System; Open Smart Register Platform and District Health Information Software 2. These selected systems were qualitatively characterized according to seven different domains: governance; system design; system management; data management; data sources, outcomes and data quality. CONCLUSION This review provides a list of active maternal and neonatal data collection systems in LMICs and their characteristics as well as their outreach, strengths, and limitations. Findings could potentially help further understand where to obtain population-based high-quality information on outcomes to inform the conduct of maternal immunization active vaccine safety surveillance activities and research in LMICs.
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Affiliation(s)
- Mabel Berrueta
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina.
| | - Agustin Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Ariel Bardach
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Federico Rodriguez Cairoli
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Fabricio J Castellano
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Xu Xiong
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, 70112, USA
| | | | - Sabra Zaraa
- University of Washington, Seattle, WA, 98195-7631, USA
| | | | - Pierre Buekens
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, 70112, USA
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Al-Taiar A, Alqaoud N, Sharaf Alddin R, Alanezi F, Subhakaran M, Dumadag A, Albatineh AN. Stunting and Combined Overweight with Stunting among Schoolchildren in Kuwait: Trends over a 13-Year Period. Med Princ Pract 2021; 30:515-521. [PMID: 34348312 PMCID: PMC8739943 DOI: 10.1159/000518533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 07/15/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the sex- and age-specific trends of stunting and combined overweight with stunting among schoolchildren over a 13-year period in Kuwait. SUBJECTS AND METHODS The Kuwait Nutrition Surveillance System objectively measured the height of 172,573 schoolchildren (5-19 years) over a 13-year period (2007-2019). Data on gender and date of birth were extracted from school records. Stunting was defined as height 2 standard deviations (SD) below the World Health Organization growth reference median. Logistic regression models were used to examine the trends of stunting over the study period while stratifying by gender. RESULTS In males, the prevalence of stunting increased from 2.46% in 2007 to 4.18% in 2019 (p for trend <0.001). In females, the prevalence of stunting fluctuated but remained around 3.80% in both 2007 and 2019. The odds of stunting significantly increased in the period 2017-2019 compared to the period 2007-2010 among males, adjusted odds ratio (AOR) 1.04 (95% confidence interval [CI]: 1.14-1.76); p = 0.009, but not females, AOR 0.89 (95% CI: 0.73-1.07); p = 0.176. Although not statistically significant, there was a tendency for the odds of combined overweight with stunting to increase in males, AOR 1.65 (95% CI: 0.90-3.04); p = 0.087, but not females, AOR 1.13 (95% CI: 0.88-1.45); p = 0.248. CONCLUSION Although the prevalence of stunting and combined stunting with overweight is low, there is an emerging upward trend in schoolboys that warrants further investigation and monitoring. This highlights the need for gender-specific interventions to reduce nutritional abnormalities in high-income countries in the Middle East countries like Kuwait.
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Affiliation(s)
- Abdullah Al-Taiar
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
- *Abdullah Al-Taiar,
| | - Nawal Alqaoud
- Food and Nutrition Administration, Ministry of Health, Kuwait City, Kuwait
| | - Reem Sharaf Alddin
- HealthCare Analytics and Delivery Science Institute, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Faheema Alanezi
- Food and Nutrition Administration, Ministry of Health, Kuwait City, Kuwait
| | - Monica Subhakaran
- Food and Nutrition Administration, Ministry of Health, Kuwait City, Kuwait
| | - Anne Dumadag
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Ahmed N. Albatineh
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
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Bhargava M, Bhargava A, Ghate SD, Rao RSP. Nutritional status of Indian adolescents (15-19 years) from National Family Health Surveys 3 and 4: Revised estimates using WHO 2007 Growth reference. PLoS One 2020; 15:e0234570. [PMID: 32569312 PMCID: PMC7307767 DOI: 10.1371/journal.pone.0234570] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/27/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The National Family Health Surveys (NFHS) in India apply adult cutoffs of nutritional status for the estimation of undernutrition/overweight in the 15-19 age group. The prevalence of thinness in boys and girls thus estimated is 58.1% and 46.8% in NFHS-3, and 45% and 42% in NFHS-4 respectively. But the WHO recommends using age and sex-specific reference for adolescents. We reanalyzed the nutritional status of the adolescents using the WHO 2007 Growth Reference to obtain revised estimates of thinness, overweight and stunting across states, rural-urban residence, and wealth quintiles. METHODS AND FINDINGS Demographic information, anthropometric data, and wealth index were accessed from the Demographic and Health Survey (DHS) database. We re-analyzed the anthropometric data using WHO AnthroPlus software which uses the WHO 2007 Growth reference. The revised estimates of thinness assessed by BMI-for-age z-scores in boys and girls was 22.3% (95%CI: 21.6, 23.0) and 9.9% (95%CI: 9.5, 10.3) in NFHS-3 and 16.5% (95%CI: 16.0,17.0) and 9% (95%CI: 8.9, 9.2) in NFHS-4 respectively. Stunting was found to be 32.2% (95% CI: 31.6, 32.9) in boys and 34.4% (95% CI: 34.2, 34.7) in girls in NFHS-4. This was higher than that in NFHS-3; 25.2% (95% CI: 24.4, 26) in boys and 31.2 (95% CI: 30.6, 31.8) in girls. There was a clear socioeconomic gradient as there were higher thinness and stunting in rural areas. There was wide variation among the states with pockets of a double burden of malnutrition. CONCLUSION Using the adult cutoffs significantly overestimates thinness in adolescents in the age group of 15-19 years old in India. Stunting, which is an indicator of long term nutrition is also widely prevalent in them. Future editions of DHS and NFHS should consider adolescents as a separate age group for nutritional assessment for a better understanding of nutritional transition in the population.
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Affiliation(s)
- Madhavi Bhargava
- Department of Community Medicine, Yenepoya Medical College, Mangalore, Karnataka, India
- Center for Nutrition Studies, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
- * E-mail:
| | - Anurag Bhargava
- Center for Nutrition Studies, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
- Department of General Medicine, Yenepoya Medical College, Mangalore, Karnataka, India
| | - Sudeep D. Ghate
- Yenepoya Research Centre, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - R. Shyama Prasad Rao
- Yenepoya Research Centre, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
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