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Khalifa AFM, Ahmed NSAM, Alhomida BAS, Abdu HM, Al-Musa HH, Al-Jarboua MKO, Bahamdan MAA, Al-Ahdal AY, Aljenid OZZ, Althebaity FYM, Nagshabandi AS. Children's body mass index and associated factors in Riyadh, Saudi Arabia. Sudan J Paediatr 2024; 24:41-48. [PMID: 38952622 PMCID: PMC11214785 DOI: 10.24911/sjp.106-1673352071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/20/2023] [Indexed: 07/03/2024]
Abstract
Twenty million children under 5 years old are estimated to suffer from malnutrition worldwide. The objective of this study is to determine factors associated with Riyadh children's nutritional status. An institutional-based cross-sectional study was conducted among children aged 6-12, excluding mentally ill children. The sample size was 200. Data were collected through interview-administered questionnaires developed for this study's purpose after consulting relevant literature and epidemiologists. Data analysis was via SPSS version-23; a p-value of 0.05 or less is considered significant. Consent was obtained before data collection, emphasizing confidentiality and the participant's rights to withdraw from the study at any time. Most of the study respondents in the age group (6-12 years) were 12 years (22%), and the predominant gender were girls (55.5%). No significant statistical relationship existed between the mother's education and the children's body mass index (BMI, p = 0.168). Many respondents had a normal BMI (40.5%), while a minority were underweight (28.5%) among all groups. There was a significant statistical relationship between the BMI of the children and with mother's BMI (p = 0.016). There was no significant statistical relationship between the food source and children's BMI (p = 0.710). There was no significant statistical relationship between the average meal and the children's BMI (p = 0.098). There is a significant relationship between the BMI of the respondents and the mother's BMI under the underweight group.
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Affiliation(s)
- Amar Fathi Mohamed Khalifa
- Assistant Professor of Community Medicine, College of Medicine, AlMareefa University, Ad Diriyah, Saudi Arabia
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Rawat S, Bhate K, Yadav A. "Silent sufferers: A study of domestic violence among pregnant women attending the ANC OPD at a Primary Health Care Centre". J Family Med Prim Care 2021; 10:232-236. [PMID: 34017732 PMCID: PMC8132773 DOI: 10.4103/jfmpc.jfmpc_1157_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/08/2020] [Accepted: 09/16/2020] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Domestic violence against women is one of the most pervasive abuses of human rights in the world. Violence during pregnancy leads to both acute injuries and profound long-term challenges to health and wellbeing. Pregnancy provides a good opportunity for healthcare personal to screen women for domestic violence. AIM To identify the pattern of domestic violence amongst pregnant women and to plan appropriate interventions. SETTINGS AND DESIGN This cross-sectional study was carried out at Primary Health Care Centre. METHODS AND MATERIAL 90 pregnant women attending the ANC OPD and fulfilling the inclusion criteria were interviewed using a semi-structured questionnaire. Data were compiled and analyzed using SPSS version 24. Percentages were calculated and Chi-square test was used wherever applicable. RESULTS Violence was mostly seen in the women who were married for five years (47.36%) and many among them experienced it within one year of marriage (34.28%). The most common violence faced by the women was verbal violence (44.73%), followed by financial violence (27.63%). Physical violence was experienced by 22.36% women. The Perceived risk factor for violence was mostly addiction of spouse in 26.31% of women and insufficient dowry and demand for male child in 19.73%. CONCLUSIONS As occurrence of violence was found to be significantly associated with duration of marriage, educational status, and earning status of women asking about intimate partner violence should be a part of routine antenatal care for early detection and identification of cases, their counseling, and appropriate interventions.
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Affiliation(s)
- Shalini Rawat
- Department of Community Medicine, Seth G.S. Medical College & KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Kamaxi Bhate
- Department of Community Medicine, Seth G.S. Medical College & KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Ashwini Yadav
- Department of Community Medicine, Seth G.S. Medical College & KEM Hospital, Parel, Mumbai, Maharashtra, India
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Das S, Chanani S, Shah More N, Osrin D, Pantvaidya S, Jayaraman A. Determinants of stunting among children under 2 years in urban informal settlements in Mumbai, India: evidence from a household census. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2020; 39:10. [PMID: 33246506 PMCID: PMC7693500 DOI: 10.1186/s41043-020-00222-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 11/19/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND There is limited evidence on the determinants of childhood stunting across urban India or specifically in slum settlements. This study aims to assess the extent of stunting among children under 2 years of age and examine its determinants in informal settlements of Mumbai. METHODS Data were collected in 2014-2015 in a post intervention census of a cluster randomized controlled trial to improve the health of women and children. Census covered 40 slum settlements of around 600 households each. A total of 3578 children were included in the study. Mixed effects logistic regression models were used to identify factors associated with stunting. RESULTS The prevalence of stunting among children aged 0-23 months was 38%. In the adjusted model, higher maternal education (AOR 0.59; 95% CI 0.42, 0.82), birth interval of at least 2 years (AOR 0.71; 95% CI 0.58, 0.87) and intended conception of the child (AOR 0.80; 95% CI 0.64, 0.99) were associated with lower odds of stunting. Maternal exposure to physical violence (AOR 1.83; 95% CI 1.21, 2.77) was associated with higher odds of being stunted. A child aged 18-23 months had 5.04 times greater odds (95% CI 3.91, 6.5) of being stunted than a child less than 6 months of age. Male child had higher odds of being stunted (AOR 1.33; 95% CI 1.14, 1.54). CONCLUSIONS Our findings support a multidimensional aetiology for stunting. The results of the study emphasize the importance of women's status and decision-making power in urban India, along with access to and uptake of family planning and services to provide support for survivors of domestic violence. Ultimately, a multilateral effort is needed to ensure the success of nutrition-specific interventions by focusing on the underlying health and social status of women living in urban slums. TRIAL REGISTRATION ISRCTN Register: ISRCTN56183183 , and Clinical Trials Registry of India: CTRI/2012/09/003004.
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Affiliation(s)
- Sushmita Das
- Society for Nutrition, Education and Health Action, Behind Bldg. No. 11, BMC Colony, Shastri Nagar, Santa Cruz (W), Mumbai, 400 054, India.
| | - Sheila Chanani
- Society for Nutrition, Education and Health Action, Behind Bldg. No. 11, BMC Colony, Shastri Nagar, Santa Cruz (W), Mumbai, 400 054, India
| | - Neena Shah More
- Society for Nutrition, Education and Health Action, Behind Bldg. No. 11, BMC Colony, Shastri Nagar, Santa Cruz (W), Mumbai, 400 054, India
| | - David Osrin
- UCL Institute for Global Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - Shanti Pantvaidya
- Society for Nutrition, Education and Health Action, Behind Bldg. No. 11, BMC Colony, Shastri Nagar, Santa Cruz (W), Mumbai, 400 054, India
| | - Anuja Jayaraman
- Society for Nutrition, Education and Health Action, Behind Bldg. No. 11, BMC Colony, Shastri Nagar, Santa Cruz (W), Mumbai, 400 054, India
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Athavale P, Hoeft K, Dalal RM, Bondre AP, Mukherjee P, Sokal-Gutierrez K. A qualitative assessment of barriers and facilitators to implementing recommended infant nutrition practices in Mumbai, India. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2020; 39:7. [PMID: 32718334 PMCID: PMC7385866 DOI: 10.1186/s41043-020-00215-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/25/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Childhood malnutrition has been a longstanding crisis in Mumbai, India. Despite national IYCF (Infant Young Child Feeding) guidelines to promote best practices for infant/toddler feeding, nearly one-third of children under age five are stunted or underweight. To improve child nutrition, interventions should address the cultural, social, and environmental influences on infant feeding practices. This study is an in-depth qualitative assessment of family barriers and facilitators to implementing recommended nutrition practices in two Mumbai slum communities, within the context of an existing nutrition education-based intervention by a local non-governmental non-profit organization. METHODS The population was purposively sampled to represent a variety of household demographics. Data were collected through 33 in-depth semi-structured interviews with caregivers (mothers and paternal grandmothers) of children age 0-2 years. Transcripts were translated and transcribed, and analyzed using qualitative analysis procedures and software. RESULTS A complex set of barriers and facilitators influence mothers'/caregivers' infant-toddler feeding practices. Most infants were fed complementary foods and non-nutritious processed snacks, counter to IYCF recommendations. Key barriers included: lack of nutrition knowledge and experience, receiving conflicting messages from different sources, limited social support, and poor self-efficacy for maternal decision-making. Key facilitators included: professional nutrition guidance, personal self-efficacy and empowerment, and family support. Interventions to improve child nutrition should address mothers'/caregivers' key barriers and facilitators to recommended infant-toddler feeding practices. CONCLUSIONS Nutrition interventions should prioritize standard messaging across healthcare providers, engage all family members, target prevention of early introduction of sugary and non-nutritious processed foods, and strengthen maternal self-efficacy for following IYCF recommended guidelines.
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Affiliation(s)
| | - Kristin Hoeft
- Department of Preventive & Restorative Dental Sciences and Center to Address Children’s Oral Health, University of California, San Francisco, USA
| | - Rupal M. Dalal
- Foundation for Mother & Child Health, 93/C Kamgar Nagar, SG Barve Marg, Kurla East, Mumbai, Maharashtra 400024 India
| | - Ameya P. Bondre
- New Horizons Health and Research Foundation (NHF), Unit No 10, Techniplex II, Veer Savarkar Flyover Bridge, Off S V Road, Opposite Hotel Grand Sarovar, Goregaon West, Mumbai, 400062 India
| | - Piyasree Mukherjee
- Foundation for Mother & Child Health, 93/C Kamgar Nagar, SG Barve Marg, Kurla East, Mumbai, Maharashtra 400024 India
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Huey SL, Finkelstein JL, Venkatramanan S, Udipi SA, Ghugre P, Thakker V, Thorat A, Potdar RD, Chopra HV, Kurpad AV, Haas JD, Mehta S. Prevalence and Correlates of Undernutrition in Young Children Living in Urban Slums of Mumbai, India: A Cross Sectional Study. Front Public Health 2019; 7:191. [PMID: 31355176 PMCID: PMC6639755 DOI: 10.3389/fpubh.2019.00191] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 06/24/2019] [Indexed: 02/04/2023] Open
Abstract
Background: Young children living in urban slums are vulnerable to malnutrition and subsequently poor health outcomes, but data on the correlates of stunting, underweight, wasting, and anemia specifically among 10-18 month-old children in India remain limited. Objective: In this analysis, we sought to describe the prevalence of and examine correlates for different markers of undernutrition, including stunting, underweight, and anemia among 10-18 month-old children living in urban slums, an understudied vulnerable group. Methods: Children and their mothers (n = 323) were screened for anthropometry, demographics, and complete blood counts for hemoglobin concentration between March and November 2017 (Clinicaltrials.gov ID: NCT02233764). Correlates included child and mother's age, sex, birth order, birth weight, illness episodes, hemoglobin concentration, family income, maternal height, and maternal education level. Risk ratios (RR, 95% CI) for binary outcomes (stunting, underweight, wasting and anemia) and mean differences (β, 95% CI) for continuous outcomes (anthropometric Z-scores, hemoglobin concentration) were calculated using multivariate binomial and linear regression (SAS 9.4). Results: The prevalence of stunting was 31.2%, underweight 25.1%, wasting (9.0%), and anemia (76%) among all children. Male children had a higher prevalence of poor growth indices and lower anthropometric Z-scores than females. Male sex, low birthweight, shorter maternal height, report of ≥1 episodes of illness within the past month, older maternal age, and birth order ≥2 were also associated with poor growth and anemia in multivariate models. Correlates of undernutrition were different among females and males. Female children had a 40% (20, 60%) higher risk of anemia associated with diarrhea, and male children who were firstborn had a 20% (0, 70%) lower risk of anemia. Conclusions: These results show that poor growth and anemia among young children is prevalent in urban slums of Mumbai, and that sex of the child may play an important role in informing interventions to address undernutrition.
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Affiliation(s)
- Samantha Lee Huey
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - Julia Leigh Finkelstein
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
- Institute for Nutritional Sciences, Global Health, and Technology (INSIGHT), Cornell University, Ithaca, NY, United States
| | - Sudha Venkatramanan
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - Shobha A. Udipi
- Department of Nutrition and Food Science, SNDT Women's University, Mumbai, India
| | - Padmini Ghugre
- Department of Nutrition and Food Science, SNDT Women's University, Mumbai, India
| | - Varsha Thakker
- Department of Nutrition and Food Science, SNDT Women's University, Mumbai, India
| | - Aparna Thorat
- Department of Nutrition and Food Science, SNDT Women's University, Mumbai, India
| | | | | | - Anura V. Kurpad
- Department of Physiology, St. John's Research Institute, Bangalore, India
| | - Jere Douglas Haas
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
- Institute for Nutritional Sciences, Global Health, and Technology (INSIGHT), Cornell University, Ithaca, NY, United States
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Abdi S, Wadugodapitiya A, Bedaf S, George CE, Norman G, Hawley M, de Witte L. Identification of priority health conditions for field-based screening in urban slums in Bangalore, India. BMC Public Health 2018; 18:309. [PMID: 29499698 PMCID: PMC5833095 DOI: 10.1186/s12889-018-5194-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 02/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urban slums are characterised by unique challenging living conditions, which increase their inhabitants' vulnerability to specific health conditions. The identification and prioritization of the key health issues occurring in these settings is essential for the development of programmes that aim to enhance the health of local slum communities effectively. As such, the present study sought to identify and prioritise the key health issues occurring in urban slums, with a focus on the perceptions of health professionals and community workers, in the rapidly growing city of Bangalore, India. METHODS The study followed a two-phased mixed methods design. During Phase I of the study, a total of 60 health conditions belonging to four major categories: - 1) non-communicable diseases; 2) infectious diseases; 3) maternal and women's reproductive health; and 4) child health - were identified through a systematic literature review and semi-structured interviews conducted with health professionals and other relevant stakeholders with experience working with urban slum communities in Bangalore. In Phase II, the health issues were prioritised based on four criteria through a consensus workshop conducted in Bangalore. RESULTS The top health issues prioritized during the workshop were: diabetes and hypertension (non-communicable diseases category), dengue fever (infectious diseases category), malnutrition and anaemia (child health, and maternal and women's reproductive health categories). Diarrhoea was also selected as a top priority in children. These health issues were in line with national and international reports that listed them as top causes of mortality and major contributors to the burden of diseases in India. CONCLUSIONS The results of this study will be used to inform the development of technologies and the design of interventions to improve the health outcomes of local communities. Identification of priority health issues in the slums of other regions of India, and in other low and lower middle-income countries, is recommended.
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Affiliation(s)
- Sarah Abdi
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, The Innovation Centre, 217 Portobello, Sheffield, S1 4DP UK
| | - Avanti Wadugodapitiya
- Zuyd University of Applied Sciences, Nieuw Eyckholt 300, 6419 DJ Heerlen, Netherlands
| | - Sandra Bedaf
- Zuyd University of Applied Sciences, Nieuw Eyckholt 300, 6419 DJ Heerlen, Netherlands
| | | | - Gift Norman
- Bangalore Baptist Hospital, Bellary Road, Hebbal, Bengaluru, Karnataka 560024 India
| | - Mark Hawley
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, The Innovation Centre, 217 Portobello, Sheffield, S1 4DP UK
| | - Luc de Witte
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, The Innovation Centre, 217 Portobello, Sheffield, S1 4DP UK
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Salge AKM, Rocha ÉL, Gaíva MAM, Castral TC, Guimarães JV, Xavier RM. Foot length measurements of newborns of high and low risk pregnancies. Rev Esc Enferm USP 2017; 51:e03200. [PMID: 28300963 DOI: 10.1590/s1980-220x2016016703200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 12/12/2016] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE Comparing foot length measurements of newborns in high and low risk pregnancies at a public hospital in Goiânia, GO, Brazil. METHOD A cross-sectional study carried out between April, 2013 and May, 2015, with a sample consisting of 180 newborns; 106 infants of women from high-risk pregnancies and 74 of women from low-risk pregnancies. Data were descriptively analyzed. Foot length measurement was performed using a stiff transparent plastic ruler, graduated in millimeters. The length of both feet was measured from the tip of the hallux (big toe) to the end of the heel. RESULTS A statistically significant relationship was found between the foot length and newborn's weight, between the cephalic and thoracic perimeters in the high-risk group and between the cephalic perimeter in the control group. CONCLUSION There is a need for creating cut-off points to identify newborns with intrauterine growth disorders using foot length. OBJETIVO Comparar as medidas do comprimento hálux-calcâneo de recém-nascidos em gestações de alto e baixo risco em um hospital público de Goiânia, GO. MÉTODO Estudo transversal, realizado no período de abril de 2013 a maio de 2015, cuja amostra constituiu-se de 180 recém-nascidos, 106 filhos de mulheres com gestação de alto risco e 74 de mulheres com gestação de baixo risco. Os dados foram analisados descritivamente. A medida do comprimento hálux-calcâneo foi realizada utilizando-se de régua plástica transparente rígida, graduada em milímetros. Foram medidos ambos os pés, aferindo-se o comprimento da ponta do hálux até a extremidade do calcâneo. RESULTADOS Foi encontrada relação estatisticamente significante entre o comprimento hálux-calcâneo e o peso do recém-nascido, entre os perímetros cefálico e torácico no grupo de alto risco e entre o perímetro cefálico no grupo controle. CONCLUSÃO Existe necessidade da criação de pontos de corte para identificar recém-nascidos com desvios de crescimento intrauterino utilizando-se do comprimento hálux-calcâneo. OBJETIVO Comparar las mediciones de la longitud hallux-calcáneo de los recién nacidos en embarazos de alto y bajo riesgo en un hospital público de Goiânia, GO.MÉTODOSEstudio transversal realizado de abril 2013 a mayo 2015, cuya muestra estuvo constituida por 180 recién nacidos, 106 de mujeres con embarazos de alto riesgo y 74 de mujeres con embarazos de bajo riesgo. Los datos se analizaron de manera descriptiva. La medida de la longitud hallux-calcáneo se realizó mediante regla de plástico rígido transparente, graduada en milímetros. Se midieron en ambos pies, las longitudes de la punta del hallux hasta el final del calcáneo. RESULTADOS Se encontró una relación estadísticamente significativa entre la longitud hallux-calcáneo y el peso del recién nacido, entre las circunferencias cefálica y torácica en el grupo de alto riesgo y entre la circunferencia cefálica en el grupo control. CONCLUSIÓN Existe la necesidad de crear puntos de corte para identificar los recién nacidos con desviaciones de crecimiento intrauterino utilizando la longitud desde el hallux hasta el calcáneo.
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Affiliation(s)
| | - Érika Lopes Rocha
- Universidade Federal de Goiás, Programa de Pós-Graduação em Enfermagem, Goiânia, GO, Brazil
| | | | | | | | - Raphaela Maioni Xavier
- Universidade Federal de Goiás, Programa de Pós-Graduação em Enfermagem, Goiânia, GO, Brazil
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How does poverty affect children's nutritional status in Nairobi slums? A qualitative study of the root causes of undernutrition. Public Health Nutr 2016; 20:608-619. [PMID: 27645101 PMCID: PMC5468798 DOI: 10.1017/s1368980016002445] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective Children in slums are at high risk of undernutrition, which has long-term negative consequences on their physical growth and cognitive development. Severe undernutrition can lead to the child’s death. The present paper aimed to understand the causes of undernutrition in children as perceived by various groups of community members in Nairobi slums, Kenya. Design Analysis of ten focus group discussions and ten individual interviews with key informants. The main topic discussed was the root causes of child undernutrition in the slums. The focus group discussions and key informant interviews were recorded and transcribed verbatim. The transcripts were coded in NVivo by extracting concepts and using a constant comparison of data across the different categories of respondents to draw out themes to enable a thematic analysis. Setting Two slum communities in Nairobi, Kenya. Subjects Women of childbearing age, community health workers, elders, leaders and other knowledgeable people in the two slum communities (n 90). Results Participants demonstrated an understanding of undernutrition in children. Conclusions Findings inform target criteria at community and household level that can be used to identify children at risk of undernutrition. To tackle the immediate and underlying causes of undernutrition, interventions recommended should aim to: (i) improve maternal health and nutrition; (ii) promote optimal infant and young children feeding practices; (iii) support mothers in their working role; (iv) increase access to family planning; (v) improve water, sanitation and hygiene (WASH); (vi) address alcohol problems at all levels; and (vii) address street food issues with infant feeding counselling.
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Krishna A, Fink G, Berkman LF, Subramanian SV. Short- and long-run associations between birth weight and children's height. ECONOMICS AND HUMAN BIOLOGY 2016; 21:156-166. [PMID: 26922363 DOI: 10.1016/j.ehb.2016.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 06/05/2023]
Abstract
Much evidence suggests that the 1000 days spanning from conception to children's second birthdays are critical for physical development. Whether influence of the exposures occurring during this window lasts later in life is unclear. Our study investigates changes in associations between birth weight and height, one measure of physical development, over different life-stages and whether greater household wealth promotes better growth for low birth weight (LBW) children. Using longitudinal data from Young Lives, we analyzed associations between birth weight and physical growth and examined differences across ages and by household wealth for 3999 children from Ethiopia, India, Peru, and Vietnam. At 6-18 months, LBW children had 0.53-SD (Standard error [SE]: 0.08) lower HAZ. Over time, the gap between normal and LBW children narrowed significantly to 0.21-SD (SE: 0.05) and 0.24-SD (SE: 0.05) at 4-5 years and 7-8 years, respectively. Prenatal experiences are most salient in establishing the greatest height deficits within the first year. Although disparities in height are reduced in the first year, height differences at age 4-5 years remain at 7-8 years of age. Even among wealthier families, there was no recovery in height for LBW children during the first year and no catch-up growth for these children in later childhood. These findings suggest that prenatal conditions, reflected in birth weight, are more important in setting height trajectories in comparison to postnatal factors, which do not help children recover fully from early growth deficits.
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Affiliation(s)
- Aditi Krishna
- Child Health Evaluative Sciences and Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada.
| | - Günther Fink
- Harvard T.H. Chan School of Public Health, Department of Global Health and Population, United States; Harvard T.H. Chan School of Public Health, Harvard Center for Population and Development Studies, United States
| | - Lisa F Berkman
- Harvard T.H. Chan School of Public Health, Department of Global Health and Population, United States; Harvard T.H. Chan School of Public Health, Harvard Center for Population and Development Studies, United States; Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, United States; Harvard T.H. Chan School of Public Health, Department of Epidemiology, United States
| | - S V Subramanian
- Harvard T.H. Chan School of Public Health, Harvard Center for Population and Development Studies, United States; Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, United States
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Singal AK, Jain VG. Maternal and infant characteristics influencing the anogenital distance and penile length in newborns. Andrologia 2015; 48:708-13. [PMID: 26666590 DOI: 10.1111/and.12507] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2015] [Indexed: 11/28/2022] Open
Abstract
Recent studies have suggested that maternal characteristics can affect reproductive health of offspring, possibly through pre-natal hormonal influence. Anogenital distance (AGD) is an anthropometric measure which is a sensitive reproductive endpoint of masculinisation. It provides a read-out of pre-natal androgen exposure and has been associated with several reproductive health outcomes in humans. We studied AGD and stretched penile length (SPL) in a large, racially homogenous sample of consecutive newborns to understand their association with maternal and infant characteristics. A prospective cross-sectional study involving measurement of AGD and SPL at birth was performed by a single trained observer. A total of 1077 newborns (553 males and 524 females) were included in final anthropometric analysis. The mean AGD of males was 2.56 ± 0.31 cm, and the mean AGD of females was 1.54 ± 0.17 cm. The mean SPL of males was 3.31 ± 0.38 cm. On multiple regression analysis, for both males and females, birthweight (β = 0.229, P < 0.001 and β = 0.135, P < 0.001, respectively) was modest but significant predictor for AGD. For SPL, only gestational age (β = 0.054, P < 0.001) was found to be statistically significant predictor. There was no significant association observed for gravidity, parity and maternal age with both AGD and SPL. Thus, no maternal characteristics (age, gravidity, parity) influence AGD or SPL in human infants.
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Affiliation(s)
- Arbinder Kumar Singal
- MITR Hospital & Hypospadias Foundation, Kharghar, Navi Mumbai, India.,Division of Pediatric Urology, MGM Medical College and MGM University of Health Sciences, Navi Mumbai, Maharashtra, India
| | - Viral G Jain
- MITR Hospital & Hypospadias Foundation, Kharghar, Navi Mumbai, India.,Department of Pediatrics, MetroHealth Medical Centre, Case Western Reserve University, Cleveland, OH, USA
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Bentley A, Das S, Alcock G, Shah More N, Pantvaidya S, Osrin D. Malnutrition and infant and young child feeding in informal settlements in Mumbai, India: findings from a census. Food Sci Nutr 2015; 3:257-71. [PMID: 25988001 PMCID: PMC4431794 DOI: 10.1002/fsn3.214] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/20/2015] [Accepted: 01/30/2015] [Indexed: 11/21/2022] Open
Abstract
Childhood malnutrition remains common in India. We visited families in 40 urban informal settlement areas in Mumbai to document stunting, wasting, and overweight in children under five, and to examine infant and young child feeding (IYCF) in children under 2 years. We administered questions on eight core WHO IYCF indicators and on sugary and savory snack foods, and measured weight and height of children under five. Stunting was seen in 45% of 7450 children, rising from 15% in the first year to 56% in the fifth. About 16% of children were wasted and 4% overweight. 46% of infants were breastfed within the first hour, 63% were described as exclusively breastfed under 6 months, and breastfeeding continued for 12 months in 74%. The indicator for introduction of solids was met for 41% of infants. Only 13% of children satisfied the indicator for minimum dietary diversity, 43% achieved minimum meal frequency, and 5% had a minimally acceptable diet. About 63% of infants had had sugary snacks in the preceding 24 h, rising to 78% in the second year. Fried and salted snack foods had been eaten by 34% of infants and 66% of children under two. Stunting and wasting remain unacceptably common in informal settlements in Mumbai, and IYCF appears problematic, particularly in terms of dietary diversity. The ubiquity of sugary, fried, and salted snack foods is a serious concern: substantial consumption begins in infancy and exceeds that of all other food groups except grains, roots, and tubers.
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Affiliation(s)
- Abigail Bentley
- UCL Institute for Global Health, Institute of Child Health 30 Guilford Street, London, WC1N 1EH, UK
| | - Sushmita Das
- SNEHA (Society for Nutrition, Education and Health Action), Urban Health Centre, Chota Sion Hospital 60 Feet Road, Shahunagar, Dharavi, Mumbai, 400017, Maharashtra, India
| | - Glyn Alcock
- UCL Institute for Global Health, Institute of Child Health 30 Guilford Street, London, WC1N 1EH, UK
| | - Neena Shah More
- SNEHA (Society for Nutrition, Education and Health Action), Urban Health Centre, Chota Sion Hospital 60 Feet Road, Shahunagar, Dharavi, Mumbai, 400017, Maharashtra, India
| | - Shanti Pantvaidya
- SNEHA (Society for Nutrition, Education and Health Action), Urban Health Centre, Chota Sion Hospital 60 Feet Road, Shahunagar, Dharavi, Mumbai, 400017, Maharashtra, India
| | - David Osrin
- UCL Institute for Global Health, Institute of Child Health 30 Guilford Street, London, WC1N 1EH, UK
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Slum living and hypertension in tropical settings: neglected issue, statistical artifact or surprisingly slight? Insights amidst adversity. J Hypertens 2013; 31:877-9. [PMID: 23552027 DOI: 10.1097/hjh.0b013e32836103fb] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Egata G, Berhane Y, Worku A. Seasonal variation in the prevalence of acute undernutrition among children under five years of age in east rural Ethiopia: a longitudinal study. BMC Public Health 2013; 13:864. [PMID: 24047474 PMCID: PMC3851835 DOI: 10.1186/1471-2458-13-864] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 09/16/2013] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Malnutrition is a deficiency state of both macro and micronutrients (under--nutrition) and their over consumption (over- nutrition) causing measurable adverse effects on human body structure and function, resulting in specific physical and clinical outcomes. Little has been known about the seasonal variation in the magnitude of acute child under-nutrition and its determinants in low and middle-income countries making difficult the choice of a better nutrition intervention. The objective of this study was to determine the prevalence of acute under-nutrition and its associated factors on children aged 6 to 36 months in east rural Ethiopia in wet and dry seasons. METHODS A longitudinal study was conducted on children aged 6 to 36 months and their mothers (mother-child pairs) from July/August 2010/2011 to January/ February 2011/2012 in east rural Ethiopia. Data were collected from 2,132 mother-child pairs using a pretested structured questionnaire and the UNICEF recommended anthropometric measuring instruments after standardization. The Odds Ratio with 95% confidence interval was estimated to identify the predictors of acute child under nutrition (wasting) using a conditional fixed- effects logistic regression. RESULTS The prevalence of acute child under-nutrition was 7.4%; 95% CI: (6.3%, 8.5%) in wet and 11. 2%; 95% CI: (9.8%, 12.5%) in dry seasons. Child wasting was more common among children of poor households who had no cooperative bank saving accounts [AOR (95% CI) = 8.2. (1.8, 37.6)], and access to health facilities [AOR (95% CI) = 2.2 (1.4, 3.6)]. CONCLUSION Acute child under-nutrition was relatively higher in the dry season. Although season was not significantly associated with child under--nutrition, poverty and poor access to health services were important predictors of wasting in the study setting. Thus, effective community-based nutrition interventions that require a multi--disciplinary approach should be scaled up to curb childhood under-nutrition.
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Affiliation(s)
- Gudina Egata
- Department of Public Health, College of Health Sciences, Haramaya University, P.O. Box: 235, Harar, Ethiopia
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Professor of Epidemiology and Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- Addis Continental Institute of Public Health, Professor of Epidemiology and Public Health, Addis Ababa, Ethiopia
- Department of Epidemiology and Biostatistics, School of Public Health, Doctor of Statistics Addis Ababa University, Addis Ababa, Ethiopia
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Developmental Functioning of Young Indian Children with Malnutrition. PSYCHOLOGICAL STUDIES 2013. [DOI: 10.1007/s12646-013-0194-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Jain VG, Singal AK. Shorter anogenital distance correlates with undescended testis: a detailed genital anthropometric analysis in human newborns. Hum Reprod 2013; 28:2343-9. [PMID: 23838161 DOI: 10.1093/humrep/det286] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
STUDY QUESTION Are the anogenital distance (AGD) and stretched penile length (SPL) shorter in human newborn males with cryptorchidism? SUMMARY ANSWER AGD is significantly shorter in boys with undescended testis (UDT) and this correlation may indicate that both have a common antecedent early in gestation. WHAT IS KNOWN ALREADY Animal studies have reported a critical time period during early gestation termed the male programming window (MPW) where androgen deficiency results in reduced AGD and penile length, as well as cryptorchidism and hypospadias. Two pilot human studies have explored this association but these studies were small and heterogeneous with regard to age, race and had selection bias. STUDY DESIGN, SIZE, DURATION A prospective descriptive study involving measurement of AGD and SPL at birth in a racially homogenous sample of 1154 consecutive newborns was performed over a period of 6 months. All measurements were taken by a single trained observer (V.J.). PARTICIPANTS/MATERIALS, SETTING, METHODS All consecutively born male infants at a community hospital were classified as having descended and or UDT. Testicular position in the undescended group was graded as high scrotal, inguinal or non-palpable. AGD (from the centre of anus to the junction of the smooth and rugated skin of scrotum) and SPL were measured. The AGD index (AGDi) was calculated by dividing AGD by cube root of birthweight. MAIN RESULTS AND THE ROLE OF CHANCE Of the 1154 infants examined, 624 were males and 71 had UDT. AGD was significantly shorter in infants with UDT when compared with infants with descended testis (mean ± SD; 2.21 ± 0.36 versus 2.56 ± 0.31 cm; P < 0.001). AGDi was also significantly shorter in infants with UDT (mean ± SD; 1.68 ± 0.27 versus 1.81 ± 0.20 cm/kg⁻³; P < 0.001). Significance was maintained even when preterm (P < 0.001) and low birthweight boys (LBW) (P < 0.001) were excluded. SPL was also significantly shorter in infants with UDT (Mean ± SD; 3.08 ± 0.52 versus 3.31 ± 0.38 cm; P < 0.001) but the significance was not maintained when preterm (P = 0.119) and LBW boys (P = 0.666) were excluded. Birthweight, gestational age and length adjusted regression models showed significantly shorter AGD in infants with UDT, but SPL was not different. Infants with higher position of testis appeared to have a shorter AGD and SPL but the correlation did not reach statistical significance. No difference in AGD or SPL was noted between boys with unilateral and bilateral UDT. LIMITATIONS, REASONS FOR CAUTION The present study did not include data pertaining to maternal or newborn health status. Also parental drug exposure or occupational exposures to endocrine-disrupting chemicals was not studied. These may possibly affect genital anthropometric measurements. WIDER IMPLICATIONS OF THE FINDINGS The study strengthens the hypothesis of existence of MPW in humans. Shorter AGD in cryptorchid infants may reflect the effect of androgen disruption or deficiency during MPW. AGD may be a more reliable non-invasive marker of androgen action during MPW than SPL to predict reproductive outcomes in humans.
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Affiliation(s)
- Viral G Jain
- Department of Paediatrics, MGM University of Health Sciences, Navi Mumbai, Maharashtra, India
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Ernst KC, Phillips BS, Duncan BD. Slums are not places for children to live: vulnerabilities, health outcomes, and possible interventions. Adv Pediatr 2013; 60:53-87. [PMID: 24007840 PMCID: PMC7112084 DOI: 10.1016/j.yapd.2013.04.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Kacey C Ernst
- Epidemiology, College of Public Health, University of Arizona, Tucson, AZ 85724, USA.
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