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Haq IU, Mehmood Z, Tahir M, Ahmad Zakki S, Siddiq K, Xu J, Wang S. Risk Factors of Wasting-Based Malnutrition in the Flood-Affected Areas of Pakistan: A Cross-Sectional Study. Ecol Food Nutr 2024; 63:343-354. [PMID: 38833628 DOI: 10.1080/03670244.2024.2361250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
The current study aimed to find the risk factors of wasting in flood-affected areas of Khyber Pakhtunkhwa, Pakistan. Sociodemographic and anthropometric data was collected. Children living in large family are 2.59 times more likely to be wasted (AOR = 2.59, 95% confidence interval (CI): 1.10, 6.10; p value = .029) and children living in medium size family are 2.23 times more likely to be wasted (AOR = 2.23, 95% CI: 1.03, 4.80; p value = .04) as compared to children in small family size. The study underscores the need for targeted interventions to address the identified risk factors and mitigate the impact of flooding on child nutrition.
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Affiliation(s)
- Ijaz Ul Haq
- Department of Nursing, Children's Hospital of Fudan University, Shanghai, China
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Pakistan
| | - Zafar Mehmood
- Department of Math's, Stats & Computer Science, The University of Agriculture Peshawar, Peshawar, Pakistan
| | - Majid Tahir
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Pakistan
| | - Shahbaz Ahmad Zakki
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Pakistan
| | - Kalsoom Siddiq
- Department of Human Nutrition & Dietetics, Women University Mardan, Mardan, Pakistan
| | - Jielian Xu
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Shengru Wang
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
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Ye X, Lin H. Global Research on Natural Disasters and Human Health: a Mapping Study Using Natural Language Processing Techniques. Curr Environ Health Rep 2024; 11:61-70. [PMID: 37957476 DOI: 10.1007/s40572-023-00418-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE OF REVIEW This review aimed to systematically synthesize the global evidence base for natural disasters and human health using natural language processing (NLP) techniques. RECENT FINDINGS We searched Embase, PubMed, Scopus, PsycInfo, and Web of Science Core Collection, using titles, abstracts, and keywords, and included only literature indexed in English. NLP techniques, including text classification, topic modeling, and geoparsing methods, were used to systematically identify and map scientific literature on natural disasters and human health published between January 1, 2012, and April 3, 2022. We predicted 6105 studies in the area of natural disasters and human health. Earthquakes, hurricanes, and tsunamis were the most frequent nature disasters; posttraumatic stress disorder (PTSD) and depression were the most frequently studied health outcomes; mental health services were the most common way of coping. Geographically, the evidence base was dominated by studies from high-income countries. Co-occurrence of natural disasters and psychological distress was common. Psychological distress was one of the top three most frequent topics in all continents except Africa, where infectious diseases was the most prevalent topic. Our findings demonstrated the importance and feasibility of using NLP to comprehensively map natural disasters and human health in the growing literature. The review identifies clear topics for future clinical and public health research and can provide an empirical basis for reducing the negative health effects of natural disasters.
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Affiliation(s)
- Xin Ye
- Institute for Global Public Policy; LSE-Fudan Research Centre for Global Public Policy, Fudan University, 220 Handan Road, Yangpu District, Shanghai, 200433, China.
| | - Hugo Lin
- CentraleSupélec, Paris-Saclay University, 91192, Paris, France
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Rahman M, Sarkar P, Islam MJ, Adam IF, Duc NHC, Al-Sobaihi S. Factors mediating the association between recurring floods and child chronic undernutrition in northern Bangladesh. Nutrition 2024; 119:112300. [PMID: 38141569 DOI: 10.1016/j.nut.2023.112300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/27/2023] [Accepted: 11/05/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVES Although there is some evidence that flood exposure in Bangladesh and other developing countries increases the risk of chronic undernutrition in children, the underlying mechanisms are, to our knowledge, unknown. The objectives of this research are to examine the association between recurrent flood exposure and the likelihood of chronic undernutrition in children and to investigate the mediators of this association. METHODS This cross-sectional study was conducted in the Naogaon District in northern Bangladesh. Purposive sampling was used to choose 800 children between the ages of 12 and 59 mo in equal numbers in the specified flood-affected and flood-unaffected areas: 400 children from the flood-affected area and 400 from the flood-unaffected area. The nutrition indicator height for age, expressed as z scores, was used to define child chronic undernutrition. Our study focused on children who have been exposed to multiple floods in the past 5 y. RESULTS In our sample data, children who had experienced flooding had a 1.74-times higher chance of having chronic undernutrition (95% CI, 1.53-2.28) than children who had not experienced flooding. The mediation analyses found inadequate minimum dietary diversity, history of diarrhea, not being fully vaccinated, not using clean cooking fuel, and not having a separate kitchen contributed 19.5%, 10%, 9.8%, 14.8%, and 10%, respectively, to the flood exposure-child undernutrition association. CONCLUSIONS Flood exposure was found associated with the likelihood of child chronic undernutrition, and this relationship was mediated through lack of having a separate kitchen, history of diarrhea, insufficient vaccination, use of unclean cooking fuel, and poor minimum dietary diversity. Interventions to reduce the prevalence of these risk factors could contribute to reducing the disparities in child undernourishment brought on by exposure to flooding.
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Affiliation(s)
- Mosiur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh.
| | - Prosannajid Sarkar
- Dr. Wazed Research and Training Institute, Begum Rokeya University, Rangpur, Bangladesh
| | - Md Jahirul Islam
- Griffith Criminology Institute, Griffith University, Mount Gravatt, Australia
| | - Izzeldin Fadl Adam
- Faculty of Public and Environmental Health, University of Khartoum, Khartoum, Sudan
| | | | - Saber Al-Sobaihi
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo, Japan
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Ginting S, Kitreerawutiwong N, Mekrungrongwong S. Factors Correlated with Child Undernutrition in Rural Communities Affected by Sinabung Eruptions in Indonesia. Ecol Food Nutr 2023; 62:269-285. [PMID: 37725056 DOI: 10.1080/03670244.2023.2258794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
This study examined factors correlated with child undernutrition in rural communities affected by the Sinabung Eruptions in Indonesia. A cross-sectional survey of children (n = 444) was conducted. The results showed that the prevalence of being underweight, stunting, and wasting was 23.4%, 37.6%, and 11.3%, respectively. Multivariate analysis revealed that immunization status, child health, the number of children under five years old, household size, monthly income, and drinking water sources were statistically associated with child undernutrition. The study suggests that there should be intervention from Ministry of Health to increase the complete immunization as well as biannual vitamin A dose for the children.
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Affiliation(s)
- Sadar Ginting
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
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Hadley K, Wheat S, Rogers HH, Balakumar A, Gonzales-Pacheco D, Davis SS, Linstadt H, Cushing T, Ziska LH, Piper C, Sorensen C. Mechanisms underlying food insecurity in the aftermath of climate-related shocks: a systematic review. Lancet Planet Health 2023; 7:e242-e250. [PMID: 36774944 DOI: 10.1016/s2542-5196(23)00003-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 06/18/2023]
Abstract
Food insecurity is prevalent, affecting 1·2 billion people globally in 2021. However, the effects of food insecurity are unequally distributed across populations and climate-related shocks threaten to exacerbate food insecurity and associated health consequences. The mechanisms underlying this exacerbation at the household level are largely unknown. We aimed to synthesise the available evidence on the mechanisms connecting extreme climate events to household-level food insecurity and highlight the research gaps that must be addressed to inform better food security and health policy. For this systematic review, a comprehensive literature search was done by a medical librarian in February, 2021 for articles about food security and climate-related shocks. Relevant publications were identified by searching the following databases with a combination of standardised index terms and keywords: MEDLINE, Embase, CINAHL, GreenFILE, Environment Complete, Web of Science Core Collection, and Global Health. Searches were limited to human studies published in English. Included studies measured food security outcomes using indicators developed by the UN Food and Agricultural Organization (ie, consumption patterns, livelihood change, malnutrition, and mortality) and explained the mechanism behind the household-level or population-level food insecurity. Purely theoretical, modelling, and review studies were excluded. Quality assessment was conducted using the appropriate Joanna Briggs Institute Critical Appraisal Tool. Data were analysed using thematic analysis of the categories of mechanism (interpreted using internationally accepted frameworks), risk and resilience factors, and author policy recommendations. We found a paucity of data with only 18 studies meeting criteria for inclusion out of 337 studies identified for full-text review. All the studies that were included in our analysis showed worse food security outcomes after climate-related shocks. Food availability was the most common mechanism cited (17 studies), although most studies addressed at least one additional mechanism (15 studies). Studies were of mixed methodologies with nuanced discussions of risk and resilience factors, and of policy recommendations. This systematic review shows that there is an incomplete assessment of food security at the household and community level after climate-related shocks in the literature and finds that food availability is the primary mechanism studied. The low number of studies on this topic limits subgroup analysis and generalisability; however, the good quality of the studies allows for important policy recommendations around improving resilience to climate shocks and suggestions for future research including the need for a more granular understanding of mechanisms and feasible adaptation solutions.
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Affiliation(s)
- Kristie Hadley
- Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Stefan Wheat
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Heidi Honegger Rogers
- College of Nursing and Office of Community Health, University of New Mexico, Albuquerque, NM, USA
| | - Arjun Balakumar
- Emergency Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Diana Gonzales-Pacheco
- College of Nursing and Office of Community Health, University of New Mexico, Albuquerque, NM, USA
| | - Sarah Shrum Davis
- College of Nursing and Office of Community Health, University of New Mexico, Albuquerque, NM, USA
| | | | - Tracy Cushing
- Strauss Health Sciences Library, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Lewis H Ziska
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Christi Piper
- Strauss Health Sciences Library, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Cecilia Sorensen
- Mailman School of Public Health, Columbia University, New York, NY, USA
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Starkweather KE, Keith MH, Zohora FT, Alam N. Economic impacts and nutritional outcomes of the 2017 floods in Bangladeshi Shodagor fishing families. Am J Hum Biol 2023; 35:e23826. [PMID: 36331095 DOI: 10.1002/ajhb.23826] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES As climate change continues to increase the frequency and severity of flooding in Bangladesh and globally, it becomes increasingly critical to understand the pathways through which flooding influences health outcomes, particularly in lower-income and subsistence-based communities. We aim to assess economic pathways that link flooding to nutritional outcomes among Shodagor fishing families in Bangladesh. METHODS We examine longitudinal economic data on kilograms of fish caught, the income earned from those fish, and household food expenditures (as a proxy for dietary intake) from before, during, and after severe flooding in August-September of 2017 to enumerate the impacts of flooding on Shodagor economics and nutrition. We also analyze seasonally collected anthropometric data to model the effects of flooding and household food expenditures on child growth rates and changes to adult body size. RESULTS While Shodagor fishing income declined during the 2017 flooding, food expenditures simultaneously spiked with market inflation, and rice became the predominant expenditure only during and immediately following the flood. Our nutritional models show that children and adults lost more body mass in households that spent more money on rice during the flood. Shodagor children lost an average of 0.36 BMI-for-age z-scores and adults lost an average of 0.32 BMI units during the flooded 2017 rainy season, and these metrics continued to decline across subsequent seasons and did not recover by the end of the study period in 2019. CONCLUSIONS These results show major flood-induced economic impacts that contributed to loss of child and adult body mass among Shodagor fishing families in Bangladesh. More frequent and severe flooding will exacerbate these nutritional insults, and more work is needed to effectively stabilize household nutrition throughout natural disasters and economic hardship.
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Affiliation(s)
- Kathrine E Starkweather
- Department of Anthropology, University of Illinois Chicago, Chicago, Illinois.,Department of Human Behavior, Ecology, and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Monica H Keith
- Department of Anthropology, Vanderbilt University, Nashville, Tennessee, USA
| | - Fatema Tuz Zohora
- Health Systems and Population Studies Division, ICDDR, B, Dhaka, Bangladesh
| | - Nurul Alam
- Health Systems and Population Studies Division, ICDDR, B, Dhaka, Bangladesh
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How does flooding affect the nutritional status of children in floodplain regions? A cross-sectional study from Assam, India. PROCEEDINGS OF THE INDIAN NATIONAL SCIENCE ACADEMY 2022. [DOI: 10.1007/s43538-022-00128-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Impact of floods on undernutrition among children under five years of age in low- and middle-income countries: a systematic review. Environ Health 2022; 21:98. [PMID: 36274126 PMCID: PMC9590165 DOI: 10.1186/s12940-022-00910-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 10/13/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Weather and climate-related disasters, including floods, impact undernutrition through multiple pathways, including food security, inadequate child care practices, and water and sanitation. This review aimed to provide systematic evidence of the impact of floods on undernutrition in children under five years of age in Low and Middle-income countries (LMICs). METHODS We searched PubMed, Web of Science, Embase, MEDLINE, CINAHL and Scopus for peer-reviewed articles. Popline, WHO Library database (WHOLIS), the International Disaster database (EM-DAT), Food and Agriculture Organisation (FAO), UNICEF and Eldis were searched for grey literature articles. Database searches were first conducted in 2016 and updated in 2020. We included English language articles that reported the effect of floods on undernutrition outcomes in children under 5 years of age in LMICs, without limitation to study design and year of publication. The quality of selected studies was assessed using the National Institutes of Health (NIH) tool for Observational Cohort and Cross-Sectional Studies. RESULTS Of the 5701 articles identified, 14 met our inclusion criteria. The review noted stunting as the most frequently reported significant form of undernutrition in flood-affected areas. Severe and recurrent floods showed the greatest impact on undernutrition. Due to weak and limited evidence, the study is inconclusive on the most significant forms within the short-term and intermediate periods following floods. On the other hand, stunting was noted as the most frequently reported significant form of undernutrition in the long-term period following floods. There was generally little evidence of the effect of floods on micronutrient deficiencies. Factors associated with child undernutrition in the flood-affected areas included age, gender, diarrhoea, maternal and paternal education, maternal age, household size, land ownership and socioeconomic status. Overall, the quality of the evidence was fairly weak, with the main challenge lying in the inability of the studies to establish causal pathways for the observed effects. CONCLUSIONS The review suggests clear plans and strategies for preventing and reducing the long-term impact of floods on undernutrition in children under five years. Future research utilising long-term prospective data is indispensable to provide more robust evidence to guide better prevention measures, response decisions and interventions.
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Randell H, Gray C, Shayo EH. Climatic conditions and household food security: Evidence from Tanzania. FOOD POLICY 2022; 112:102362. [PMID: 37064798 PMCID: PMC10099342 DOI: 10.1016/j.foodpol.2022.102362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Food security and adequate nutrition are critical for achieving progress toward sustainable development. Two billion people worldwide experience moderate to severe food insecurity, and rates of hunger have increased over the past several years after declining steadily for decades. The FAO attributes this increase in large part to climate change, though empirical evidence on the relationship between climatic conditions and food security remains limited. We examine this question by linking nationally representative longitudinal data from four rounds of the Tanzania National Panel Survey to high-resolution gridded climate data. We then estimate a set of fixed effects regression models to understand the linkages between recent rainy season precipitation and temperature and two indicators of household food security: Food Consumption Score (FCS) and reduced Coping Strategies Index (rCSI). We find that low rainfall-particularly dry and cool conditions-is negatively associated with food security. Moving from a typical rainfall year to a particularly dry one increases the risk of being food insecure on both measures simultaneously by 13-percentage points. This suggests that a lack of rainfall impedes households' ability to access food, likely through reduced agricultural production and increased food prices, leading to lower dietary diversity and food shortages. Vulnerability is higher among households with fewer working age members, suggesting that households with a greater supply of labor can better withstand droughts. As climate change alters precipitation and temperature patterns over the coming decades, policies to increase resilience will be critical for improving food security, particularly among populations heavily reliant on agriculture.
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Affiliation(s)
- Heather Randell
- Department of Agricultural Economics, Sociology, and Education, 110-A Armsby Building, Penn State, University Park, PA, USA 16802
| | - Clark Gray
- Department of Geography, University of North Carolina, Chapel Hill
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Fernandes Q, Augusto O, Chicumbe S, Anselmi L, Wagenaar BH, Marlene R, Agostinho S, Gimbel S, Pfeiffer J, Inguane C, Uetela DM, Crocker J, Ramiro I, Matsinhe B, Tembe S, Carimo N, Gloyd S, Manhiça I, Tavede E, Felimone P, Sherr K. Maternal and Child Health Care Service Disruptions and Recovery in Mozambique After Cyclone Idai: An Uncontrolled Interrupted Time Series Analysis. GLOBAL HEALTH, SCIENCE AND PRACTICE 2022; 10:e2100796. [PMID: 36109066 PMCID: PMC9476482 DOI: 10.9745/ghsp-d-21-00796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 06/09/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Climate change-related extreme weather events have increased in frequency and intensity, threatening people's health, particularly in places with weak health systems. In March 2019, Cyclone Idai devastated Mozambique's central region, causing infrastructure destruction, population displacement, and death. We assessed the impact of Idai on maternal and child health services and recovery in the Sofala and Manica provinces. METHODS Using monthly district-level routine data from November 2016 to March 2020, we performed an uncontrolled interrupted time series analysis to assess changes in 10 maternal and child health indicators in all 25 districts before and after Idai. We applied a Bayesian hierarchical negative binomial model with district-level random intercepts and slopes to estimate Idai-related service disruptions and recovery. RESULTS Of the 4.44 million people in Sofala and Manica, 1.83 (41.2%) million were affected. Buzi, Nhamatanda, and Dondo (all in Sofala province) had the highest proportion of people affected. After Idai, all 10 indicators showed an abrupt substantial decrease. First antenatal care visits per 100,000 women of reproductive age decreased by 23% (95% confidence interval [CI]=0.62, 0.96) in March and 11% (95% CI=0.75, 1.07) in April. BCG vaccinations per 1,000 children under age 5 years declined by 21% (95% CI=0.69, 0.90) and measles vaccinations decreased by 25% (95% CI=0.64, 0.87) in March and remained similar in April. Within 3 months post-cyclone, almost all districts recovered to pre-Idai levels, including Buzi, which showed a 22% and 13% relative increase in the number of first antenatal care visits and BCG, respectively. CONCLUSION We found substantial health service disruptions immediately after Idai, with greater impact in the most affected districts. The findings suggest impressive recovery post-Idai, emphasizing the need to build resilient health systems to ensure quality health care during and after natural disasters.
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Affiliation(s)
- Quinhas Fernandes
- National Directorate of Public Health, Ministry of Health, Mozambique.
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Orvalho Augusto
- Department of Global Health, University of Washington, Seattle, WA, USA
- Eduardo Mondlane University, Maputo, Mozambique
| | | | - Laura Anselmi
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, United Kingdom
| | - Bradley H Wagenaar
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Rosa Marlene
- Mozambique Permanent Mission, Geneva, Switzerland
| | - Sãozinha Agostinho
- National Directorate of Planning and Cooperation, Ministry of Health, Mozambique
| | - Sarah Gimbel
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA, USA
| | - James Pfeiffer
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Anthropology, University of Washington, Seattle, WA, USA
| | - Celso Inguane
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Dorlim Moiana Uetela
- Department of Global Health, University of Washington, Seattle, WA, USA
- Instituto Nacional de Saúde, Ministry of Health, Mozambique
| | - Jonny Crocker
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Isaías Ramiro
- Comité para a Saúde de Moçambique, Maputo, Mozambique
| | - Benigna Matsinhe
- National Directorate of Public Health, Ministry of Health, Mozambique
| | - Stélio Tembe
- National Directorate of Public Health, Ministry of Health, Mozambique
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Naziat Carimo
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Stephen Gloyd
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Ivan Manhiça
- National Directorate of Public Health, Ministry of Health, Mozambique
| | | | | | - Kenneth Sherr
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Industrial & Systems Engineering, University of Washington
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Hossain MB, Khan JR, Parvez M. Residential district multi-hazard risk is associated with childhood undernutrition: evidence from Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:2005-2016. [PMID: 34075819 DOI: 10.1080/09603123.2021.1932766] [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: 12/23/2020] [Accepted: 05/18/2021] [Indexed: 06/12/2023]
Abstract
Child undernutrition and natural disasters are major public health concerns in Bangladesh, but research into their relationship is lacking. This study assessed the association between residential district multi-hazard-risk and undernutrition among children aged less than 5 years (under-5) in Bangladesh. Data for 22,055 under-5 children were extracted from the 2019 Multiple Indicator Cluster Survey of Bangladesh. Multi-hazard risk was categorized as low (score<10), moderate (score 10-20), and high (score>20) using a combined score of four major hazards: tornado, cyclone, earthquake, and flood. We found that children from high multi-hazard risk districts were 19% more likely to be stunted and 23% more likely to be underweight compared to low-risk districts. However, wasting was not associated with multi-hazard risk. Strategies such as agricultural adaptation and coping mechanisms, long-term post-disaster nutritional response, extended periods of relief supports, and enhanced quality maternal and child care services may help to reduce undernutrition burdens in Bangladesh.
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Affiliation(s)
- Md Belal Hossain
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Jahidur Rahman Khan
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Mahmood Parvez
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
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Challenges and Barriers of Humanitarian Hygiene Items Management in Recent Disasters in Iran. Disaster Med Public Health Prep 2022; 17:e150. [PMID: 35545811 DOI: 10.1017/dmp.2022.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The provision and continuation of the basic needs of affected communities, including water, food, and shelter remain the most important priorities in responding to disasters. In this regard, this study sought to investigate the management challenges of humanitarian hygiene items in recent disasters in Iran. METHODS This qualitative study was conducted through a semi-structured interview. Nineteen participants with different experiences, roles, and responsibilities in the recent disaster of Iran and experiences of various events in the national and international arenas were included in the study. A thematic analysis was used, and an initial conceptual framework was defined based on the study aim. The relationship between the components was compared and interpreted in this framework and the main and subthemes were extracted accordingly. RESULTS Six main themes and 21 subthemes were extracted based on the results. The main challenges in recent disasters were the lack of protocols and standard guidelines, inappropriate selection of items in each hygiene kit, the lack of standard distribution of hygiene kits, and the lack of attention to the affected population's culture. CONCLUSIONS Overall, it is necessary to define a system for preparation, supply, storage, and timely distribution of hygiene. Finally, it is suggested that an organization should be appointed for this purpose.
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Chan EYY, Guha-Sapir D, Dubois C, Shaw R, Wong CS. Challenges of Data Availability and Use in Conducting Health-EDRM Research in a Post-COVID-19 World. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073917. [PMID: 35409599 PMCID: PMC8997713 DOI: 10.3390/ijerph19073917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/07/2022] [Accepted: 03/22/2022] [Indexed: 12/10/2022]
Abstract
Disasters disrupt communication channels, infrastructure, and overburden health systems. This creates unique challenges to the functionality of surveillance tools, data collection systems, and information sharing platforms. The WHO Health Emergency and Disaster Risk Management (Health-EDRM) framework highlights the need for appropriate data collection, data interpretation, and data use from individual, community, and global levels. The COVID-19 crisis has evolved the way hazards and risks are viewed. No longer as a linear event but as a protracted hazard, with cascading and compound risks that affect communities facing complex risks such as climate-related disasters or urban growth. The large-scale disruptions of COVID-19 show that disaster data must evolve beyond mortality and frequency of events, in order to encompass the impact on the livelihood of communities, differentiated between population groups. This includes relative economic losses and psychosocial damage. COVID-19 has created a global opportunity to review how the scientific community classifies data, and how comparable indicators are selected to inform evidence-based resilience building and emergency preparedness. A shift into microlevel data, and regional-level information sharing is necessary to tailor community-level interventions for risk mitigation and disaster preparedness. Real-time data sharing, open governance, cross-organisational, and inter-platform collaboration are necessary not just in Health-EDRM and control of biological hazards, but for all natural hazards and man-made disasters.
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Affiliation(s)
- Emily Ying Yang Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, Hong Kong, China;
- Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
- GX Foundation, Hong Kong, China
- Accident & Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
- Correspondence: ; Tel.: +852-2252-8850
| | - Debarati Guha-Sapir
- Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université Catholique de Louvain, 1200 Brussels, Belgium;
- Center for Humanitarian Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Caroline Dubois
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
- GX Foundation, Hong Kong, China
| | - Rajib Shaw
- Graduate School of Media and Governance, Keio University, Fujisawa 252-0882, Japan;
| | - Chi Sing Wong
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, Hong Kong, China;
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
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Khan JR, Hossain MB, Awan N. Community-level environmental characteristics predictive of childhood stunting in Bangladesh - a study based on the repeated cross-sectional surveys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:473-486. [PMID: 32602734 DOI: 10.1080/09603123.2020.1777947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 03/08/2020] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
Coastal morphology makes Bangladesh vulnerable to environmental hazards and climate change. Therefore, environmental characteristics may shape population health, including child health. The prevalence of stunting among under-five aged (U5) children is high in Bangladesh. However, there is a lack of research on environmental predictors of stunting. This study aimed to assess the association between community-level environmental characteristics and stunting using pooled data from the three latest Bangladesh demographic and health surveys (BDHS). According to the multilevel model, rainfall, distance to protected areas, and vegetation index showed a nonlinear association with stunting. The temperature was inversely, and distance to water bodies was positively related to stunting. Overall, results evidence the environmental characteristics are predictive of stunting, and these characteristics should be taken into account during intervention design to minimise the negative effects of environmental change on child health. Further research is also necessary to comprehend the causal pathways between environmental characteristics and stunting in Bangladesh.
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Affiliation(s)
- Jahidur Rahman Khan
- Health Research Institute, Faculty of Health, University of Canberra, ACT, Australia
| | - Md Belal Hossain
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Nabil Awan
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
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15
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Preparedness to Combat Determinants of Underweight-Based Child Malnutrition in Flood-Affected Areas of Pakistan. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6464901. [PMID: 35118157 PMCID: PMC8807031 DOI: 10.1155/2022/6464901] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/01/2021] [Accepted: 12/20/2021] [Indexed: 11/17/2022]
Abstract
Aims. Floods badly impact the food and nutrition security in developing countries. The role of the government and the impact of floods on the underweight status of children in the affected areas is not clear. We aimed to find the determinants of underweight in flood-affected areas of Khyber Pakhtunkhwa, Pakistan. Methods. We used a multistage sampling technique and selected 656 households during in the flood-affected areas of Pakistan. Data were collected in the three most affected districts. A validated questionnaire was used to find socioeconomic and demographic information, hygiene, and sanitation information. We used logistic regression to find the determinants of underweight, controlling for confounders. Results. The prevalence of global malnutrition based on underweight was 25.2%. The prevalence of underweight was higher in young age mothers (40.6%), younger age children (71.4%), large family size (28.4%), joint family (27%), and no toilet facility (28.9%). District Nowshera was at high risk of underweight based undernutrition, followed by district Charsadda compared to children belonging to Dera Ismail Khan. The significant risk factor that causes underweight was child lower age (
), young age of mothers (
), children access to unimproved water sources (
), and location (districts) due to environmental and constant flood consequences (
). Conclusion. In conclusion, risk factors of underweight should be appropriately targeted in the flood-hit areas of Pakistan. Governments should preallocate budgetary resources and enhance the emergency preparedness levels to facilitate the communities with flooding incidents and their aftermath in the shape of child underweight-based malnutrition.
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16
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Lieber M, Chin-Hong P, Kelly K, Dandu M, Weiser SD. A systematic review and meta-analysis assessing the impact of droughts, flooding, and climate variability on malnutrition. Glob Public Health 2022; 17:68-82. [PMID: 33332222 PMCID: PMC8209118 DOI: 10.1080/17441692.2020.1860247] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 11/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Both the World Health Organization and the Intergovernmental Panel on Climate Change project that malnutrition will be the greatest contributor to climate change-associated morbidity and mortality. Although there have been several studies that have examined the potential effects of climate change on human health broadly, the effects on malnutrition are still not well understood. We conducted a systematic review investigating the role of three climate change proxies (droughts, floods, and climate variability) on malnutrition in children and adults. METHODS AND FINDINGS We identified 22 studies examining the effects of droughts, floods, and climate variability on at least one malnutrition metric. We found that 17 out of 22 studies reported a significant relationship between climate change proxies and at least one malnutrition metric. In meta-analysis, drought conditions were significantly associated with both wasting (Odds Ratio [OR] 1.46, 95% Confidence Interval [CI] 1.05-2.04) and underweight prevalence (OR 1.46, 95% CI 1.01-2.11). CONCLUSIONS Given the long-term consequences of malnutrition on individuals and society, adoption of climate change adaptation strategies such as sustainable agriculture and water irrigation practices, as well as improving nutritional interventions aimed at children aged 1-2 years and older adults, should be prioritised on global policy agendas in the coming years.
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Affiliation(s)
- Mark Lieber
- Johns Hopkins Bayview Medical Center. 4940 Eastern Avenue, Baltimore, MD 21224
| | - Peter Chin-Hong
- University of California, San Francisco School of Medicine. 513 Parnassus Avenue, San Francisco, CA 94143
| | - Knox Kelly
- California Pacific Medical Center. 3700 California Street, San Francisco, CA 94118
| | - Madhavi Dandu
- University of California, San Francisco School of Medicine. 513 Parnassus Avenue, San Francisco, CA 94143
| | - Sheri D. Weiser
- University of California, San Francisco, Division of HIV, Infectious Disease and Global Medicine
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17
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Kyamwine IB, Namukose S, Wibabara Y, Bulage L, Kwesiga B, Ario AR, Harris JR. Patterns of wasting among pregnant and lactating women in Uganda, 2015-2018: analysis of Nutrition surveillance data. BMC Nutr 2021; 7:59. [PMID: 34645523 PMCID: PMC8515752 DOI: 10.1186/s40795-021-00464-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/29/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Maternal nutrition is closely linked to the survival and development of children during the first 1000 days of life. Maternal wasting, a measure of malnutrition, is measured using the mid-upper arm circumference. However, in 2019, the rate and distribution of wasting among pregnant and lactating women was not known. We described annual trends and distribution of wasting among pregnant and lactating women (PLW), Uganda, 2015-2018, to inform programming on targeted nutritional interventions. METHODS We analyzed nutrition surveillance data from the District Health Information System for all PLW from 2015 to 2018. We used the World Health Organization standard thresholds to determine wasting among PLW by year and region, drawing choropleth maps to demonstrate the geographic distribution of wasting among PLW. We used logistic regression to assess wasting trends. RESULTS During 2015-2018, 268,636 PLW were wasted (prevalence = 5.5%). Of the 15 regions of Uganda, Karamoja (prevalence = 21%) and Lango (prevalence = 17%) registered the highest prevalence while Toro (prevalence = 2.7%) and Kigezi (prevalence = 2.0%) registered the lowest prevalence. The national annual prevalence of wasting among PLW declined by 31% from 2015 to 2018 (OR = 0.69, p < 0.001). Regions in the north had increasing trends of wasting over the period [Lango (OR = 1.6, p < 0.001) and Acholi (OR = 1.2, p < 0.001)], as did regions in the east [(Bugisu (OR = 3.4, p < 0.001), Bukedi (OR = 1.4, p < 0.001), and Busoga (OR = 1.3, p < 0.001)]. The other 11 regions showed declines. CONCLUSION The trend of wasting among PLW nationally declined during the study period. Lango and Acholi regions, both of which were experiencing a nutrition state of emergency during this period, had both high and rising rates of wasting, as did the Karamoja region, which experienced the highest wasting rates. We recommended that the Ministry of Health increases its focus on nutrition monitoring for PLW and conduct an analysis to clearly identify the factors underlying malnutrition specific for PLW in these regions.
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Affiliation(s)
| | | | - Yvette Wibabara
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Lilian Bulage
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Benon Kwesiga
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Alex Riolexus Ario
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Julie R Harris
- Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Kampala, Uganda
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18
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Nicholas K, Campbell L, Paul E, Skeltis G, Wang W, Gray C. Climate anomalies and childhood growth in Peru. POPULATION AND ENVIRONMENT 2021; 43:39-60. [PMID: 34456407 PMCID: PMC8389738 DOI: 10.1007/s11111-021-00376-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/08/2021] [Indexed: 06/06/2023]
Abstract
Climate change has been linked to poor childhood growth and development through maternal stress, nutritional insults related to lean harvests, and exposure to infectious diseases. Vulnerable populations are often most susceptible to these stressors. This study tested whether susceptibility to linear growth faltering is higher among Peruvian children from indigenous, rural, low-education, and low-income households. High-resolution weather and household survey data from Demographic and Health Survey 1996-2012 were used to explore height-for-age z-scores (HAZ) at each year of life from 0 to 5. Rural, indigenous children at age 0-1 experience a HAZ reduction of 0.35 units associated with prenatal excess rainfall which is also observed at age 4-5. Urban, non-indigenous children at age 4-5 experience a HAZ increase of 0.07 units associated with postnatal excess rainfall, but this advantage is not seen among rural, indigenous children. These findings highlight the need to consider developmental stage and social predictors as key components in public health interventions targeting increased climate change resilience.
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Affiliation(s)
- Khristopher Nicholas
- Carolina Population Center, University of North Carolina At Chapel Hill, Chapel Hill, NC,, USA
- Department of Nutrition, University of North Carolina At Chapel Hill, 123 W Franklin St, Chapel Hill, NC 27516, USA
| | - Leah Campbell
- Department of City and Regional Planning, University of North Carolina At Chapel Hill, Chapel Hill, NC,, USA
| | - Emily Paul
- Department of City and Regional Planning, University of North Carolina At Chapel Hill, Chapel Hill, NC,, USA
- Department of Health Behavior, University of North Carolina At Chapel Hill, Chapel Hill, NC,, USA
| | - Gioia Skeltis
- Department of Anthropology, University of North Carolina At Chapel Hill, Chapel Hill, NC,, USA
| | - Wenbo Wang
- Department of Biostatistics, University of North Carolina At Chapel Hill, Chapel Hill, NC,, USA
| | - Clark Gray
- Carolina Population Center, University of North Carolina At Chapel Hill, Chapel Hill, NC,, USA
- Department of Geography, University of North Carolina At Chapel Hill, Chapel Hill, NC,, USA
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19
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Mugabe VA, Gudo ES, Inlamea OF, Kitron U, Ribeiro GS. Natural disasters, population displacement and health emergencies: multiple public health threats in Mozambique. BMJ Glob Health 2021; 6:e006778. [PMID: 34489329 PMCID: PMC8422305 DOI: 10.1136/bmjgh-2021-006778] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/15/2021] [Indexed: 12/28/2022] Open
Abstract
In early 2019, following the 2015-2016 severe drought, the provinces of Sofala and Cabo Delgado, Mozambique, were hit by Cyclones Idai and Kenneth, respectively. These were the deadliest and most destructive cyclones in the country's history. Currently, these two provinces host tens of thousands of vulnerable households due to the climatic catastrophes and the massive influx of displaced people associated with violent terrorist attacks plaguing Cabo Delgado. The emergence of the COVID-19 pandemic added a new challenge to this already critical scenario, serving as a real test for Mozambique's public health preparedness. On the planetary level, Mozambique can be viewed as a 'canary in the coal mine', harbingering to the world the synergistic effects of co-occurring anthropogenic and natural disasters. Herein, we discuss how the COVID-19 pandemic has accentuated the need for an effective and comprehensive public health response in a country already deeply impacted by health problems associated with natural disasters and population displacement.
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Affiliation(s)
- Vánio A Mugabe
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Universidade Licungo, Quelimane, Zambezia, Mozambique
| | | | | | - Uriel Kitron
- Department of Environmental Sciences, Emory University, Atlanta, Georgia, USA
| | - Guilherme S Ribeiro
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil
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20
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Ramesh B, Jagger MA, Zaitchik B, Kolivras KN, Swarup S, Deanes L, Gohlke JM. Emergency department visits associated with satellite observed flooding during and following Hurricane Harvey. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:832-841. [PMID: 34267308 PMCID: PMC8448911 DOI: 10.1038/s41370-021-00361-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND Flooding following heavy rains precipitated by hurricanes has been shown to impact the health of people. Earth observations can be used to identify inundation extents for subsequent analysis of health risks associated with flooding at a fine spatio-temporal scale. OBJECTIVE To evaluate emergency department (ED) visits before, during, and following flooding caused by Hurricane Harvey in 2017 in Texas. METHODS A controlled before and after design was employed using 2016-2018 ED visits from flooded and non-flooded census tracts. ED visits between landfall of the hurricane and receding of flood waters were considered within the flood period and post-flood periods extending up to 4 months were also evaluated. Modified Poisson regression models were used to estimate adjusted rate ratios for total and cause specific ED visits. RESULTS Flooding was associated with increased ED visits for carbon monoxide poisoning, insect bite, dehydration, hypothermia, intestinal infectious diseases, and pregnancy complications. During the month following the flood period, the risk for pregnancy complications and insect bite was still elevated in the flooded tracts. SIGNIFICANCE Earth observations coupled with ED visits increase our understanding of the short-term health risks during and following flooding, which can be used to inform preparedness measures to mitigate adverse health outcomes and identify localities with increased health risks during and following flooding events.
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Affiliation(s)
- Balaji Ramesh
- Department of Geography, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | | | - Benjamin Zaitchik
- Morton K. Blaustein Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Korine N Kolivras
- Department of Geography, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Samarth Swarup
- Biocomplexity Institute and Initiative, University of Virginia, Charlottesville, VA, USA
| | - Lauren Deanes
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Julia M Gohlke
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
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21
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Haq IU, Mehmood Z, Afzal T, Khan N, Ahmed B, Nawsherwan, Ali L, Khan A, Muhammad J, Khan EA, Khan J, Zakki SA, Xu J, Shu Y. Prevalence and determinants of stunting among preschool and school-going children in the flood-affected areas of Pakistan. BRAZ J BIOL 2021; 82:e249971. [PMID: 34259717 DOI: 10.1590/1519-6984.249971] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/13/2021] [Indexed: 11/22/2022] Open
Abstract
Stunting is a significant public health problem in low- and middle-income countries. This study assessed the prevalence of stunting and associated risk factors of stunting among preschool and school-going children in flood-affected areas of Pakistan. A cross-sectional study was conducted by visiting 656 households through multi-stage sampling. Respondent's anthropometric measurements, socio-demographic information and sanitation facilities were explored. A logistic regression model was used to determine determinants of stunting, controlling for all possible confounders. The overall prevalence of stunting in children was 40.5%, among children 36.1% boys and 46.3% of girls were stunted. The prevalence of stunting in under-five children was 50.7%. Female children (OR=1.35, 95% CI:0.94-2.0), children aged 13-24 months (OR=6.5, 95% CI: 3.0-13.9), mothers aged 15-24 years (OR=4.4, 95% CI: 2.6-7.2), joint family (OR=2.1, 95% CI: 1.4-3.0) did not have access to improved drinking water (OR=3.3, 95% CI: 1.9-5.9), and the toilet facility (OR=2.8, 95% CI, 1.9-4.3), while the children from district Nowshera (OR=1.7, 95% CI: 0.9-3.2) were significantly (P<0.05) associated in univariate analysis. The regression model revealed that child age, maternal age, family type, quality of water, and toilet facility, were the significant (P<0.05) factors contributing to child stunting in the flood-hit areas. Identification of key factors might be helpful for policymakers in designing comprehensive community-based programs for the reduction of stunting in flood-affected areas. In disasters such as flood, the detrimental consequences of the stunting problem could be even more on children. Evidence-based education and care must be provided to the families in the flood-affected regions to reduce the stunting problem. The determinants of stunting should be targeted by making comprehensive policies regarding proper nutrition, livelihood, clean water, and sanitation facilities in flood-hit regions.
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Affiliation(s)
- I Ul Haq
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Z Mehmood
- Department of Math's, Stats & Computer Science, The University of Agriculture Peshawar, Pakistan
| | - T Afzal
- Basic Health Unit Rakhi Mounh, Tehsil Koh-e-Suleman, District Health Authority Dera Ghazi Khan, Pakistan
| | - N Khan
- Goat Production Research Station Charbagh Swat, Livestock and Dairy Development Research Department Khyber Pakhtunkhwa, Pakistan
| | - B Ahmed
- School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Nawsherwan
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, China
| | - L Ali
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
| | - A Khan
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - J Muhammad
- Department of Microbiology, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - E A Khan
- Institute of Nursing Sciences, Khyber Medical University, Peshawar, Pakistan
| | - J Khan
- Department of Agriculture, University of Swabi, Khyber Pakhtunkhwa, Pakistan
| | - S A Zakki
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - J Xu
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Y Shu
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
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22
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Mahapatra B, Walia M, Rao CAR, Raju BMK, Saggurti N. Vulnerability of agriculture to climate change increases the risk of child malnutrition: Evidence from a large-scale observational study in India. PLoS One 2021; 16:e0253637. [PMID: 34181668 PMCID: PMC8238181 DOI: 10.1371/journal.pone.0253637] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 06/09/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The impact of climate change on agriculture and food security has been examined quite thoroughly by researchers globally as well as in India. While existing studies provide evidence on how climate variability affects the food security and nutrition, research examining the extent of effect vulnerability of agriculture to climate change can have on nutrition in India are scarce. This study examined a) the association between the degree of vulnerability in agriculture to climate change and child nutrition at the micro-level b) spatial effect of climate vulnerability on child nutrition, and c) the geographical hotspots of both vulnerability in agriculture to climate change and child malnutrition. METHODS The study used an index on vulnerability of agriculture to climate change and linked it to child malnutrition indicators (stunting, wasting, underweight and anaemia) from the National Family Health Survey 4 (2015-16). Mixed-effect and spatial autoregressive models were fitted to assess the direction and strength of the relationship between vulnerability and child malnutrition at macro and micro level. Spatial analyses examined the within-district and across-district spill-over effects of climate change vulnerability on child malnutrition. RESULTS Both mixed-effect and spatial autoregressive models found that the degree of vulnerability was positively associated with malnutrition among children. Children residing in districts with a very high degree of vulnerability were more like to have malnutrition than those residing in districts with very low vulnerability. The analyses found that the odds of a child suffering from stunting increased by 32%, wasting by 42%, underweight by 45%, and anaemia by 63% if the child belonged to a district categorised as very highly vulnerable when compared to those categorised as very low. The spatial analysis also suggested a high level of clustering in the spatial distribution of vulnerability and malnutrition. Hotspots of child malnutrition and degree of vulnerability were mostly found to be clustered around western-central part of India. CONCLUSION Study highlights the consequences that vulnerability of agriculture to climate change can have on child nutrition. Strategies should be developed to mitigate the effect of climate change on areas where there is a clustering of vulnerability and child malnutrition.
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Affiliation(s)
| | - Monika Walia
- International Food Policy Research Institute, New Delhi & Ex-Population Council, New Delhi, India
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23
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Randell H, Grace K, Bakhtsiyarava M. Climatic Conditions and Infant Care: Implications for Child Nutrition in Rural Ethiopia. POPULATION AND ENVIRONMENT 2021; 42:524-552. [PMID: 34149138 PMCID: PMC8210853 DOI: 10.1007/s11111-020-00373-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 06/12/2023]
Abstract
We examine the relationships between climatic conditions, breastfeeding behavior, and maternal time use in Ethiopia. Infant feeding practices are important predictors of child nutrition that may be affected by a number of factors including mother's time engaging in agricultural labor, food security, cultural beliefs, and antenatal care. We use panel data from the Living Standards Measurement Study to investigate linkages between climatic conditions during a child's first year of life and year prior to birth and duration of exclusive breastfeeding. We then explore one potential mechanism: women's agricultural labor. Results indicate that rainfall during the primary agricultural season-kiremt-in a child's first year of life plays an important role in duration of exclusive breastfeeding. Experiencing 25 cm of average monthly kiremt rainfall, versus 5 cm, is associated with a 20-percentage-point decrease in the likelihood of being exclusively breastfed for the recommended six months. More kiremt rainfall is associated with a greater number of days that women spend planting and harvesting, and at high levels of rainfall women with infants do not engage in significantly fewer days of agricultural labor than those without infants. Lastly, we find that during the year before birth, greater rainfall during kiremt as well as the dry season is associated with a lower likelihood of six months of exclusive breastfeeding, potentially due to the early introduction of complementary foods. Our findings indicate that agricultural labor demands may in part drive breastfeeding behaviors, leading to "sub-optimal" feeding practices in the short-term, but resulting in improved household food security in the longer-term.
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Affiliation(s)
- Heather Randell
- Department of Agricultural Economics, Sociology, and Education, Pennylvania State University, 110-A Armsby Building, University Park, PA 16802
| | - Kathryn Grace
- Department of Geography, Environment, and Society, University of Minnesota-Twin Cities
| | - Maryia Bakhtsiyarava
- Department of Geography, Environment, and Society, University of Minnesota-Twin Cities
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24
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Haq IU, Mehmood Z, Khan N, Khan MN, Israr M, Ali Khan E, Nisar M, Ahmad MI, Ali M. Risk Factors of Mid-upper Arm Circumference (MUAC) Based Child Malnutrition in the Flood-affected Areas of Pakistan: A Cross-sectional Study. Ecol Food Nutr 2021; 60:491-507. [PMID: 33472422 DOI: 10.1080/03670244.2021.1872024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Low- and middle-income countries are usually at high risk of malnutrition. Not only that but the prevalence of malnutrition is much higher. It is important to evaluate the determinants of malnutrition in flood-affected areas of Pakistan. The present study examined the prevalence and risk factors of MUAC-based child malnutrition in flood-hit regions of Khyber Pakhtunkhwa, Pakistan. Multi-stage sampling was employed to select 656 households. Finally, 298 children of 6-59 months were selected. MUAC, an independent anthropometric parameter, was used to investigate the nutritional status of children. An automated logistic regression model was used to identify the risk factors of MUAC-based malnutrition. The prevalence of MUAC-based malnutrition was found 46%, including 40.5% females and 52.1% males. More than 90% of people had improved water quality and soap hand washing facility. Almost 17% of respondents had no toilet facility. Through automated logistic model, child age, maternal age, family size, income level, mother education, water quality, toilet facility were the significant determinants (P < .05) of MUAC-based undernutrition in flood affecting the area. The findings suggest that MUAC-based malnutrition can be minimized in flood-hit areas by targeting the listed risk factors. Community-based awareness programs regarding guidance on nutrition might be a key to reducing malnutrition in the target areas.
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Affiliation(s)
- Ijaz Ul Haq
- School of Food Science, Jiangsu Food & Pharmaceutical Science College, Jiangsu, Huai'an, China.,Department of Public Health and Nutrition, University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Zafar Mehmood
- School of Food Science, Jiangsu Food & Pharmaceutical Science College, Jiangsu, Huai'an, China.,Department of Math's, Stats & Computer Science, the University of Agriculture Peshawar, Pakistan
| | - Nadar Khan
- Department of Animal Nutrition, The University of Agriculture Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Muhammad Nadeem Khan
- Department of Medicine, Lady Reading Hospital, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Muhammad Israr
- Department of Ophthalmology, Hayatabad Medical Complex, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Ejaz Ali Khan
- Institue of Nursing Sciences, Khyber Medical University Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Muhammad Nisar
- Department of Epidemiology & Public Health, Cholistan University of Veterinary and Animal Sciences, Punjab, Pakistan
| | - Muhammad Ijaz Ahmad
- College of Food Science and Technology, Nanjing Agricultural University, Nanjing, China
| | - Majid Ali
- Department of Health Policy, School of Health Policy and Management, Nanjing Medical University, Nanjing, Jiangsu, China
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Impact of improved small-scale livestock farming on human nutrition. Sci Rep 2021; 11:191. [PMID: 33420257 PMCID: PMC7794515 DOI: 10.1038/s41598-020-80387-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 12/10/2020] [Indexed: 11/20/2022] Open
Abstract
Micronutrient deficiencies and stunting rates are high in many low-income countries. Increasing and diversifying food intake are often challenging for small-scale farmers in lowland areas as flooding often results in crop losses and drowning of livestock. A cluster-randomised controlled trial was conducted over 12-months in Bangladesh, involving 150 small-scale duck rearing households, including 50 control, and 50 households each in two intervention arms. Interventions focussing on improving duck health and duck nutrition were applied on a village level. Data analysis focussed on assessing the impact of interventions on duck mortality, sales and consumption, and on dietary diversity of household members. Improved duck rearing increased the consumption and the sales of ducks. Household selling more ducks were more likely to purchase and consume milk products, contributing to an improved households’ dietary diversity. Our results suggest that improving duck rearing can provide a suitable and sustainable alternative to maintain and improve dietary diversity of households in flood-prone areas.
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Davis KF, Downs S, Gephart JA. Towards food supply chain resilience to environmental shocks. NATURE FOOD 2021; 2:54-65. [PMID: 37117650 DOI: 10.1038/s43016-020-00196-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 11/09/2020] [Indexed: 04/30/2023]
Abstract
Environmental variability and shock events can be propagated or attenuated along food supply chains by various economic, political and infrastructural factors. Understanding these processes is central to reducing risks associated with periodic food shortages, price spikes and reductions in food quality. Here we perform a scoping review of the literature to examine entry points for environmental variability along the food supply chain, the evidence of propagation or attenuation of this variability, and the food items and types of shock that have been studied. We find that research on food supply shocks has primarily focused on maize, rice and wheat, on agricultural production and on extreme rainfall and temperatures-indicating the need to expand research into the full food basket, diverse sources of environmental variability and the links connecting food production to consumption and nutrition. Insights from this new knowledge can inform key responses-at the level of an individual (for example, substituting foods), a company (for example, switching sources) or a government (for example, strategic reserves)-for coping with disruptions.
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Affiliation(s)
- Kyle Frankel Davis
- Department of Geography and Spatial Sciences, University of Delaware, Newark, DE, USA.
- Department of Plant and Soil Sciences, University of Delaware, Newark, DE, USA.
- Data Science Institute, Columbia University, New York, NY, USA.
| | - Shauna Downs
- Department of Urban-Global Public Health, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Jessica A Gephart
- Department of Environmental Science, American University, Washington DC, USA
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Dhoubhadel BG, Raya GB, Shrestha D, Shrestha RK, Dhungel Y, Suzuki M, Yasunami M, Smith C, Ariyoshi K, Parry CM. Changes in nutritional status of children who lived in temporary shelters in Bhaktapur municipality after the 2015 Nepal earthquake. Trop Med Health 2020; 48:53. [PMID: 32607058 PMCID: PMC7321544 DOI: 10.1186/s41182-020-00225-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 05/15/2020] [Indexed: 01/02/2023] Open
Abstract
Abstract
Background
The nutritional status of children may deteriorate after natural disasters such as earthquakes. A 7.8 Richter scale earthquake struck Nepal in 2015 that affected 1.1 million children. Children whose homes were destroyed and had to live in temporary shelters were at risk of malnutrition. With the support of Nagasaki University School of Tropical Medicine and Global Health (TMGH) and Siddhi Memorial Hospital (SMH), we conducted a nutritional survey of under-5 children living in temporary shelters in Bhaktapur Municipality in 2015 immediately after the earthquake and a follow-up survey in 2017.
Results
We found 591 under-5 children living in 22 temporary shelters in 2015. A total of 285 children were followed up and re-assessed in 2017. In a paired analysis (n = 285), the prevalence of underweight children increased from 10.9% in 2015 to 14.0% in 2017 (P < 0.001), stunting increased from 26.7 to 31.9% (P = 0.07), and wasting decreased from 4.2 to 2.5% (P = 0.19).
Conclusions
Children who lived in temporary shelters after the 2015 Nepal earthquake might be at increased risk of a deterioration in nutritional status.
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Randell H, Gray C, Grace K. Stunted from the start: Early life weather conditions and child undernutrition in Ethiopia. Soc Sci Med 2020; 261:113234. [PMID: 32823214 PMCID: PMC7716344 DOI: 10.1016/j.socscimed.2020.113234] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/26/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
This paper examines the relationship between weather conditions and child nutrition in Ethiopia. We link data from four rounds of the Ethiopia Demographic and Health Survey to high-resolution climate data to measure exposure to rainfall and temperature in utero and during early life. We then estimate a set of multivariate regression models to understand how weather conditions impact child stunting, an indicator of sustained early life undernutrition. We find that greater rainfall during the rainy seasons in early life is associated with greater height for age. In addition, higher temperatures in utero, particularly during the first and third trimesters, and more rainfall during the third trimester, are positively associated with severe stunting, though stunting decreases with temperature in early life. We find potential evidence for a number of pathways underlying the weather-child nutrition relationship including agricultural livelihoods, heat stress, infectious disease transmission, and women's time use during pregnancy. These findings illuminate the complex pathways through which climate change may influence child health and should motivate additional research focused on identifying the causal mechanisms underlying these links.
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Affiliation(s)
- Heather Randell
- Department of Agricultural Economics, Sociology, and Education, Penn State University, 110-A Armsby Building, University Park, PA, 16802, USA.
| | - Clark Gray
- Department of Geography, University of North Carolina at Chapel Hill, USA
| | - Kathryn Grace
- Department of Geography, Environment, and Society, University of Minnesota, Twin Cities, USA
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Coping through a drought: the association between child nutritional status and household food insecurity in the district of iLembe, South Africa. Public Health Nutr 2020; 24:1052-1065. [PMID: 32404228 DOI: 10.1017/s1368980020000105] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess and compare the association between household food insecurity and child nutritional status over two time-points taking into consideration the effects of a severe drought. DESIGN The study used two cross-sectional household surveys during and after a severe drought, consistent with a natural experiment design. SETTING The study took place in the district of iLembe, KwaZulu-Natal, South Africa. PARTICIPANTS Households with children aged <5 years were invited to participate in the survey. Anthropometric measures were taken for the respective children in each of the participating households. RESULTS The results indicated that all forms of poor nutritional status increased over the two time-points, with the most significant increases being for stunting (P < 0·016) and obesity (P < 0·001). There was evidence of an association between increasing food insecurity and stunting (P < 0·003) at the end of the drought, but not wasting, underweight or overweight. The results indicated a strong link between chronic food insecurity and chronic undernutrition. The results also showed stronger evidence of an association between food insecurity and stunting for urban households (P < 0·001) compared to their rural counterparts (P < 0·019). CONCLUSIONS The negative effects of drought appear to contribute to increased rates of child stunting through higher levels of household food insecurity. Future research should assess this relationship through longitudinal studies. Interventions aimed at improving food security may assist in reducing child malnutrition, but policymakers should consider urban-rural differences as well as climatic and environmental events.
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Dimitrova A, Bora JK. Monsoon weather and early childhood health in India. PLoS One 2020; 15:e0231479. [PMID: 32275697 PMCID: PMC7147999 DOI: 10.1371/journal.pone.0231479] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 03/24/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND India is expected to experience an increase in the frequency and intensity of extreme weather events in the coming decades, which poses serious risks to human health and wellbeing in the country. OBJECTIVE This paper aims to shed light on the possible detrimental effects of monsoon weather shocks on childhood undernutrition in India using the Demographic and Health Survey 2015-16, in combination with geo-referenced climate data. METHODS Undernutrition is captured through measures of height-for-age, weight-for-height, stunting and wasting among children aged 0-59 months. The standardised precipitation and evapotranspiration index (SPEI) is used to measure climatic conditions during critical periods of child development. RESULTS The results of a multivariate logistic regression model show that climate anomalies experienced in utero and during infancy are associated with an increased risk of child undernutrition; exposure to excessive monsoon precipitation during these early periods of life elevates the risk of stunting, particularly for children in the tropical wet and humid sub-tropical regions. In contrast, the risk of stunting is reduced for children residing in the mountainous areas who have experienced excessive monsoon precipitation during infancy. The evidence on the short-term effects of climate shocks on wasting is inconclusive. We additionally show that excessive precipitation, particularly during the monsoon season, is associated with an increased risk of contracting diarrhoea among children under five. Diseases transmitted through water, such as diarrhoea, could be one important channel through which excessive rainfall increases the risk of stunting. CONCLUSIONS We find a positive association between childhood undernutrition and exposure to excessive monsoon precipitation in India. Pronounced differences across climate zones are found. The findings of the present analysis warn of the urgent need to provide health assistance to children in flood-prone areas.
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Affiliation(s)
- Anna Dimitrova
- Wittgenstein Centre for Demography and Global Human Capital (IIASA, VID/ ÖAW and WU), International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Jayanta Kumar Bora
- Wittgenstein Centre for Demography and Global Human Capital (IIASA, VID/ ÖAW and WU), International Institute for Applied Systems Analysis, Laxenburg, Austria
- Indian Institute of Dalit Studies, New Delhi, India
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Hintsa S, Gereziher K. Determinants of underweight among 6-59 months old children in Berahle, Afar, North East Ethiopia: a case control study 2016. BMC Res Notes 2019; 12:753. [PMID: 31744519 PMCID: PMC6862735 DOI: 10.1186/s13104-019-4805-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/12/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The objective of this study was to identify determinants of underweight among 6-59 months old children in Berahle Woreda, Afar, North East Ethiopia, in 2016. RESULT The median age (IQR) of cases and controls were 24 (34) and 18 (23) months respectively and 51.6% of the children were not exclusively breast-fed but 64.8% controls were exclusively breastfed. Age group of 48-59 months (AOR = 11.93; 95% CI 3.88-36.67), illiterate mothers (AOR = 2.32; 95% CI 1.19-4.55), low dietary diversity (AOR = 4.57; 95% CI 2.40-8.69), diarrhea in the past of 2 weeks (AOR = 2.93; 95% CI 1.46-5.85), birth interval (AOR = 5.17; 95% CI 2.37-11.26) and unprotected source of water (AOR = 2.62; 95% CI 1.42-4.85) were determinant factors of underweight.
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Affiliation(s)
- Solomon Hintsa
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Science, Aksum University, P. O. Box: 298, Aksum, Ethiopia.
| | - Kiros Gereziher
- Department of Nutrition, School of Public Health, College of Health Science, Aksum University, Aksum, Ethiopia
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Epstein A, Torres JM, Glymour MM, López-Carr D, Weiser SD. Do Deviations From Historical Precipitation Trends Influence Child Nutrition? An Analysis From Uganda. Am J Epidemiol 2019; 188:1953-1960. [PMID: 31497852 DOI: 10.1093/aje/kwz179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 08/01/2019] [Accepted: 08/08/2019] [Indexed: 11/13/2022] Open
Abstract
Changes in precipitation patterns might have deleterious effects on population health. We used data from the Uganda National Panel Survey from 2009 to 2012 (n = 3,223 children contributing 5,013 assessments) to evaluate the link between rainfall and undernutrition in children under age 5 years. We considered 3 outcomes (underweight, wasting, and stunting) and measured precipitation using household-reported drought and deviations from long-term precipitation trends measured by satellite. We specified multilevel logistic regression models with random effects for the community, village, and individual. Underweight (13%), wasting (4%), and stunting (33%) were common. Reported drought was associated with underweight (marginal risk ratio (RR) = 1.18, 95% confidence interval (CI): 1.04, 1.35) in adjusted analyses. Positive annual deviations (greater rainfall) from long-term precipitation trends were protective against underweight (marginal RR per 50-mm increase = 0.94, 95% CI: 0.92, 0.97) and wasting (marginal RR per 50-mm increase = 0.93, 95% CI: 0.87, 0.98) but not stunting (marginal RR per 50-mm increase = 1.00, 95% CI: 0.98, 1.01). Precipitation was associated with measures of acute but not chronic malnutrition using both objective and subjective measures of exposure. Sudden reductions in rainfall are likely to have acute adverse effects on child nutritional status.
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Arora A, Bansal S, Ward PS. Do farmers value rice varieties tolerant to droughts and floods? Evidence from a discrete choice experiment in Odisha, India. WATER RESOURCES AND ECONOMICS 2019; 25:27-41. [PMID: 31608207 PMCID: PMC6777508 DOI: 10.1016/j.wre.2018.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 03/07/2018] [Accepted: 03/12/2018] [Indexed: 05/24/2023]
Abstract
Abiotic stresses such as droughts and floods significantly constrain rice production in India. New stress tolerant technologies have the potential to reduce yield variability and help insulate farmers from the risks posed by these hazards. Using discrete choice experiments conducted in rural Odisha, we estimate farmers' valuation for drought-tolerant (DT) and submergence-tolerant (SubT) traits embodied in rice cultivars. Our results demonstrate that farmers in both drought-prone as well as submergence prone regions value reduction in yield variability offered by new, stress-tolerant cultivars, and would generally be willing to pay a significant premium for these traits. While virtually all farmers perceive the threat of drought and are willing to pay for protection against drought risk, only farmers in flood-prone areas would be willing to pay for rice that can withstand being submerged for prolonged periods, suggesting the potential for market segmentation along geographical or ecological lines.
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Affiliation(s)
| | - Sangeeta Bansal
- Centre for International Trade and Development, Jawaharlal Nehru University, New Delhi 110067, India
| | - Patrick S. Ward
- Environment and Production Technology Division, International Food Policy Research Institute, USA
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Fanzo J, Davis C, McLaren R, Choufani J. The effect of climate change across food systems: Implications for nutrition outcomes. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2018. [DOI: 10.1016/j.gfs.2018.06.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Floods are the most common type of natural disaster in both developed and developing countries and have led to extensive morbidity and mortality throughout the world. Worldwide, over the past 30 years, flooding has claimed the lives of more than 200,000 people and affected more than 2.8 billion others. The impact of flooding on health varies among populations and depends primarily on vulnerability and the kind of event experienced. It severely disrupts livelihoods and has a significant impact on the health of pregnant women and children. In addition, it may exacerbate a range of negative psychological and physiological child and reproductive health outcomes. Awareness-raising, education, and the issuing of warnings appear to be key initiatives to mitigate or prevent flood morbidity and mortality, especially among people living in low- and middle-income countries. Agencies responding to emergencies also need to be more cognisant of the dangers, specifically those engaged in healthcare, nutrition, and water safety programmes.
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Affiliation(s)
- Lea H Mallett
- Research Scientist, Joseph J. Zilber School of Public Health and Children's Environmental Health Sciences Core Center, University of Wisconsin-Milwaukee, United States
| | - Ruth A Etzel
- Professor, Joseph J. Zilber School of Public Health and Children's Environmental Health Sciences Core Center, University of Wisconsin-Milwaukee, United States
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Moriyama H, Fuchimukai T, Kondo N, Takayama JI. Obesity in elementary school children after the Great East Japan Earthquake. Pediatr Int 2018; 60:282-286. [PMID: 29205642 DOI: 10.1111/ped.13468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 09/29/2017] [Accepted: 11/30/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Rikuzentakata was one of the cities most devastated by the Great East Japan Earthquake on 11 March 2011. Many buildings were swept away or destroyed and affected families were placed into temporary housing. The aim of this study was to determine the impact of long-term temporary housing on the body mass index (BMI) of elementary school children living in Rikuzentakata City. METHODS A retrospective cohort study was carried out of students attending 1st-3rd grade in 2010, and 4th-6th grade in 2013, in eight elementary schools in Rikuzentakata City. Height and weight were measured annually. We compared changes in BMI between children in temporary housing and those in permanent housing. Separately, parents of students attending one of the elementary schools were surveyed in 2013. RESULTS Of 526 children in the present study, 32% were living in temporary housing. The prevalence of obesity climbed from 5.3% in 2010 to 7.8% in 2013 in the temporary housing group, and from 7.6% to 7.8% in the permanent housing group. BMI z-score in the temporary housing group increased by 0.102 points between 2010 and 2013 (P < 0.02). Children in temporary housing spent more time reading comic books and their walking commute time had decreased by 2 min compared with before the disaster. CONCLUSION Obesity prevalence and BMI z-score increased in children in temporary housing compared with permanent housing. A more sedentary lifestyle may explain this trend. It is important for policy makers and health-care providers to recognize potential consequences of long-term residence in temporary housing.
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Affiliation(s)
- Hidenori Moriyama
- Department of Pediatrics, Iwate Prefectural Ofunato Hospital, Ofunato City, Iwate, Japan
| | - Toru Fuchimukai
- Department of Pediatrics, Iwate Prefectural Ofunato Hospital, Ofunato City, Iwate, Japan
| | - Naoki Kondo
- Department of Health Education and Health Sociology/Department of Health and Social Behavior, School of Public Health, University of Tokyo, Tokyo, Japan
| | - John I Takayama
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
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No Calm After the Storm: A Systematic Review of Human Health Following Flood and Storm Disasters. Prehosp Disaster Med 2017; 32:568-579. [PMID: 28606191 DOI: 10.1017/s1049023x17006574] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Introduction How the burden of disease varies during different phases after floods and after storms is essential in order to guide a medical response, but it has not been well-described. The objective of this review was to elucidate the health problems following flood and storm disasters. METHODS A literature search of the databases Medline (US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA); Cinahl (EBSCO Information Services; Ipswich, Massachusetts USA); Global Health (EBSCO Information Services; Ipswich, Massachusetts USA); Web of Science Core Collection (Thomson Reuters; New York, New York USA); Embase (Elsevier; Amsterdam, Netherlands); and PubMed (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA) was conducted in June 2015 for English-language research articles on morbidity or mortality and flood or storm disasters. Articles on mental health, interventions, and rescue or health care workers were excluded. Data were extracted from articles that met the eligibility criteria and analyzed by narrative synthesis. RESULTS The review included 113 studies. Poisonings, wounds, gastrointestinal infections, and skin or soft tissue infections all increased after storms. Gastrointestinal infections were more frequent after floods. Leptospirosis and diabetes-related complications increased after both. The majority of changes occurred within four weeks of floods or storms. CONCLUSION Health changes differently after floods and after storms. There is a lack of data on the health effects of floods alone, long-term changes in health, and the strength of the association between disasters and health problems. This review highlights areas of consideration for medical response and the need for high-quality, systematic research in this area. Saulnier DD , Brolin Ribacke K , von Schreeb J . No calm after the storm: a systematic review of human health following flood and storm disasters. Prehosp Disaster Med. 2017;32(5):568-579.
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Pradhan PMS, Dhital R, Subhani H. Nutrition interventions for children aged less than 5 years following natural disasters: a systematic review. BMJ Open 2016; 6:e011238. [PMID: 27650759 PMCID: PMC5051354 DOI: 10.1136/bmjopen-2016-011238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The objective of this paper was to review various nutritional interventions targeted at under-five children in countries that had suffered from natural disasters and to analyse their effect on nutrition-related outcomes. DESIGN Systematic review. SETTING Countries that had suffered from natural disasters. PARTICIPANTS Children aged <5 years who were given any nutritional intervention to improve overall nutritional status after a natural disaster. PRIMARY AND SECONDARY OUTCOME MEASURES Primary nutrition-related outcomes were stunting, wasting and underweight. The secondary nutrition-related outcome was anaemia. RESULTS Of the 1218 studies that the reviewers agreed on, five matched the inclusion criteria and were included in this narrative synthesis. Four studies were longitudinal and one was cross-sectional in design. Food supplementation was an integral part of nutritional interventions in all the included studies. The most consistent nutritional outcome in all five included studies was reduced prevalence of wasting, followed by reduced prevalence of underweight in four, stunting in three and anaemia in one of the five included studies. The largest reduction in the prevalence of wasting and underweight was reported by the study in Sri Lanka. Overall, the quality of evidence ranged from moderate to weak. CONCLUSIONS Integrated nutrition interventions using locally available health resources yielded the best results. However, sound evidence on the most effective interventions is still lacking. Intervention studies with comparison groups are necessary to obtain more robust evidence on the effectiveness of nutrition interventions.
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Affiliation(s)
- Pranil Man Singh Pradhan
- Department of Community Medicine and Public Health, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Rolina Dhital
- Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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Gaire S, Delbiso TD, Pandey S, Guha-Sapir D. Impact of disasters on child stunting in Nepal. Risk Manag Healthc Policy 2016; 9:113-27. [PMID: 27354834 PMCID: PMC4908949 DOI: 10.2147/rmhp.s101124] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Stunting is a major public health problem that results from inadequate nutritional intake over a long period of time. Disasters have major implications in poor and vulnerable children. The aim of this study was, therefore, to assess the impact of disasters on child stunting in Nepal. Method A sample consisting of 2,111 children aged 6–59 months was obtained from the 2011 Nepal Demographic and Health Survey. We used bivariate and multivariate analyses to examine moderate and severe stunting against disaster, controlling for all possible confounders. Result Out of the total study sample, 43% were stunted (17.1% severely and 25.9% moderately). The final model, after adjusting for confounders, showed that epidemics have no impact on child stunting (adjusted odds ratio [OR] =1.14, 95% confidence interval [CI]: 0.66, 1.97 and adjusted OR =1.04, 95% CI: 0.66, 1.65 for severe and moderate stunting, respectively). Floods have impact on child stunting (adjusted OR =0.57, 95% CI: 0.31, 0.96 and adjusted OR =0.66, 95% CI: 0.41, 0.94 for severe and moderate stunting, respectively). However, children aged 6–11 months, nonvaccinated children, children of working women, children who live in mountainous areas, and children from the poorest households were more likely to be moderately stunted. Similarly, children aged 36–47 months, Dalit and other ethnic groups, children from rural settings, and children from the poorest households were more likely to be severely stunted. Conclusion This article illustrates the need to rethink about child stunting in Nepal. This study suggests need for further research, integration of disaster data in the Nepal Demography Health Survey, educational interventions, public awareness, promotion of vaccination, and equity in health service delivery.
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Affiliation(s)
- Surya Gaire
- Centre for Research on the Epidemiology of Disaster (CRED), Institute of Health and Society (IRSS), Université Catholique de Louvain (UCL), Brussels, Belgium
| | - Tefera Darge Delbiso
- Centre for Research on the Epidemiology of Disaster (CRED), Institute of Health and Society (IRSS), Université Catholique de Louvain (UCL), Brussels, Belgium
| | - Srijana Pandey
- Department of Nursing, Tribhuvan University Teaching Hospital (TUTH), Institute of Medicine (IOM), Baluwatar, Kathmandu, Nepal
| | - Debarati Guha-Sapir
- Centre for Research on the Epidemiology of Disaster (CRED), Institute of Health and Society (IRSS), Université Catholique de Louvain (UCL), Brussels, Belgium
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Rodriguez-Llanes JM, Ranjan-Dash S, Mukhopadhyay A, Guha-Sapir D. Looking upstream: enhancers of child nutritional status in post-flood rural settings. PeerJ 2016; 4:e1741. [PMID: 26966670 PMCID: PMC4782687 DOI: 10.7717/peerj.1741] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 02/06/2016] [Indexed: 11/20/2022] Open
Abstract
Background. Child undernutrition and flooding are highly prevalent public health issues in many developing countries, yet we have little understanding of preventive strategies for effective coping in these circumstances. Education has been recently highlighted as key to reduce the societal impacts of extreme weather events under climate change, but there is a lack of studies assessing to what extent parental education may prevent post-flood child undernutrition. Methods and Materials. One year after large floods in 2008, we conducted a two-stage cluster population-based survey of 6-59 months children inhabiting flooded and non-flooded communities of Jagatsinghpur district, Odisha (India), and collected anthropometric measurements on children along with child, parental and household level variables through face-to-face interviews. Using multivariate logistic regression models, we examined separately the effect of maternal and paternal education and other risk factors (mainly income, socio-demographic, and child and mother variables) on stunting and wasting in children from households inhabiting recurrently flooded communities (2006 and 2008; n = 299). As a comparison, separate analyses on children in non-flooded communities were carried out (n = 385). All analyses were adjusted by income as additional robustness check. Results. Overall, fathers with at least completed middle education (up to 14 years of age and compulsory in India) had an advantage in protecting their children from child wasting and stunting. For child stunting, the clearest result was a 100-200% lower prevalence associated with at least paternal secondary schooling (compared to no schooling) in flooded-areas. Again, only in flooded communities, an increase in per capita annual household income of 1,000 rupees was associated to a 4.7-4.9% lower prevalence of child stunting. For child wasting in flooded areas, delayed motherhood was associated to better nutritional outcomes (3.4% lower prevalence per year). In flooded communities, households dedicated to activities other than agriculture, a 50-51% lower prevalence of child wasting was estimated, suggesting farmers and fishermen as the most vulnerable livelihoods under flooding. In flooded areas, lower rank castes were at higher odds of both child wasting and stunting. Conclusions. In the short-term, protracted nutritional response in the aftermath of floods should be urgently implemented and target agricultural livelihoods and low-rank castes. Education promotion and schooling up to 14 years should have positive impacts on improving children nutritional health in the long run, especially under flooding. Policies effectively helping sustainable livelihood economic development and delayed motherhood are also recommended.
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Affiliation(s)
- Jose Manuel Rodriguez-Llanes
- Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université Catholique de Louvain , Brussels , Belgium
| | - Shishir Ranjan-Dash
- Department of Management, Siksha 'O' Anusandhan University, Bhubaneswar, India; Tata Trusts, Mumbai, India
| | | | - Debarati Guha-Sapir
- Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université Catholique de Louvain , Brussels , Belgium
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Rodriguez-Llanes JM, Ranjan-Dash S, Mukhopadhyay A, Guha-Sapir D. Flood-Exposure is Associated with Higher Prevalence of Child Undernutrition in Rural Eastern India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:210. [PMID: 26861372 PMCID: PMC4772230 DOI: 10.3390/ijerph13020210] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 02/02/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Child undernutrition and flooding are highly prevalent public health issues in Asia, yet epidemiological studies investigating this association are lacking. METHODS To investigate to what extent floods exacerbate poor nutritional status in children and identify most vulnerable groups, we conducted a population-based survey of children aged 6-59 months inhabiting flooded and non-flooded communities of the Jagatsinghpur district, Odisha (India), one year after large floods in 2008. Anthropometric measurements on 879 children and child, parental and household level variables were collected through face-to-face interviews in September 2009. The association between flooding and the prevalence of wasting, stunting and underweight was examined using weighted multivariate logistic regression for children inhabiting communities exposed solely to floods in 2008 and those communities repeatedly flooded (2006 and 2008) controlling for parental education and other relevant variables. We examined the influence of age on this association. Propensity score matching was conducted to test the robustness of our findings. RESULTS The prevalence of wasting among children flooded in 2006 and 2008 was 51.6%, 41.4% in those flooded only in 2008, and 21.2% in children inhabiting non-flooded communities. Adjusting by confounders, the increased prevalence relative to non-flooded children in the exposed groups were 2.30 (adjusted prevalence ratio (aPR); 95% CI: 1.86, 2.85) and 1.94 (95% CI: 1.43, 2.63), respectively. Among repeatedly flooded communities, cases of severe wasting in children were 3.37 times more prevalent than for children inhabiting in those non-flooded (95% CI: 2.34, 4.86) and nearly twice more prevalent relative to those flooded only once. Those children younger than one year during previous floods in 2006 showed the largest difference in prevalence of wasting compared to their non-flooded counterparts (aPR: 4.01; 95% CI: 1.51, 10.63). RESULTS were robust to alternative adjusted models and in propensity score matching analyses. For similar analyses, no significant associations were found for child stunting, and more moderate effects were observed in the case of child underweight. CONCLUSIONS Particularly in low-resource or subsistence-farming rural settings, long-lasting nutritional response in the aftermath of floods should be seriously considered to counteract the long-term nutritional effects on children, particularly infants, and include their mothers on whom they are dependent. The systematic monitoring of nutritional status in these groups might help to tailor efficient responses in each particular context.
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Affiliation(s)
- Jose Manuel Rodriguez-Llanes
- Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université catholique de Louvain, Brussels 1200, Belgium.
| | - Shishir Ranjan-Dash
- Department of Management, Siksha 'O' Anusandhan University, Bhubaneswar 751003, India.
- Tata Trusts, Mumbai 400001, India.
| | | | - Debarati Guha-Sapir
- Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université catholique de Louvain, Brussels 1200, Belgium.
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Akerkar S. Development of a normative framework for disaster relief: learning from colonial famine histories in India. DISASTERS 2015; 39 Suppl 2:219-243. [PMID: 26395110 DOI: 10.1111/disa.12155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Contemporary academic debates on the history of the colonial Famine Codes in India--also considered to be the first coded and institutionalised normative frameworks for natural disaster response on the continent--generally are based on one of two perspectives. The first focuses on their economic rationale, whereas the second underlines that they constitute an anti-famine contract between the colonial masters and the people of India. This paper demonstrates that both of these viewpoints are limited in scope and that they simplify the nature of governance instituted through famine response practices in Colonial India. It links this reality to current disaster response policies and practices in India and shows that the discussion on the development of normative frameworks underlying disaster response is far from over. The paper goes on to evaluate the development of normative frameworks for disaster response and recovery, which remain embroiled in the politics of governmentality that underlies their development.
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Affiliation(s)
- Supriya Akerkar
- Senior Lecturer in Disaster Risk Reduction, Oxford Brookes University, United Kingdom
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Systematic review of current efforts to quantify the impacts of climate change on undernutrition. Proc Natl Acad Sci U S A 2015. [PMID: 26216952 DOI: 10.1073/pnas.1409769112] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Malnutrition is a challenge to the health and productivity of populations and is viewed as one of the five largest adverse health impacts of climate change. Nonetheless, systematic evidence quantifying these impacts is currently limited. Our aim was to assess the scientific evidence base for the impact of climate change on childhood undernutrition (particularly stunting) in subsistence farmers in low- and middle-income countries. A systematic review was conducted to identify peer-reviewed and gray full-text documents in English with no limits for year of publication or study design. Fifteen manuscripts were reviewed. Few studies use primary data to investigate the proportion of stunting that can be attributed to climate/weather variability. Although scattered and limited, current evidence suggests a significant but variable link between weather variables, e.g., rainfall, extreme weather events (floods/droughts), seasonality, and temperature, and childhood stunting at the household level (12 of 15 studies, 80%). In addition, we note that agricultural, socioeconomic, and demographic factors at the household and individual levels also play substantial roles in mediating the nutritional impacts. Comparable interdisciplinary studies based on primary data at a household level are urgently required to guide effective adaptation, particularly for rural subsistence farmers. Systemization of data collection at the global level is indispensable and urgent. We need to assimilate data from long-term, high-quality agricultural, environmental, socioeconomic, health, and demographic surveillance systems and develop robust statistical methods to establish and validate causal links, quantify impacts, and make reliable predictions that can guide evidence-based health interventions in the future.
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Nouri Saeidlou S, Babaei F, Ayremlou P. Children malnutrition in northwestern, central and southern regions of Iran: does geographic location matter? Glob J Health Sci 2014; 6:36-41. [PMID: 24999126 PMCID: PMC4825249 DOI: 10.5539/gjhs.v6n4p36] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 02/26/2014] [Accepted: 02/10/2014] [Indexed: 11/21/2022] Open
Abstract
Introduction: Malnutrition is one of the most important morbidity and mortality causes in children. In comparison with healthy children malnourished children are at higher risk of illness and death as 60 percent of more than 7 million deaths in children aged less than five years are attributed to the malnutrition. The present study is intended to determine the prevalence of malnutrition in West Azerbaijan and compare with Kermanshah and Isfahan provinces. Materials and Methods: The current survey is a cross-sectional study which is conducted with the aim of determining the nutritional status of children aged less than five years in three West Azerbaijan, Kermanshah and Isfahan provinces using ENA software and has been performed since 16th until 30th October, 2011 with the cooperation of the Office of Community Nutrition Improvement and the United Nations Children’s Fund (UNICEF). Research data are collected by questionnaire and according WHO index, percentage of children with malnutrition (underweight, wasting, stunting) were calculated. Chi-square test was used to assess the relationship between variables and malnutrition. Results: The rate of underweight, stunting, and wasting in West Azerbaijan was 2.3%, 7.3% and 1.4%, respectively. Wasting rate in boys was higher than in girls while stunting and underweight were more common in girls but differences were not significant. Results showed that the percentage prevalence of stunting in rural areas was higher than in urban areas, and this difference was significant. (p<0.03) prevalence of overweight in West Azarbijan, Kermanshah and Isfahan was 5.1%, 4.5% and 3.7%, respectively. Also, Prevalence of obesity in West Azarbijan, Kermanshah and Isfahan was 1.3%, 0.7% and 0.1%, respectively. Conclusion: Given the differences between various provinces and regions of the country which are as a result of the differences between the levels of development in these areas, the necessity of designing and implementing targeted strategies are required for different areas.
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Affiliation(s)
| | | | - Parvin Ayremlou
- Food and Beverage Safety Research Center, Urmia University of Medical Science, Urmia, Iran.
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Affiliation(s)
- Jennifer Leaning
- From the François-Xavier Bagnoud Center for Health and Human Rights, Harvard School of Public Health, Boston (J.L.); and the World Health Organization Collaborating Center for Research on the Epidemiology of Disasters, Institute of Health and Society, University of Louvain, Brussels (D.G.-S.)
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