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Gebre T, Abraha Z, Zenebe A, Zeweld W. A comprehensive analysis of food insecurity in the drought-prone rural areas of Tigray. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:66. [PMID: 38755735 PMCID: PMC11097430 DOI: 10.1186/s41043-024-00564-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 05/05/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND The number of globally food-insecure people is increasing since 2017. Sub-Saharan Africa has the highest proportion of severely food-insecure people in the world. Tigray region of Ethiopia is one of the food-insecure regions, which, over the past many decades has been affected by recurrent food insecurities. In the drought-prone rural areas of Tigray, many people are living under the condition of chronic hunger. Proper food security studies are vital for proper intervention mechanisms. Yet, previous food security studies have rarely addressed the four pillars of food security: availability, access, utilization, and stability. In this study, all components are duly considered to assess the food insecurity status in the drought-prone rural areas of Tigray, Ethiopia. Of the 34 rural districts in Tigray, 363 households from three drought-prone rural districts were studied. RESULTS Household Food Insecurity Access Scale and Food Insecurity Experience Scale were adapted to measure the food availability, access to food, and stability components of food security; and, Household Dietary Diversity Score (HDDS), Food Consumption Score (FCS), mid-upper arm circumference, and Bitot's spot were used to analyze the food utilization aspect. Findings show that 68% of the studied community frequently ate less food than they felt they needed and 82.1% of the households have experienced hunger because of lack of food. The study rural districts were unconnected to road networks; hence, 87.9% of the elderly and 20.4% of the women and girls had no access to food markets. Regarding the food utilization, 81.5% of the studied households had poor FCS; and the average HDDS and FCS for the study areas were 2.47 and 18.9, respectively. The prevalence of Global acute malnutrition, severe acute malnutrition (SAM), and moderate acute malnutrition (MAM) for 6-59 months of age children in the study areas were 50.3, 4.2, and 46.1%, respectively. More notably, the prevalence of SAM for children from the food-insecure households was 21.2%. The prevalence of MAM for pregnant and lactating women (PLW) in the study areas was 59.5. Further, the prevalence of Bitot's spot among 6-59 months of age children was 1.9%. On the other hand, all the rural households had anxiety about their future food demands. CONCLUSION The rural households living in the studied areas were critically food-insecure. All the measurements implied that the food insecurity situation in the study areas was unacceptably worrisome and life-threatening. This calls for an instant action to avert the occurrence of famine and starvation in the drought-prone rural areas of Tigray region. Thus, interventions should primarily target the vulnerable rural people and need to be planned based on attaining food availability first rather than concurrently addressing all components of food security. Further, due emphasis should be given to diversifying livelihood strategies of the vulnerable villagers.
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Affiliation(s)
- Tewelde Gebre
- Mekelle University - Institute of Environment, Gender, and Development Studies (IEGDS), Mekelle City, Ethiopia.
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Yitayew YA, Yalew ZM, Nebiyu S, Jember DA. Acute malnutrition relapse and associated factors among 6-59 months old children treated in the community-based management of acute malnutrition in Dessie, Kombolcha, and Haik towns, Northeast Ethiopia. Front Public Health 2024; 11:1273594. [PMID: 38259754 PMCID: PMC10801196 DOI: 10.3389/fpubh.2023.1273594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Undernutrition is a major health concern in many developing countries, and is one of the main health problems affecting children in Ethiopia. Although many children experience multiple relapses following the management of severe acute malnutrition, it is scarcely studied in Ethiopia. Methods A community-based cross-sectional study was conducted in Dessie, Kombolcha, and Haik towns among 6-59-month-old children enrolled and discharged from community-based acute malnutrition management (CMAM). The total sample size was 318 children, and data were collected from April 15, 2021, to May 14, 2021. The data were entered into EPI data version 4.4.1 before being exported and analyzed with SPSS version 25 software. A multivariate logistic regression analysis was performed, and a 95% confidence interval and p-value <0.05 were used to identify significantly associated variables. Additionally, the weight-for-height z-score (WHZ) was generated using the WHO Anthro 3.2.2 software. Result The overall acute malnutrition relapse after discharge from CMAM was 35.2% (6.6% relapsed to severe acute malnutrition and 28.6% relapsed to moderate acute malnutrition). The following variables were significantly associated with the relapse of acute malnutrition: child age (AOR: 3.08, 95% CI; 1.76, 5.39), diarrhea after discharge (AOR: 2.93, 95%CI; 1.51, 5.69), have not immunized (AOR: 3.05, 95% CI; 1.14, 8.23), MUAC at discharge (AOR: 3.16, 95% CI; 1.56, 6.40), and poorest and poor wealth index (AOR: 3.65, 95% CI; 1.45, 9.18) and (AOR: 2.73, 95% CI; 1.13, 6.59), respectively. Conclusion Over one-third of children treated with the CMAM program reverted to SAM or MAM. The age of the child, diarrhea after discharge, lack of immunization, MUAC at discharge (<13 cm), and poor and poorest wealth index were significantly associated with acute malnutrition relapse. Therefore, adequate health education and counseling services are essential for mothers to improve child immunization coverage and maintain adequate hygiene to prevent diarrhea. In addition, further experimental research is needed to investigate the effect of MUAC at discharge on the risk of acute malnutrition relapse.
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Affiliation(s)
- Yibeltal Asmamaw Yitayew
- Department of Pediatric and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Zemen Mengesha Yalew
- Department of Comprehensive Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Samuel Nebiyu
- Department of Pediatric and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Desalegn Abebaw Jember
- Department of Pediatric Nursing, St. Paul Millennium Medical College, Addis Ababa, Ethiopia
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Gizaw AT, Sopory P, Sudhakar MN. Effectiveness of a positive deviance approach to improve appropriate feeding and nutritional status in South West Region, Ethiopia: A study protocol for a cluster randomized control trial. PLoS One 2024; 19:e0266151. [PMID: 38166090 PMCID: PMC10760826 DOI: 10.1371/journal.pone.0266151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/24/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Non-optimal infant and young child feeding practices (IYCFP) are linked to malnutrition and infant mortality in poor countries, notably in Ethiopia. The majority of growth stalls occur within the first two years of life; hence, there is a need to discover interventions that enhance appropriate IYCFP for improving nutritional outcomes during this critical period. Using the experience of mothers who have come up with solutions to their IYCFP problems to educate others, is a potential pathway to initiate and sustain behavioral changes in resource-limited areas. However, such interventions are not widely implemented in Ethiopia. OBJECTIVE This study aims to assess the effectiveness of a positive deviance approach (PDA) to improve appropriate feeding and nutritional status in South West region, Ethiopia. METHODS A cluster randomized controlled trial will be conducted to compare the effect of positive deviant intervention versus routine health education. The intervention will be provided by positive deviant mothers based on uncommon practices that potentially benefit IYCFP will be identified. Training of the trainers manual on counselling and supporting non-positive deviant mothers based on the uncommon practices identified and WHO IYCFP guidelines will be provided for facilitating change. Culturally appropriate and scientifically acceptable operational packages of information will be developed. A total of 516 mothers will be recruited from 36 zones. The intervention arm will receive 12 demonstration sessions in groups and every 15th day home visit by positive deviant mothers. Data will be entered into epi data version 3.1 and analyzed using STATA version 16.0. All analyses will be done as intention-to-treat. We will fit the mixed effects linear regression model for continuous outcomes and mixed effects linear probability model for the binary outcomes in the study zone as a random intercept to estimate study arm difference (intervention vs. routine health education) adjusted for the baseline values of the outcome and additional relevant covariates. DISCUSSION We expect that the trial will generate findings informing IYCFP and nutritional policies and practices in Ethiopia. TRIAL REGISTRATION This trial was registered at ClinicalTrials.gov as PACTR202108880303760, 30/8/2021.
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Affiliation(s)
- Abraham Tamirat Gizaw
- Faculty of Public Health,Department of Health, Behavior, and Society, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Pradeep Sopory
- Department of Communication, Wayne State University, Detroit, Michigan, United States of America
| | - Morankar N. Sudhakar
- Faculty of Public Health,Department of Health, Behavior, and Society, Institute of Health, Jimma University, Jimma, Ethiopia
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Chapagain R, Giri B, Bhattarai T, Dhungana J, Walters M, Damasco E, Blanco J, Ladas KD, Antoniades A, Ladas E. A cross-sectional study evaluating the prevalence and predictors of malnutrition among children and adolescents visiting an urban academic hospital in Nepal. Public Health Nutr 2023; 26:2738-2747. [PMID: 37811557 PMCID: PMC10755450 DOI: 10.1017/s136898002300188x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 08/17/2023] [Accepted: 08/29/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE To examine the prevalence of malnutrition among children and adolescents visiting Kanti Children’s Hospital (KCH) and identify predictors associated with malnutrition. Results will guide the development of a newly established nutrition programme at KCH. DESIGN This cross-sectional pilot study recruited children and adolescents over a 1-month period. Nutritional anthropometrics (height, weight and mid-upper arm circumference (MUAC)) and socio-demographic questionnaires were administered. Clinical data were abstracted from the medical chart. SETTING KCH in Kathmandu, Nepal. PARTICIPANTS 370 children and adolescents. RESULTS Most participants were male (65·1 %); mean age was 3·9 years (±3·4 years). The prevalence of stunting was 25·9 %, wasting was 17·3 % and 24·0 % when classified by BMI-for-age Z-score or MUAC, respectively. Two percent of participants were overweight. Notably, 32·1 % of children ≥5 years were classified with wasting based on MUAC-for-age Z-score, which is higher than that observed in children <5 (20·2 %). Food insecurity was reported among 58·2 % of children with stunting and 34·0 % with wasting. Chronic medical conditions predicted stunting and wasting. The lowest level of wealth predicted stunting, while ethnicity predicted wasting. Ethnicity and education level predicted food insecurity. CONCLUSIONS We found that the prevalence of stunting and wasting at KCH are higher than previously published studies in Nepal. Malnutrition persists beyond 5 years, and we identified several predictors of malnutrition. Increased provision of and access to clinical nutrition programmes is an essential need for KCH. Twinning programs that provide local clinicians with increased opportunities for education and mentorship of local staff remains a pressing need in Nepal.
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Affiliation(s)
- Ram Chapagain
- Department of Paediatrics, Kanti Children’s Hospital, National Academy of Medical Sciences (NAMS), Kathmandu, Nepal
| | - Bishnu Giri
- Oncology Unit, Kanti Children’s Hospital, Kathmandu, Nepal
| | - Tribhuwan Bhattarai
- Department of Paediatrics, Kanti Children’s Hospital, National Academy of Medical Sciences (NAMS), Kathmandu, Nepal
| | - Juna Dhungana
- Oncology Unit, Kanti Children’s Hospital, Kathmandu, Nepal
| | - Michelle Walters
- Division of Hematology/Oncology/Stem Cell Transplant, Department of Pediatrics, Columbia University, Irving Medical Centre, 3959 Broadway, CHN 10-06A, New York, NY10032, USA
| | - Erika Damasco
- Division of Hematology/Oncology/Stem Cell Transplant, Department of Pediatrics, Columbia University, Irving Medical Centre, 3959 Broadway, CHN 10-06A, New York, NY10032, USA
| | - Jessica Blanco
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Kyriaki D Ladas
- Aristotle University School of Medicine, Thessaloniki, Greece
| | | | - Elena Ladas
- Division of Hematology/Oncology/Stem Cell Transplant, Department of Pediatrics, Columbia University, Irving Medical Centre, 3959 Broadway, CHN 10-06A, New York, NY10032, USA
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Mishra M, Raghav A, Tripathi P, Rao YK, Singh DD. Evaluation of Micronutrients and Pro-Inflammatory Cytokines Levels in Nutritionally Deprived Children-A Tertiary Care Hospital-Based Study. Nutrients 2023; 15:4865. [PMID: 38068727 PMCID: PMC10707871 DOI: 10.3390/nu15234865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Severe acute malnutrition (SAM) is a significant public health problem in developing countries, including India, where a significant proportion of children suffer from malnutrition. OBJECTIVE This research aims to investigate the factors contributing to severe acute malnutrition (SAM). Additionally, the study seeks to explore the relationship between micronutrient levels and pro-inflammatory cytokines in SAM children with and without clinical complications. Furthermore, the effectiveness of antibiotic treatment in SAM children without complications is evaluated. METHODS The study involved three groups comprising 66 subjects each: a healthy control group, SAM children with complications, and SAM children without complications. Blood samples were collected, and various analyses were conducted, including biochemical, hematological, micronutrient, and pro-inflammatory marker quantification. The data were analyzed using SPSS version 22.0. RESULTS The results indicate that the levels of IL-6, CRP, and TNF-α were significantly higher in the SAM group with complications compared to both the control group and the SAM group without complications. Zinc and copper levels were significantly lower in both SAM groups compared to the control group, and a negative correlation was observed between zinc levels and inflammatory markers. The study also assessed the efficacy of antibiotic treatment in SAM children without complications by comparing their weight, height, weight-for-height, and weight-for-age at baseline and after a 15-day follow-up period. Significant improvements in these parameters were observed in both the group receiving antibiotic treatment and the group not receiving antibiotic treatment. CONCLUSION The findings suggest that a combination of antibiotic treatment and nutritional support can lead to significant clinical improvements in SAM children without complications. This study has important implications for the management and treatment of SAM in India and other developing countries.
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Affiliation(s)
- Malvika Mishra
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur 303002, India;
| | - Alok Raghav
- Department of Anatomy and Cell Biology, Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Republic of Korea;
| | - Prashant Tripathi
- Department of Biochemistry, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur 208002, India;
| | - Yashwant Kumar Rao
- Department of Pediatrics, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur 208002, India;
| | - Desh Deepak Singh
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur 303002, India;
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Saif S, Anwar S. Unraveling the South Asian enigma: concurrent manifestations of child anthropometric failures and their determinants in selected South Asian countries. BMC Nutr 2023; 9:120. [PMID: 37904239 PMCID: PMC10614331 DOI: 10.1186/s40795-023-00771-4] [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: 08/16/2022] [Accepted: 09/28/2023] [Indexed: 11/01/2023] Open
Abstract
Malnutrition among children is pervasive in South Asia and there are also reports of overnutrition. To better understand this phenomenon, we need a composite measure. However, the existing measures such as CIAF (Composite Index of Anthropometric Failure) and its revised version have ignored the overnutrition aspect of the phenomenon. This study proposes an extended version of CIAF which also considers overnutrition. This new measure was compared with the existing measures by using data from 1990 to 2018 for three selected South Asian countries including Pakistan, India and Bangladesh. We also examined the effects of socioeconomic and environmental variables on the outcome variable. The results reveal that the new measure (ECIAF) is better at measuring the phenomena. The burden of overall malnutrition has been decreased in the region. However, an increase in the concomitant prevalence of wasting and underweight is observed in both Pakistan and India and stunting and overweight is observed only in India. Besides, political stability, prevalence of undernourishment, anemia in children, mother's education, household size, dependency ratio, air pollution and unimproved sanitation are significantly correlated with childhood malnutrition. The findings also testified to long-run cointegrating relationship among the variables.
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Affiliation(s)
- Sabeen Saif
- Department of Economics, Government College University, Faisalabad, Pakistan.
| | - Sofia Anwar
- Department of Economics, Government College University, Faisalabad, Pakistan
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Jebero Z, Moga F, Gebremichael B, Tesfaye T. Determinants of Acute Malnutrition among Under-Five Children in Governmental Health Facilities in Sodo Town, Southern Ethiopia: Unmatched Case-Control Study. Int J Pediatr 2023; 2023:3882801. [PMID: 37497078 PMCID: PMC10368497 DOI: 10.1155/2023/3882801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/17/2023] [Accepted: 06/25/2023] [Indexed: 07/28/2023] Open
Abstract
Background Acute malnutrition is a major public health challenge among children globally. The burden is high in low-income countries like Ethiopia. Different reports and literatures revealed different risk factors of acute malnutrition in different geographical areas, but there were regional variations. So, the main aim of this study was to identify determinants of acute malnutrition among under-five children in governmental health facilities of Sodo town, Southern Ethiopia. Methods An institutional-based unmatched case-control study was conducted from February 1 to March 1, 2021. Consecutive sampling was used to select cases, and controls were selected using a systematic random sampling technique. An interviewer-administered structured questionnaire was used to collect data, and standardized anthropocentric measurement equipment was used to identify cases and controls. Data were analyzed using SPSS version 26. A logistic regression model was used to identify the determinants of acute malnutrition, and statistical significance was declared at P < 0.05. Result A total of 133 cases and 266 controls were included in the study making a response rate of 97.8%. Mothers with no formal education, birth interval less than 24 months, marital status (divorced widowed and separated), diarrhea in the past two weeks, using nonprotected water for drinking, exclusive breastfeeding less than 6 months, not taking sick children to health facility within 24 hours of the onset of any sickness, low birth weight, breastfeeding for less than 24 months, using nonimproved toilet, low dietary diversity, and food insecurity were significantly associated with acute malnutrition. Conclusion This study identified the major determinants of acute malnutrition among under-five children in the study area. Thus, ensuring safe water supply, empowering women, and improving knowledge and practices of mothers regarding exclusive breastfeeding and family planning are recommended.
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Affiliation(s)
- Zenebe Jebero
- College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Fikre Moga
- College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | | | - Tewodros Tesfaye
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Chowdhury MRK, Rahman MS, Billah B, Rashid M, Almroth M, Kader M. Prevalence and factors associated with severe undernutrition among under-5 children in Bangladesh, Pakistan, and Nepal: a comparative study using multilevel analysis. Sci Rep 2023; 13:10183. [PMID: 37349482 PMCID: PMC10287716 DOI: 10.1038/s41598-023-36048-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 05/28/2023] [Indexed: 06/24/2023] Open
Abstract
Despite economic growth and poverty reduction, under-5 child undernutrition is still rampant in South Asian countries. This study explored the prevalence and risk factors of severe undernutrition among under-5 children in Bangladesh, Pakistan, and Nepal for comparison using the Composite Index of Severe Anthropometric Failure. We utilised information on under-5 children from recent Demographic Health Surveys. We used multilevel logistic regression models for data analysis. The prevalence of severe undernutrition among under-5 children was around 11.5%, 19.8%, and 12.6% in Bangladesh, Pakistan, and Nepal, respectively. Children from the lowest socioeconomic quintile, and children born with low birth weight were key factors associated with severe undernutrition in these countries. The factors, parental education, maternal nutritional status, antenatal and postnatal care, and birth order were not homogeneous in explaining the determinants of child severe undernutrition across the countries. Our results suggest that the poorest households, and low birth weight of children have significant effects on severe undernutrition among under-5 children in these countries, which should be considered to formulate an evidence-based strategy to reduce severe undernutrition in South Asia.
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Affiliation(s)
- Mohammad Rocky Khan Chowdhury
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Md Shafiur Rahman
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, University of Fukui, Osaka, Japan
| | - Baki Billah
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Mamunur Rashid
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Gävle, Sweden
| | - Melody Almroth
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Manzur Kader
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
- Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Maria Aspmans Gata 30A, 17176, Stockholm, Sweden.
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Ghodsi D, Rasekhi H, Yari Z, Roustaee R, Nikooyeh B, Faramarzi A, Eini-Zinab H, Neyestani TR. Prediction and analysis of trends in the nutritional status of children under 5 years in Iran: reanalysis of the results of national surveys conducted between 1998 and 2020. Front Nutr 2023; 10:1083318. [PMID: 37252238 PMCID: PMC10213970 DOI: 10.3389/fnut.2023.1083318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/12/2023] [Indexed: 05/31/2023] Open
Abstract
Background and aim Malnutrition is a major public health problem, especially in developing countries. The aim of this study was to analyze the trend in malnutrition among children under 5 years of age in Iran over recent decades and to estimate malnutrition status for 2020. Methods This study took the form of a secondary analysis of the reports and data from three cross-sectional national surveys on children's nutritional status conducted between 1998 and 2017. Anthropometric indices, including markers of underweight, wasting, stunting, overweight, and obesity, were used as indicators of the nutritional status of children under 5 years. Malnutrition indicators are reported separately based on regional food security status. Linear mixed-effects modeling was used to predict the status of malnutrition indicators for 2020. Results The results of this study indicated a downward trend in the prevalence of stunting, underweight, and wasting, from 15.4 to 4.8%, 10.9 to 4.3%, and 4.9 to 4.3%, respectively, between 1998 and 2017. The proportion of children at risk of overweight and prevalence of childhood overweight/obesity showed a downward trend between 2010 and 2017, from 3.73 to 3.02% and from 12.1 to 10.3%, respectively. However, the trend varied between different provinces. Estimates of the prevalence of malnutrition in 2020 also indicated a decrease in the prevalence of all indicators among children. Conclusion Despite the decreasing trend in malnutrition over the past three decades, the prevalence of stunting, underweight, and wasting is still high in food-insecure provinces. Moreover, following the COVID-19 pandemic and its economic consequences, an increase in the prevalence of malnutrition, especially in food-insecure provinces, is plausible.
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Affiliation(s)
- Delaram Ghodsi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Rasekhi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Yari
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roshanak Roustaee
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahereh Nikooyeh
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Hassan Eini-Zinab
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tirang R. Neyestani
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Raru TB, Ayana GM, Merga BT, Negash B, Deressa A, Birhanu A, Hassen FA, Roba KT. Magnitude of under-nutrition among under five children in Ethiopia based on 2019 Mini-Ethiopia Demographic and Health Survey: Generalized Linear Mixed Model (GLMM). BMC Nutr 2022; 8:113. [PMID: 36253811 PMCID: PMC9575191 DOI: 10.1186/s40795-022-00598-5] [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: 01/18/2022] [Accepted: 09/06/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Malnutrition is a major public health problem that is experienced by many developing countries, like Ethiopia. Though some studies were conducted to identify the magnitude and determinants of acute malnutrition among under-five children, there is a lack of evidence that is representative of all children in Ethiopia. Hence, this national-level data could be representative of all targets and provide us with updated information on the nation-wide magnitude of nutritional status among children under the age of five in Ethiopia. METHODS This study used data from the 2019 Mini-Ethiopia Demographic and Health Survey (EDHS). Children aged 0-59 months with anthropometry data were included. Data processing and analysis were performed using STATA 15 software. Cross-tabulations and summary statistics were done to describe the study population. Generalized Linear Mixed Models (GLMMs) were used to estimate the association between nutritional status and explanatory variables and were expressed as an odds ratio with a 95% confidence interval (CI). Model comparison was done based on Akaike and Bayesian information criteria (AIC and BIC). RESULTS The magnitude of stunting was 37.71% [95%CI: 36.35-39.08], while the magnitude of wasting was 7.14% [95%CI: 6.52-7.91]. Living in Tigray [AOR = 2.90, 95%CI: 2.05-4.11], Amhara [AOR = 1.98, 95%CI: 1.41-2.79], having a child aged 24-35 [AOR = 3.79, 95%CI: 3.07-4.68], and being a rural resident were all significantly associated with stunting. Being born in Tigray [AOR = 1.75, 95% CI: 1.02-3.01], being born into the richest family [AOR = 0.74, 95% CI: 0.27-0.80], and being born from mothers aged 25-29 [AOR = 0.73, 95% CI: 0.55-0.96] were all significantly associated with wasting. CONCLUSION The magnitude of stunting and wasting is relatively high in Ethiopia. Region, place of residence, and age of the child were significantly associated with stunting, and region, wealth index, and age of the child were significantly associated with wasting. This result provides a clue to give due consideration to under-five children to mitigate the risks of malnutrition through various techniques.
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Affiliation(s)
- Temam Beshir Raru
- School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, Ethiopia
| | - Galana Mamo Ayana
- School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, Ethiopia
| | - Bedasa Taye Merga
- School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, Ethiopia.
| | - Belay Negash
- School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, Ethiopia.
| | - Alemayehu Deressa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, Ethiopia
| | - Abdi Birhanu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fila Ahmed Hassen
- School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Intersectional Inequalities in Anthropometric Failure among Indian Children: Evidence from the National Family Health Survey (2015-2016). J Biosoc Sci 2022:1-28. [PMID: 36193705 DOI: 10.1017/s0021932022000323] [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: 11/05/2022]
Abstract
Increasing body of health planning and policy research focused upon unravelling the fundamental drivers of population health and nutrition inequities, such as wealth status, educational status, caste/ethnicity, gender, place of residence, and geographical context, that often interact to produce health inequalities. However, very few studies have employed intersectional framework to explicitly demonstrate how intersecting dimensions of privilege, power, and resources form the burden of anthropometric failures of children among low-and-middle income countries including India. Data on 2,15,554 sampled children below 5 years of age from the National Family Health Survey 2015-2016 were analysed. This study employed intersectional approach to examine caste group inequalities in the anthropometric failure (i.e. moderate stunting, severe stunting, moderate underweight, severe underweight, moderate wasting, severe wasting) among children in India. Descriptive statistics and multinomial logistic regression models were fitted to investigate the heterogeneities in the burden of anthropometric failure across demographic, socioeconomic and contextual factors. Interaction effects were estimated to model the joint effects of socioeconomic position (household wealth, maternal education, urban/rural residence and geographical region) and caste groups with the likelihood of anthropometric failure among children.More than half of under-5 children suffered from anthropometric failure in India. Net of the demographic and socioeconomic characteristics, children from the disadvantageous caste groups whose mother were illiterate, belonged to economically poor households, resided in the rural areas, and coming from the central and eastern regions experienced disproportionately higher risk of anthropometric failure than their counterparts in India. Concerted policy processes must recognize the existing heterogeneities between and within population groups to improve the precision targeting of the beneficiary and enhance the efficiency of the nutritional program among under-5 children, particularly for the historically marginalized caste groups in India.
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Severe acute malnutrition and associated factors among children under-five years: A community based-cross sectional study in Ethiopia. Heliyon 2022; 8:e10791. [PMID: 36203897 PMCID: PMC9529577 DOI: 10.1016/j.heliyon.2022.e10791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/10/2021] [Accepted: 09/21/2022] [Indexed: 11/21/2022] Open
Abstract
Background Despite consistent efforts to reduce child undernutrition, severe acute malnutrition (SAM) continues to be a serious obstacle to child survival and development in Ethiopia. This study aimed to identify severe acute malnutrition and associated factors among children aged 6–59 months in Ethiopia. Methods A cross-sectional study was undertaken with 384 under-five children from February to March, 2020 in Ethiopia. A mid-upper arm circumference (MUAC) tape, weight scale, height board (standing) and recumbent length measurements (for children <24 months) were measured. To determine the variables associated with SAM, adjusted odds ratio was computed using multivariable analysis and p < 0.05 was declared as significant. Results The prevalence of acute undernutrition was 26%; 18% and 8% of the children were moderately and severely undernourished, respectively. Family size (≥5 members) (AOR: 3.71, 95% CI: 1.55–8.89), younger age group (6–11 months) (AOR: 4.80, 95% CI: 1.61–14.31) and history of diarrhea in the two weeks prior to the survey (AOR: 5.36, 95% CI: 1.97–14.61) were independently associated with SAM in the study population. Conclusion Large family size, child age, diarrheal and household insecurity were important determinants of SAM among children. Therefore, aligning social protection programmes and improving health related interventions along with improving optimal breastfeeding, prevention and control of child morbidity, and strengthening family planning services are recommended to reduce child SAM.
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Associated Factors of Wasting among Infants and Young Children (IYC) in Kuyu District, Northern Oromia, Ethiopia. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9170322. [PMID: 35909485 PMCID: PMC9328999 DOI: 10.1155/2022/9170322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022]
Abstract
Wasting among infants and young children in underdeveloped countries including Ethiopia is one of the most serious public health issues. Therefore, this study was designed to assess the magnitude of wasting and the variables that associate with it among infants and young children in the Kuyu district of Northern Oromia, Ethiopia. A community-based cross-sectional study of 612 infants and young children aged 6-23 months was conducted. To select eligible infants and young children from each family in the Kuyu district, a multilevel sampling approach was used. The amount and determinants related to wasting were investigated using the Statistical Package for Social Sciences (SPSS) version 20.0. In the study area, 14.1% of infants and young children were found to be wasting. Maternal educational status (AOR = 1.8, 95% CI; 1.01, 4.32), diarrhoea (AOR = 2.3, 95% CI; 1.98, 4.56), exclusive breastfeeding (AOR = 2.46, 95% CI, 1.4, 4.58), antenatal care visits (AOR = 2.21; 95% CI, 1.32, 3.48), and wealth index (AOR = 1.66, 95% CI; 1.07, 4.47) were significantly associated with wasting. According to the findings of this study, mother educational status, the occurrence of diarrhoea, exclusive breastfeeding, antenatal care visits, and wealth index have an impact on infants and young children's wasting. Therefore, to lower the burden of wasting among infants and young children in the study, community-based schooling and nutritional interventions are urgently needed.
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Katoch OR. Determinants of malnutrition among children: A systematic review. Nutrition 2022; 96:111565. [DOI: 10.1016/j.nut.2021.111565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/17/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
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Tadesse T, Turi E, Wirtu D, Bikila H, Assefa L. Determinants of wasting among South Sudanese 6- to 59-month-old children in Okugo refugee camp, Gambella Region, South-Western Ethiopia: Unmatched case–control study. SAGE Open Med 2022; 10:20503121211070727. [PMID: 35070312 PMCID: PMC8771739 DOI: 10.1177/20503121211070727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 12/15/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction: Wasting among refugee children continues to be a serious public health problem particularly in conflict and in situations when people are displaced. Evidence of risk factors in the refugee context is crucial to successfully prevent malnutrition and its consequences. However, little information is known about the determinants of wasting in a refugee setting. Hence, this study was aimed to identify determinants of wasting among South Sudanese 6- to 59-month-old children in Okugo refugee camp, South-Western Ethiopia. Methods: Institutional-based unmatched case–control study was conducted on 99 acute malnutrition children (cases) and 297 children who are not malnourished (control) from 6 April to 2 May 2019. The study participant was selected by systematic random sampling and data on exposure variables were collected by face-to-face interview using a structured questionnaire. Data were entered into Epi data version 3.1 and was exported to SPSS version 25 for further analysis. Descriptive, bivariable, and multivariable analyses were done to compute summary statistics and to identify determinants of wasting. Result: The mean age of the cases and controls with standard deviation (SD) was 13.8 (±6.9) and 19.2 (±8.7) months, respectively. Multi-variable analysis revealed that mothers who were unable to read and write (adjusted odds ratio = 3.26, 95% confidence interval (1.07–7.93)), fathers only decision-maker to use donations items in the household (adjusted odds ratio = 3.75, 95% confidence interval (1.28–10.85)), not used all donated refugee food and non-food items (adjusted odds ratio = 2.57; 95% confidence interval (1.17–5.66)), the incidence of diarrhea 2 weeks preceding the survey (adjusted odds ratio = 5.28, 95% confidence interval (2.31–12.04)), and mother’s smoking habit (adjusted odds ratio = 2.98, 95% confidence interval (1.19–7.44)) were significant determinants of wasting. Conclusion: The finding shows that mothers who are unable to read and write, father only decision-maker, parents’ smoking habit, not using all donated refugee food items, and diarrheal disease were found to be independent determinants of wasting. Hence, interventions on acute malnutrition which are focused on empowering women through training and strengthening their control over the household assets, proper utilization of donated food, and non-food items will play a paramount role.
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Affiliation(s)
| | - Ebisa Turi
- Department of Public Health, Wollega University, Nekemte, Ethiopia
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Gut microbiome dysbiosis in malnutrition. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2022; 192:205-229. [DOI: 10.1016/bs.pmbts.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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17
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Dalaba MA, Nonterah EA, Chatio ST, Adoctor JK, Dambayi E, Nonterah EW, Azalia S, Ayi-Bisah D, Erzse A, Watson D, Hardy-Johnson P, Kehoe SH, Tugendhaft A, Ward K, Debpuur C, Oduro A, Ofosu W, Danis M, Barker M. Engaging community members in setting priorities for nutrition interventions in rural northern Ghana. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000447. [PMID: 36962493 PMCID: PMC10022374 DOI: 10.1371/journal.pgph.0000447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/13/2022] [Indexed: 11/18/2022]
Abstract
This study used "Choosing All Together" (CHAT), a deliberative engagement tool to prioritise nutrition interventions and to understand reasons for intervention choices of a rural community in northern Ghana. The study took an exploratory cross-sectional design and used a mixed method approach to collect data between December 2020 and February 2021. Eleven nutrition interventions were identified through policy reviews, interaction with different stakeholders and focus group discussions with community members. These interventions were costed for a modified CHAT tool-a board-like game with interventions represented by colour coded pies and the cost of the interventions represented by sticker holes. Supported by trained facilitators, six community groups used the tool to prioritise interventions. Discussions were audio-recoded, transcribed and thematically analysed. The participants prioritised both nutrition-sensitive and nutrition-specific interventions, reflecting the extent of poverty in the study districts and the direct and immediate benefits derived from nutrition-specific interventions. The prioritised interventions involved livelihood empowerment, because they would create an enabling environment for all-year-round agricultural output, leading to improved food security and income for farmers. Another nutrition-sensitive, education-related priority intervention was male involvement in food and nutrition practices; as heads of household and main decision makers, men were believed to be in a position to optimise maternal and child nutrition. The prioritised nutrition-specific intervention was micronutrient supplementation. Despite low literacy, participants were able to use CHAT materials and work collectively to prioritize interventions. In conclusion, it is feasible to modify and use the CHAT tool in public deliberations to prioritize nutrition interventions in rural settings with low levels of literacy. These communities prioritised both nutrition-sensitive and nutrition-specific interventions. Attending to community derived nutrition priorities may improve the relevance and effectiveness of nutrition health policy, since these priorities reflect the context in which such policy is implemented.
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Affiliation(s)
- Maxwell Ayindenaba Dalaba
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
- Institute of Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Engelbert A Nonterah
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
- Julius Global Health, Julius Centre for Health Science and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Samuel T Chatio
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - James K Adoctor
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Edith Dambayi
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Esmond W Nonterah
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Stephen Azalia
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Doreen Ayi-Bisah
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Agnes Erzse
- SAMRC/ Wits Centre for Health Economics and Decision Science, PRICELESS SA, University of Witwatersrand School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa
| | - Daniella Watson
- Global Health Research Institute, School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Polly Hardy-Johnson
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- AECC University College, Bournemouth, United Kingdom
| | - Sarah H Kehoe
- Global Health Research Institute, School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Aviva Tugendhaft
- SAMRC/ Wits Centre for Health Economics and Decision Science, PRICELESS SA, University of Witwatersrand School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa
| | - Kate Ward
- Global Health Research Institute, School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Cornelius Debpuur
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
- Research and Development Division, Ghana Health Service, Accra, Ghana
| | - Abraham Oduro
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
- Research and Development Division, Ghana Health Service, Accra, Ghana
| | - Winfred Ofosu
- Upper East Regional Health Directorate, Ghana Health Service, Bolgatanga, Ghana
| | - Marion Danis
- Department of Bioethics, National Institutes of Health, Bethesda, MD, United States of America
| | - Mary Barker
- Global Health Research Institute, School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton Foundation Trust, Southampton General Hospital, Southampton, United Kingdom
- School of Health Sciences, University of Southampton, Highfield, Southampton, United Kingdom
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Karim MR, Al Mamun ASM, Rana MM, Mahumud RA, Shoma NN, Dutt D, Bharati P, Hossain MG. Acute malnutrition and its determinants of preschool children in Bangladesh: gender differentiation. BMC Pediatr 2021; 21:573. [PMID: 34903193 PMCID: PMC8667456 DOI: 10.1186/s12887-021-03033-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/22/2021] [Indexed: 01/26/2023] Open
Abstract
Background Children acute malnutrition (AM) is a global public health concern, especially in low and middle income countries. AM is associated with multiple physiological vulnerabilities, including immune dysfunction, enteric barrier disruption, gut microbiome dysbiosis, and essential nutrient deficits. This study aimed to determine the prevalence of AM and its associated factors among preschool children in Rajshahi district, Bangladesh. Methods This cross-sectional study was conducted from October to December, 2016. Children acute malnutrition was assessed using mid-upper arm circumference. Multiple binary logistic regression analyses were employed to determine the associated factors after adjusting the effect of independent factors of children AM. Result The prevalence of AM amongst preschool children was 8.7%, among them 2.2 and 6.5% were severe acute malnutrition and moderate acute malnutrition, respectively. Z-proportional test demonstrated that the difference in AM between girls (11.6) and boys (5.9%) was significant (p < 0.05). Children AM was associated with being: (i) children aged 6–23 months (aOR = 2.29, 95% CI: 1.20–4.37; p < 0.05), (ii) early childbearing mothers’ (age < 20 years) children (aOR = 3.06, 95% CI: 1.08–8.66; p < 0.05), (iii) children living in poor family (aOR = 3.08, 95% CI: 1.11–8.12; p < 0.05), (iv) children living in unhygienic latrine households (aOR = 2.81, 95% CI: 1.52–5.09; p < 0.01), (v) Hindu or other religion children (aOR = 0.42, 95% CI: 0.19–0.92; p < 0.05). Conclusion The prevalence of AM was high among these preschool children. Some modifiable factors were associated with AM of preschool children. Interventions addressing social mobilization and food security could be an effective way to prevent acute malnutrition among children in Bangladesh.
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Affiliation(s)
- Md Reazul Karim
- Department of Statistics, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | | | - Md Masud Rana
- DASCOH Foundation, Lutheren Mission Complex, Dingadoba, Rajpara, Rajshahi, 6201, Bangladesh
| | - Rashidul Alam Mahumud
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Nurun Naher Shoma
- DASCOH Foundation, Lutheren Mission Complex, Dingadoba, Rajpara, Rajshahi, 6201, Bangladesh
| | - Dhiman Dutt
- Swiss Red Cross, House# 35, Road # 117, Gulshan-1, Dhaka, 1212, Bangladesh
| | - Premananda Bharati
- Biological Anthropology, Indian Statistical Institute, 203 BT Road, Kolkata, West Bengal, 700 108, India
| | - Md Golam Hossain
- Department of Statistics, University of Rajshahi, Rajshahi, 6205, Bangladesh.
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Saleem J, Zakar R, Mushtaq F, Bukhari GMJ, Fischer F. Comparative analysis of developmental profile between normal and severe acute malnourished under-five children in Pakistan: a multicentre cross-sectional study. BMJ Open 2021; 11:e048644. [PMID: 34389574 PMCID: PMC8365806 DOI: 10.1136/bmjopen-2021-048644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study aims to compare the developmental profile of severe acute malnourished (SAM) and normal under-five children and to find sociodemographic determinants accountable for their developmental disabilities. SETTING We conducted a multi-centre cross-sectional study in three basic health units and one rural health centre in Pakistan. PARTICIPANTS 200 children (SAM and healthy) aged 6-59 months. PRIMARY AND SECONDARY MEASURES We screened for nutritional status and clinical complications. Children underwent for developmental assessment by Denver Development Screening Tool II. A pretested structured questionnaire on sociodemographic characteristics and nutrition was used for collecting data about determinants of developmental delay. RESULTS We observed statistically significant differences in anthropometric measurements among SAM compared with normal nourished in weight, height, mid-upper arm circumference and weight-for-height z-scores. SAM serves as a significant risk factors (p<0.001) for delayed personal or social development (69% vs 11%; OR (95% CI)=18.01 (8.45 to 38.37)), delayed fine motor development (39% vs 8%; OR (95% CI)=7.35 (3.22 to 16.81)), delayed language development (32% vs 8%; OR (95% CI)=5.41 (2.35 to 12.48)), delayed gross motor development (34% vs 10%; OR (95% CI)=4.64 (2.14 to 10.05)) and delayed global development (66% vs 20%; OR (95% CI)=7.77 (4.09 to 14.74)). Applying logistic regression, personal or social development (p<0.001) and language development (p<0.05), under-five siblings was a risk factor, while among gross motor development, mother's educational status (p<0.05) was a significant risk factor for developmental delay. CONCLUSIONS Our analysis indicates that children with malnutrition have a high frequency of developmental delays. Missing maternal education and a higher number of under-five siblings are also potential risk factors for developmental delay.
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Affiliation(s)
- Javeria Saleem
- Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
| | - Rubeena Zakar
- Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
| | | | | | - Florian Fischer
- Institute of Public Health, Charité Universitätsmedizin Berlin, Berlin, Germany
- Institute of Gerontological Health Services and Nursing Research, University of Applied Sciences Ravensburg-Weingarten, Weingarten, Germany
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Strysko JP, Steenhoff AP. Biomarkers Make the Case for a Comprehensive Approach to Diagnosing Severe Acute Malnutrition. Pediatrics 2021; 147:peds.2021-050215. [PMID: 34021064 DOI: 10.1542/peds.2021-050215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/18/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jonathan P Strysko
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; .,Botswana-University of Pennsylvania Partnership, Gaborone, Botswana; and.,Department of Paediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Andrew P Steenhoff
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Botswana-University of Pennsylvania Partnership, Gaborone, Botswana; and.,Department of Paediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
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Abu-Manga M, Al-Jawaldeh A, Qureshi AB, Ali AME, Pizzol D, Dureab F. Nutrition Assessment of Under-Five Children in Sudan: Tracking the Achievement of the Global Nutrition Targets. CHILDREN-BASEL 2021; 8:children8050363. [PMID: 34062925 PMCID: PMC8147258 DOI: 10.3390/children8050363] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 12/26/2022]
Abstract
Background: Malnutrition places a heavy burden on the health, well-being, and sustainable development of populations in Sudan, especially a country affected by conflict, which continues to experience high levels of food insecurity, undernutrition, and micronutrient deficiencies; 3.3 million are acutely malnourished, with 522,000 children suffering from severe acute malnutrition and approximately 2.2 million children requiring treatment for moderate acute malnutrition. This study aims to describe the nutritional status of children under five years old and identify the progress toward the achievement of the Global Nutrition Targets. Methods: This is a secondary data analysis of a quantitative survey, using the second-round of the Simple Spatial Survey Method (S3M II) in Sudan in the period 2018–2019. The analysis used an area-based sampling methodology in all 18 Sudanese states. Data from the WHO Tracking Tools of the Global Nutrition Targets was used to reflect the progress in achieving the targets in Sudan. Results: Global stunting prevalence was at 36.35 percent including moderate stunting prevalence and severe stunting prevalence (21.25 percent and 15.06 percent respectively). Global wasting prevalence was 13.6 percent including moderate wasting prevalence and severe wasting prevalence (10.8 percent and 2.7 percent respectively). Sudan has made great progress in achieving the target of increasing exclusive breastfeeding. However, despite the welcome commitments by the Government and all stakeholders, Sudan is still struggling to implement strategies, policies, and regulatory measures to address malnutrition and achieve the Global Nutrition Targets in 2025 and the Sustainable Developmental Goals in 2030. Therefore, more than ever, there is a need for comprehensive, multi-sectoral action to address malnutrition in all its forms.
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Affiliation(s)
- Mohamed Abu-Manga
- Federal Ministry of Health, National Nutrition Program, Khartoum 11111, Sudan;
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo 7608, Egypt;
| | | | | | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum 11111, Sudan;
| | - Fekri Dureab
- Heidelberg Institute of Global Health, Hospital University Heidelberg, 69120 Heidelberg, Germany
- Institute for Research in International Assistance, Akkon-Hochschule für Humanwissenschaften, 12099 Berlin, Germany
- Correspondence: ; Tel.: +49-176-2008-4242
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Dahal K, Yadav DK, Baral D, Yadav BK. Determinants of severe acute malnutrition among under 5 children in Satar community of Jhapa, Nepal. PLoS One 2021; 16:e0245151. [PMID: 33534789 PMCID: PMC7857586 DOI: 10.1371/journal.pone.0245151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 12/22/2020] [Indexed: 11/23/2022] Open
Abstract
Background Severe acute malnutrition (SAM) is the most extreme and visible form of undernutrition plagued by chronic poverty, household food insecurity, lack of education. One of the indigenous and marginalized community of Nepal, Satar/Santhal has often been neglected and is devoid of good education and are economically deprived. This predisposes under 5 children of Satar into malnutrition. The study aims to assess determinants of SAM among children under 5 years of age in Satar community of Jhapa district, Nepal. Material & methods A community based matched case control study was carried from September 2019 to February 2020 among under five children of Satar community residing in Jhapa district. Multistage random sampling technique was used to select 50 cases and 100 controls in the ratio of 1:2. Information was collected through personal interview with the parents and anthropometric measurement of the children was measured. Bivariate and multivariate conditional logistic regression analysis was used to explore the determinants of severe acute malnutrition. Results A total of 664 children between the age group of 6–59 months were screened for SAM. The prevalence of SAM was found 7.53%. Factors like, low economic status, birth interval less than 2 years, frequency of breast feeding <8 times/day and household food insecurity were found to be significant determinants of SAM. Multivariate logistic regression documented low economic status (AOR: 11.14, 95% CI 1.42 to 87.46); and frequency of breast feeding <8 times/day (AOR: 2.09, 95% CI 1.00 to 4.37) as determinants of SAM. Conclusion Low economic status and frequency of breast feeding less than 8times/day were major determinants of SAM among children under 5yrs of age. Ending malnutrition will require greater efforts and integrated approaches to eradicate extreme poverty. Multi-sector approaches have been conducting for SAM in Nepal but there are no specific approaches for marginalized community.
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Affiliation(s)
- Kajol Dahal
- School of Public Health and Community Medicine, B.P Koirala Institute of Health Sciences, Dharan, Nepal
- * E-mail:
| | - Deepak Kumar Yadav
- Faculty of School of Public Health and Community Medicine, B.P Koirala Institute of Health Sciences, Dharan, Nepal
| | - Dharanidhar Baral
- Faculty of School of Public Health and Community Medicine, B.P Koirala Institute of Health Sciences, Dharan, Nepal
| | - Birendra Kumar Yadav
- Faculty of School of Public Health and Community Medicine, B.P Koirala Institute of Health Sciences, Dharan, Nepal
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