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de Camargo EM, Chen S, Jiménez-López E, Victoria-Montesinos D, Smith L, López-Gil JF. Food insecurity and academic performance in Spanish adolescents: Results from the EHDLA study. Heliyon 2024; 10:e29489. [PMID: 38681539 PMCID: PMC11053195 DOI: 10.1016/j.heliyon.2024.e29489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 04/08/2024] [Accepted: 04/08/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction Food insecurity is a growing global issue that affects both developed and developing nations, and mounting evidence suggests that decreased consumption of healthy foods has been linked to lower academic performance in adolescents. The present study aimed to examine the relationship between food insecurity and academic performance in a sample of Spanish adolescents aged 12-17 years from the Valle de Ricote (Region of Murcia, Spain). Methods The present study analyzed data from the Eating Healthy and Daily Life Activities study, which included a sample of 777 adolescents (55.3 % girls). The Spanish Child Food Security Survey Module was used to assess food insecurity, and academic performance was evaluated using school records provided by the schools. Linear regression models (fitted by robust methods) were used to compare the relationships between food insecurity status and academic performance-related indicators. Results Adolescents with the highest levels of food insecurity reported the lowest academic performance in language (mean [M] = 4.7; 95 % confidence interval [CI] 3.6 to 5.7), math (M = 4.6; 95 % CI 3.5 to 5.8), foreign language (M = 4.8; 95 % CI 3.8 to 5.8), and grade point average (M = 5.7; 95 % CI 4.9 to 6.5). Conversely, adolescents with the lowest levels of food insecurity reported the highest academic performance in language (M = 6.2; 95 % CI 6.0 to 6.5), math (M = 5.9; 95 % CI 5.5 to 6.2), foreign language (M = 6.2; 95 % CI 5.9 to 6.4), and grade point average (M = 6.7; 95 % CI 6.5 to 6.9) compared to those with higher food security. Conclusions Living in a more food-insecure household could explain the lower academic performance of adolescents. Food insecurity should always be on the agenda of public policies. The availability of quality basic food essentials must be ensured in permanently satisfactory quantities without compromising access to other fundamental needs.
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Affiliation(s)
- Edina Maria de Camargo
- Department of Physical Education, Universidade Federal do Paraná (UFPR), Curitiba 81531-980, Paraná, Brazil
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha (UCLM), 16071 Cuenca, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
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Osei-Owusu C, Dhillon S, Luginaah I. The impact of food insecurity on mental health among older adults residing in low- and middle-income countries: A systematic review. PLoS One 2024; 19:e0301046. [PMID: 38530847 DOI: 10.1371/journal.pone.0301046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
Over the past few years, food insecurity has been increasing globally due to the COVID-19 pandemic, climate change, economic downturns and conflict and a number of other intersecting factors. Older adults residing in low- and middle-income countries are more vulnerable to food insecurity. While the impacts of food insecurity on physical health outcomes have been thoroughly researched, the effect on mental health outcomes remains under-researched, especially among older adults. Hence, this systematic review aims to investigate existing literature to assess how food insecurity impacts the mental health of older persons residing in LMICs. A systematic search of six databases and Google for studies was conducted. The search was limited to studies written in English and published between 2000 to the present. We identified 725 studies, out of which 40 studies were selected for a full-text review and 12 studies were included for a final analysis. The significant finding in all the included studies was that food insecurity is associated with the worsening mental health of older adults. We also found a complex interplay of factors such as gender, age, rural/urban and health conditions associated with the aggravation of several mental health outcomes. The findings of this study illuminate the need for improved food programs to improve food security and, consequently, mental health among older adults.
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Affiliation(s)
- Cornelius Osei-Owusu
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Satveer Dhillon
- Department of Geography and Environment, Western University, London, Ontario, Canada
| | - Isaac Luginaah
- Department of Geography and Environment, Western University, London, Ontario, Canada
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Atlas HE, Brander RL, Tickell KD, Bunyige L, Oongo S, McGrath CJ, John-Stewart GC, Richardson BA, Singa BO, Denno DM, Walson JL, Pavlinac PB. Prevalence and Correlates of Stunting among a High-Risk Population of Kenyan Children Recently Hospitalized for Acute Illnesses. Am J Trop Med Hyg 2024; 110:356-363. [PMID: 38150727 PMCID: PMC10859817 DOI: 10.4269/ajtmh.23-0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 09/30/2023] [Indexed: 12/29/2023] Open
Abstract
Stunting (length/height-for-age z-score < -2) is associated with significant morbidity and mortality among children under 5 years of age in sub-Saharan Africa. Children who are stunted and recently hospitalized for acute illness may be at particularly elevated risk for post-discharge mortality. In this cross-sectional analysis, we measured the prevalence of stunting at hospital discharge and identified host, caregiver, and environmental correlates of stunting among children aged 1-59 months in Western Kenya enrolled in the Toto Bora Trial. Child age- and site-adjusted prevalence ratios were estimated using Poisson regression. Of the 1,394 children included in this analysis, 23% were stunted at hospital discharge. Older children (12-23 months and 24-59 months versus 0-5 months) had a higher prevalence of stunting (adjusted prevalence ratio [aPR]: 1.58; 95% CI: 1.04-2.36 and aPR: 1.59; 95% CI: 1.08-2.34, respectively). HIV-exposed, uninfected children (aPR: 1.94; 95% CI: 1.39-2.70), children with HIV infection (aPR: 2.73; 95% CI: 1.45-5.15), and those who were never exclusively breastfed in early life (aPR 2.51; 95% CI: 1.35-4.67) were more likely to be stunted. Caregiver education (primary school or less) and unimproved sanitation (pit latrine without slab floor or open defecation) were associated with increased risk of stunting (aPR: 1.94; 95% CI: 1.54-2.44; aPR: 1.99; 95% CI: 1.20-3.31; aPR: 3.57; 95% CI: 1.77-7.21, respectively). Hospital discharge represents an important opportunity for both identifying and delivering targeted interventions for nutrition-associated poor outcomes among a high-risk population of children.
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Affiliation(s)
- Hannah E Atlas
- Department of Global Health, University of Washington, Seattle, Washington
| | - Rebecca L Brander
- International Food Policy Research Institute, Division of Poverty, Health, and Nutrition, Baltimore, Maryland
| | - Kirkby D Tickell
- Department of Global Health, University of Washington, Seattle, Washington
- Childhood Acute Illness & Nutrition Network, Nairobi, Kenya
| | - Lucy Bunyige
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Susan Oongo
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Christine J McGrath
- Department of Global Health, University of Washington, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Grace C John-Stewart
- Department of Global Health, University of Washington, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle, Washington
- Department of Pediatrics, University of Washington, Seattle, Washington
- Department of Allergy and Infectious Disease, University of Washington, Seattle, Washington
| | - Barbra A Richardson
- Department of Global Health, University of Washington, Seattle, Washington
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Benson O Singa
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
- Childhood Acute Illness & Nutrition Network, Nairobi, Kenya
| | - Donna M Denno
- Department of Global Health, University of Washington, Seattle, Washington
- Department of Pediatrics, University of Washington, Seattle, Washington
- Department of Health Services, University of Washington, Seattle, Washington
- Childhood Acute Illness & Nutrition Network, Nairobi, Kenya
| | - Judd L Walson
- Department of Global Health, University of Washington, Seattle, Washington
- Department of International Health, Johns Hopkins University, Baltimore, Maryland
- Childhood Acute Illness & Nutrition Network, Nairobi, Kenya
| | - Patricia B Pavlinac
- Department of Global Health, University of Washington, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle, Washington
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Zerfu TA, Nguyen G, Duncan AJ, Baltenweck I, Brown F, Iannotti LL, McNeill G. Associations between livestock keeping, morbidity and nutritional status of children and women in low- and middle-income countries: a systematic review. Nutr Res Rev 2023; 36:526-543. [PMID: 36522652 DOI: 10.1017/s0954422422000233] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Livestock keeping can positively influence the nutritional status of populations and households through increased consumption of animal-source foods (ASF) and other indirect pathways, but can also adversely affect health by increasing the risk of diseases. We conducted a systematic review synthesising the current state of knowledge on the associations among livestock keeping, infectious disease and the nutritional status of children under 5 years and women of reproductive age in low- and lower-middle-income countries (LMICs). A comprehensive search of 12 electronic databases and grey literature sources published from 1991 to the end of December 2020 was conducted. Investigations exploring relationships between livestock keeping and risk of infectious disease transmission and nutritional status were selected using pre-defined inclusion criteria. After screening and filtering of 34,402 unique references, 176 references were included in the final synthesis. Most (160/176, 90.1%) of the references included in the final synthesis were from sub-Saharan Africa (SSA) and Asia. About two out of every five (42%) studies reviewed showed that livestock production is associated with improved height-for-age Z scores (HAZ) and weight-for-length/height Z scores (WHZ), while close to a third (30.7%) with improved weight-for-age Z scores (WAZ). Similarly, livestock production showed a positive or neutral relationship with women's nutritional status in almost all the references that reported on the topic. Conversely, four-fifths (66/81, 79.5%) of the references reporting on infection and morbidity outcomes indicated that livestock keeping is linked to a wide range of infectious disease outcomes, which are spread primarily through water, food and insects. In conclusion, in many LMIC settings, livestock production is associated with better nutritional outcomes but also a higher risk of disease transmission or morbidity among women and children.This review was prospectively registered on PROSPERO 2020 [CRD42020193622].
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Affiliation(s)
- Taddese Alemu Zerfu
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Edinburgh, UK
- International Livestock Research Institute (ILRI), Nairobi, Kenya
| | - Giang Nguyen
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Edinburgh, UK
| | - Alan J Duncan
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Edinburgh, UK
- International Livestock Research Institute (ILRI), Nairobi, Kenya
| | | | - Fiona Brown
- Library and University Collections, Information Services, University of Edinburgh, Edinburgh, UK
| | - Lora L Iannotti
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Geraldine McNeill
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Edinburgh, UK
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Lye CW, Sivasampu S, Mahmudiono T, Majid HA. A systematic review of the relationship between household food insecurity and childhood undernutrition. J Public Health (Oxf) 2023; 45:e677-e691. [PMID: 37291061 DOI: 10.1093/pubmed/fdad070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/21/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND This systematic review aims to investigate the association between household food insecurity (HFIS) and undernutrition in children under 5 years old, thereby informing policymakers on the vital factors needed to be considered in tailoring an effective strategy to tackle childhood undernutrition and ultimately HFIS. METHODS We performed a systematic review that examined household food insecurity among the undernourished under-five children. PubMed, Cochrane, EBSCO Host, Web of Science and Cumulative Index to Nursing and Allied Health Literature were searched from 1 January 2012 to 1 April 2022, for relevant articles. Outcome measures were stunting, underweight or wasting. Of the 2779 abstracts screened, 36 studies that fulfilled the inclusion and exclusion criteria were included. A range of tools had been used to measure HFIS, the most common being Household Food Insecurity Access Scale. HFIS has been found to be significantly associated with undernutrition, particularly stunting and underweight. This is observed proportionately across all national income levels. CONCLUSIONS Sustainable and inclusive economic growth, which aims to reduce income, education and gender inequality, should be a key policy goal in the minimizing food insecurity and childhood undernutrition. Multisectoral interventions are needed to address these issues.
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Affiliation(s)
- Chuan Way Lye
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Sheamini Sivasampu
- Centre for Clinical Outcome Research, Institute for Clinical Research, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Trias Mahmudiono
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Hazreen Abdul Majid
- The Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
- School of Chiropractor, AECC University College, Parkwood Campus, Dorset BH5 2DF, UK
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Mudadu Silva JR, Vieira LL, Murta Abreu AR, de Souza Fernandes E, Moreira TR, Dias da Costa G, Mitre Cotta RM. Water, sanitation, and hygiene vulnerability in child stunting in developing countries: a systematic review with meta-analysis. Public Health 2023; 219:117-123. [PMID: 37159976 DOI: 10.1016/j.puhe.2023.03.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/23/2023] [Accepted: 03/28/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVES This study aimed to perform a systematic review and meta-analysis to assess the scientific evidence of the relationship between vulnerability to access to safe drinking water, sanitation, and hygiene (WASH) practices on stunting in children aged <5 years in developing countries. STUDY DESIGN This is a systematic review and meta-analysis article to assess the relationship between under-five stunting and WASH vulnerability in developing countries. METHODS The systematic review with meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol methodology. The following databases were used: LILACS, MEDLINE (via PubMed), SciELO, Web of Science, ScienceDirect, SCOPUS, and Embase. All original studies identified that related WASH vulnerability to stunting in children aged <5 years in developing countries was included. Three authors performed independently the selection and extraction of data from the articles. The statistical software STATA version 11 was used. Cochran's Q test and Chi-square test (I2) with 95% significance were used to assess the heterogeneity of the studies. RESULTS The search resulted in the initial identification of 2047 articles; after reading the abstracts, followed by the full articles, 14 articles were included in the systematic review and eight articles were included in the meta-analysis. The studies selected for the systematic review were published between the years 1992 and 2021 and conducted in eight countries, namely, Ethiopia, India, Indonesia, Bangladesh, Tanzania, Peru, China, and Lesotho. The studies assessed vulnerability to access to WASH on the growth of children aged <5 years. There was a significant difference when relating WASH vulnerability to children's height. The meta-analysis of this study showed that the impact of WASH on child stunting is significant when it comes to lack of sanitation in 72% of the studies. CONCLUSIONS The study found that WASH vulnerability contributes to stunting in children aged <5 years in developing countries. Based on our findings, we recommend incorporating WASH strategies, especially sanitation, into the formulation of interventions integrating with health promotion policies for healthy early childhood development.
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Affiliation(s)
- J R Mudadu Silva
- Departamento de Ciências dos Solos - Universidade Federal de Viçosa, Brazil.
| | - L L Vieira
- Departamento de Nutrição e Saúde - Universidade Federal de Viçosa, Brazil
| | - A R Murta Abreu
- Departamento de Nutrição e Saúde - Universidade Federal de Viçosa, Brazil
| | | | - T R Moreira
- Departamento de Medicina e Enfermagem - Universidade Federal de Viçosa, Brazil
| | - G Dias da Costa
- Departamento de Nutrição e Saúde - Universidade Federal de Viçosa, Brazil
| | - R M Mitre Cotta
- Departamento de Nutrição e Saúde - Universidade Federal de Viçosa, Brazil
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Kalinda C, Phri M, Qambayot MA, Ishimwe MCS, Gebremariam A, Bekele A, Wong R. Socio-demographic and environmental determinants of under-5 stunting in Rwanda: Evidence from a multisectoral study. Front Public Health 2023; 11:1107300. [PMID: 36998275 PMCID: PMC10043183 DOI: 10.3389/fpubh.2023.1107300] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
Child stunting is an important household, socio-economic, environmental and nutritional stress indicator. Nationally, 33% of children under 5 in Rwanda are stunted necessitating the need to identify factors perpetuating stunting for targeted interventions. Our study assessed the individual and community-level determinants of under-5 stunting essential for designing appropriate policy and program responses for addressing stunting in Rwanda. A cross-sectional study was conducted between September 6 and October 9, 2022, in five districts of Rwanda including, Kicukiro, Ngoma, Burera, Nyabihu and Nyanza. 2788 children and their caregivers were enrolled in the study and data on the individual level (child, caregiver/household characteristics), and community-level variables were collected. A multilevel logistic regression model was used to determine the influence of individual and community-level factors on stunting. The prevalence of stunting was 31.4% (95% CI: 29.5–33.1). Of this, 12.2% were severely stunted while 19.2% were moderately stunted. In addition, male gender, age above 11 months, child disability, more than six people in the household, having two children below the age of five, a child having diarrhea 1–2 weeks before the study, eating from own plate when feeding, toilet sharing, and open defecation increased the odds of childhood stunting. The full model accounted for 20% of the total variation in the odds of stunting. Socio-demographic and environmental factors are significant determinants of childhood stunting in Rwanda. Interventions to address under-five stunting should be tailored toward addressing individual factors at household levels to improve the nutritional status and early development of children.
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Affiliation(s)
- Chester Kalinda
- Bill and Joyce Cummings Institute of Global Health, University of Global Health Equity, Kigali, Rwanda
- *Correspondence: Chester Kalinda ;
| | - Million Phri
- School of Humanities and Social Sciences, University of Zambia, Great East Road Campus, Lusaka, Zambia
| | | | | | | | - Abebe Bekele
- School of Medicine, University of Global Health Equity, Kigali, Rwanda
| | - Rex Wong
- Bill and Joyce Cummings Institute of Global Health, University of Global Health Equity, Kigali, Rwanda
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Motbainor A, Arega Z, Tirfie M. Comparing level of food insecurity between households with and without home gardening practices in Zege, Amhara region, North West Ethiopia: Community based study. PLoS One 2022; 17:e0279392. [PMID: 36542650 PMCID: PMC9770380 DOI: 10.1371/journal.pone.0279392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Globally, close to 1 billion people suffer from hunger and food insecurity. Evidence showed that prevalence of household food insecurity in Ethiopia is ranged from 25.5%-75.8%. Home gardening is one way to alleviate food insecurity. Hence, the study aimed to determine level of food insecurity and its associated factors between home gardening and non-home gardening household in Zegie, North west Ethiopia. METHODS Community-based study was conducted from February 10th-March 10th/2020. A total of 648 samples were included. First, 2142 total households who have 6-59 months of age children in the area identified and registered. Then, households categorized in to home garden practicing (1433) and non-home garden practicing (709). The calculated sample size, 324 for each group were selected using simple random sampling technique. RESULTS The overall prevalence of food insecurity was 38.1% (95% CI: 34.29-42.11%). Food insecurity was significantly higher in non-home gardening groups than their counter parts 45.5% (95% CI: 39.80-51.20%). Having primary education and above (AO = 1.89, 95% CI: 1.25-2.86%), wealth index; 2nd quantile (AOR = 0.44, 95% CI: 0.25-0.85%), 3rd quantile (AOR = 0.32, 95% CI: 0.17-0.62%) and 4th quantile (AOR = 0.27, 95% CI: 0.15-0.54%), dietary diversity (AOR = 1.83, 95% CI: 1.15-2.92%) and home garden practices (AOR = 1.57, 95% CI: 1.06-2.32%) were variables significantly associated with food insecurity. CONCLUSION Food insecurity in non-home garden practicing households is higher than practicing households. The local agriculture sector needs to emphasis and empowered households on home gardening practices to realize food security.
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Affiliation(s)
- Achenef Motbainor
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- * E-mail:
| | - Zerfalem Arega
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mulat Tirfie
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Nsubuga EJ, Arinda Kato I, Lee S, Ssenyondo M, Isunju JB. Predictors of Stunting and Underweight Among Children Aged 6 to 59 months in Bussi Islands, Wakiso District, Uganda: A Cross-Sectional Study. Nutr Metab Insights 2022; 15:11786388221125107. [PMID: 36187343 PMCID: PMC9520166 DOI: 10.1177/11786388221125107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/12/2022] [Indexed: 11/15/2022] Open
Abstract
Background Child undernutrition is a major public health concern in Uganda that can lead to increased risks of death with its prevalence higher in rural hard-to-reach areas than in urban areas. While it is assumed that the prevalence will be more concerning in islands with restricted accessibility to healthcare resources, limited research has been conducted on the prevalence and associated factors of stunting and underweight among children in Bussi Islands of Uganda. This study aimed to assess the prevalence and predictors of stunting and underweight among children aged 6 to 59 months in Bussi Islands of Wakiso District in Uganda. Methods A cross-sectional study was conducted in Bussi Islands of Wakiso District. Sociodemographic and anthropometric measurements were obtained for randomly sampled 409 caretaker-child pairs from 409 households. Data was collected using pre-tested structured electronic questionnaires validated by the Uganda Ministry of Health. Anthropometric indices were calculated using ENA-SMART version 2011 and data analysis was conducted using STATA version 14. Modified Poisson regression was used to generate Unadjusted and Adjusted Prevalence Ratios (APRs) with 95% confidence intervals. Results Prevalence of stunting and underweight among children in Bussi Islands were 29.8% and 16.1%, respectively. Independent predictors of stunting included: suffering from diarrhea (APR: 1.8; 95% CI: 1.3, 2.5); household food insecurity (APR: 1.7; 95% CI: 1.2, 2.4); and child age of 12 to 23 months and 24 to 35 months (APR: 2.3; 95% CI: 1.3, 4.0 and APR: 2.0; 95% CI: 1.1, 3.6 respectively). Protective factors against stunting were not suffering from measles (APR: 0.62; 95% CI: 0.42, 0.92); receiving deworming tablets every 6 months (APR: 0.58; 95% CI: 0.42, 0.81); and daily household utilization of more than 80 L of water (APR: 0.48; 95% CI: 0.24, 0.95). Predictors of underweight were suffering from diarrhea (APR: 2.2; 95% CI: 1.4, 3.4) and having more than 9 household members (APR: 2.8; 95% CI: 1.1, 7.5). Conclusions Child stunting and underweight are prevalent public health problems in Bussi Islands of Wakiso District. Therefore, the study suggests that nutrition interventions in the Islands should focus on childhood vaccination, family planning, sufficient safe water coverage, household food security, and health education of child caretakers on optimal infant and young child feeding and development.
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Affiliation(s)
| | | | - Seungwon Lee
- Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, USA
| | | | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
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Kibemo B, Mulugeta A, Hailu D, Gelaw B. The association of socio-demographic and environmental factors with stunting among under-five children in Hawassa City, Sidama National Regional State, Ethiopia. J Nutr Sci 2022; 11:e33. [PMID: 35620765 PMCID: PMC9108000 DOI: 10.1017/jns.2022.29] [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: 11/30/2021] [Revised: 03/10/2022] [Accepted: 04/11/2022] [Indexed: 11/22/2022] Open
Abstract
Undernutrition in children is a challenging problem in developing countries, including Ethiopia. Stunting is the most prevalent form of undernutrition. The majority of studies on childhood stunting and its associated factors focused on children, maternal and socioeconomic components. However, a few studies reported poor WaSH status and antibiotic exposure as environmental risk factors for child stunting, and the case of socio-demographic factors also lacks consistency. Concerning this, there is a lack of information in Ethiopia. Therefore, the present study assessed the association of socio-demographic, WaSH, and antibiotic exposure with stunting among under-five children. A cross-sectional study was conducted involving 340 mother-child pairs. Anthropometric data were collected using standard and calibrated height and weight scales. For factorial data, an interviewer-guided standard questionnaire was used. Logistic regression analyses were used to identify factors determining childhood stunting. In the present study, the prevalence of stunting, underweight and wasting was 14⋅7 % (95 % CI 10⋅9, 18⋅5), 4⋅4 % (95 % CI 2⋅4, 6⋅8) and 2⋅1 % (95 % CI 0⋅6, 3⋅5), respectively. Low dietary diversity, being born from a mother with an education level of secondary school, and belonging to a female-headed household were positively associated (P < 0⋅05) with stunting. The prevalence of overall undernutrition was lower (21⋅2 %) in the study area. Stunting was significantly associated with dietary diversity, maternal educational level and sex of households head. The government policy should focus on enhancing the dietary diversity of households, and encouraging women's education.
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Affiliation(s)
- Berhanu Kibemo
- School of Nutrition, Food Science and Technology, College of Agriculture, University of Hawassa, Hawassa, Ethiopia
| | - Afework Mulugeta
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Dejene Hailu
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Baye Gelaw
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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11
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Yuliantini E, Sukiyono K, Yuliarso MZ, Sulistyo B. Food Security and Stunting Incidences in the Coastal Areas of Indonesia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Food insecurity is a condition determined by limited or uncertain access to nutritious food for active, healthy, disproportionate people or community of people who are not prepared to anticipate. Stunting in coastal areas such as Indonesia is still severe at 30.8%, higher than the global data at 22.2%. Stunting in sub-Saharan Africa is 34.5%, Ethiopia is 52.4%, and Congo is 40%. The World Health Organization has determined that nutritional problems in a country should be <20% since it leads to impaired growth, development, and degenerative diseases in later adulthood.
AIM: This study aimed to identify the risk factors of the determinant of food security and stunting in the Indonesian Coastal regions.
METHODS: This review was conducted by collecting literature from various publications or articles in English and Indonesian, using the online database of PubMed, ScienceDirect, ProQuest, and manual searching using Google Scholar in reputable journals since the 2000s regarding factors related to or influencing factors can determine food security and the occurrence of stunting in the Indonesian Coastal regions.
RESULTS: Several studies pointed out that one of the causes of stunting in children is the lack of good nutrition for an extended period and often not realized by the parents until their children reach over 2 years old and look stunted. Based on the results of the literature review, it shows that the risk factors for stunting in coastal areas of Indonesia include birth length at risk of 16.43 times, low maternal education at risk of 3.27 times, children living in villages at risk of 2.45 times, LBW at risk 4.5 times, no ANC at risk of 3.4 times, no immunization at risk of 6.38 times, and not exclusively breastfeed at risk of 4.0 times.
CONCLUSION: The results of this synthesis that consistently become risk factors for stunting in children in coastal areas are family socio-economic status (family income), mother’s education, low birth weight, premature birth, non-exclusive breastfeeding, length of birth, and macronutrient and micronutrient deficiencies. Those are given the complex risk factors for stunting.
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Kabue M, Abubakar A, Ssewanyana D, Angwenyi V, Marangu J, Njoroge E, Ombech E, Mokaya MM, Obulemire EK, Mugo C, Malti T, Moran G, Martin MC, Proulx K, Marfo K, Zhang L, Lye S. A community engagement approach for an integrated early childhood development intervention: a case study of an urban informal settlement with Kenyans and embedded refugees. BMC Public Health 2022; 22:711. [PMID: 35410147 PMCID: PMC8995906 DOI: 10.1186/s12889-022-13185-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Community engagement is crucial for the design and implementation of community-based early childhood development (ECD) programmes. This paper aims to share key components and learnings of a community engagement process for an integrated ECD intervention. The lessons shared are drawn from a case study of urban informal settlement with embedded refugees in Nairobi, Kenya. METHODS We conducted three stakeholder meetings with representatives from the Ministry of Health at County and Sub-County, actors in the ECD sector, and United Nations agency in refugee management, a transect walk across five villages (Ngando, Muslim, Congo, Riruta and Kivumbini); and, six debrief meetings by staff from the implementing organization. The specific steps and key activities undertaken, the challenges faced and benefits accrued from the community engagement process are highlighted drawing from the implementation team's perspective. RESULTS Context relevant, well-planned community engagement approaches can be integrated into the five broad components of stakeholder engagement, formative research, identification of local resources, integration into local lives, and shared control/leadership with the local community. These can yield meaningful stakeholder buy-in, community support and trust, which are crucial for enabling ECD programme sustainability. CONCLUSION Our experiences underscore that intervention research on ECD programmes in urban informal settlements requires a well-planned and custom-tailored community engagement model that is sensitive to the needs of each sub-group within the community to avoid unintentionally leaving anyone out.
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Affiliation(s)
- Margaret Kabue
- Institute for Human Development, Aga Khan University, Nairobi, Kenya.
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Derrick Ssewanyana
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, Canada
| | - Vibian Angwenyi
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Joyce Marangu
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Eunice Njoroge
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Eunice Ombech
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | | | | | - Catherine Mugo
- Ministry of Health-Kenya, Nairobi Metropolitan Services, Dagoretti Sub-county, Nairobi, Kenya
| | - Tina Malti
- Centre for Child Development, Mental Health, and Policy, University of Toronto Mississauga, Toronto, Canada.,Department of Psychology University of Toronto, Toronto, Canada
| | - Greg Moran
- Academics without Borders, Toronto, Canada
| | - Marie-Claude Martin
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, Canada
| | - Kerrie Proulx
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, Canada
| | - Kofi Marfo
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Linlin Zhang
- School of Psychology, Capital Normal University, Beijing, China
| | - Stephen Lye
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, Canada
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Associations of Nutritional Status with Full Immunization Coverage and Safe Hygiene Practices among Thai Children Aged 12–59 Months. Nutrients 2021; 14:nu14010034. [PMID: 35010909 PMCID: PMC8746758 DOI: 10.3390/nu14010034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/17/2022] Open
Abstract
Prevailing prevention measures against morbidity, such as vaccination and safe hygiene practices, vary among local cultural contexts, and little is known about the extent to which these behaviors mitigate poor nutritional status in young children in Southeast Asia. We examined the associations between nutrition status with full immunization coverage, and water, sanitation and hygiene status among children aged 12–59 months in the 2015–2016 Thailand Multiple Indicator Cluster Survey (n = 9060). When adjusted for confounding factors, children with incomplete immunization status were more likely to be stunted (adjusted odds ratio (aOR) 1.47; 95% confidence interval (CI): 1.24–1.75, p < 0.001), wasted (aOR 1.67, 95% CI: 1.31–2.12, p < 0.001), and overweight (aOR 1.24, 95% CI: 1.01–1.51, p < 0.05), whereas children who used unimproved water sources were more likely to be overweight (aOR 2.43, 95% CI: 1.27–4.64, p < 0.01). The further implementation of simple and cost-effective health promotion activities and practices at the household level may be important interventions for healthy child growth and development, particularly under restricted living conditions due to COVID-19.
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Masthalina H, Santosa H, Sudaryat E, Zuska F. Household Food Insecurity, Level of Nutritional Adequacy, and Nutritional Status of Toddlers in the Coastal Area of Central Tapanuli Regency. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The food security and livestock service office of North Sumatra Province (2020) noted that almost a third of the area or 35% of the subdistricts in Central Tapanuli Regency are food-insecure areas.
AIM: This study aims to determine the level of family food insecurity, the level of nutritional adequacy, and the nutritional status of children under 5 in the coastal area of Central Tapanuli Regency.
METHODS: This research is part of a dissertation study entitled Positive Deviance in Household Food Insecure in Improving the Nutritional Status of Toddlers in the Coastal Area of Central Tapanuli Regency. The steps in this research are to identify the level of household food insecurity, level of nutritional adequacy, and nutritional status of children under 5. The research was conducted by interviewing respondents (mothers of toddlers) and taking anthropometric measurements of 59 children under 5 purposively in the coastal area of Central Tapanuli Regency.
RESULTS: Most of the occupations of the head of the family are fishers (78.0%) and the household food insecurity status as much as 81.4% is food insecure. The nutritional status of children under 5 in the less category is 50.8%, the nutritional status of stunting is 35.6%, and wasting is 10.2%. There is a significant relationship between family food insecurity and the level of adequacy of nutrients: Energy (p = 0.000; odds ratio [OR] = 38.000) and protein (p = 0.002; OR = 10.929). There is a significant relationship between household food insecurity and nutritional status of weight for age (p = 0.0039; OR = 6.300).
CONCLUSION: Household food insecurity is related to the level of nutritional adequacy (energy and protein) and nutritional status of weight for age.
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Qualitative Accounts of School-Aged Children's Diets during the COVID-19 Pandemic in Rural, Central, Kenya. Nutrients 2021; 13:nu13103543. [PMID: 34684544 PMCID: PMC8541243 DOI: 10.3390/nu13103543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/29/2021] [Accepted: 10/05/2021] [Indexed: 11/26/2022] Open
Abstract
The COVID-19 pandemic has caused disruption to food security in many countries, including Kenya. However, the impact of this on food provision to children at an individual level is unknown. This small study aimed to provide a qualitative snapshot of the diets of children during the COVID-19 pandemic. During completion of 24-h food recalls, with 15 families with children aged 5–8 years, caregivers were asked about changes they had made to foods given to their children due to the pandemic. Food recalls were analysed to assess nutrient intakes. Qualitative comments were thematically analysed. Most of the families reported making some changes to foods they provided to their children due to COVID-19. Reasons for these changes fell into three themes, inability to access foods (both due to formal restriction of movements and fear of leaving the house), poorer availability of foods, and financial constraints (both decreases in income and increases in food prices). The COVID-19 pandemic has affected some foods parents in rural Kenya can provide to their children.
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Haq IU, Mehmood Z, Afzal T, Khan N, Ahmed B, Nawsherwan, Ali L, Khan A, Muhammad J, Khan EA, Khan J, Zakki SA, Xu J, Shu Y. Prevalence and determinants of stunting among preschool and school-going children in the flood-affected areas of Pakistan. BRAZ J BIOL 2021; 82:e249971. [PMID: 34259717 DOI: 10.1590/1519-6984.249971] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/13/2021] [Indexed: 11/22/2022] Open
Abstract
Stunting is a significant public health problem in low- and middle-income countries. This study assessed the prevalence of stunting and associated risk factors of stunting among preschool and school-going children in flood-affected areas of Pakistan. A cross-sectional study was conducted by visiting 656 households through multi-stage sampling. Respondent's anthropometric measurements, socio-demographic information and sanitation facilities were explored. A logistic regression model was used to determine determinants of stunting, controlling for all possible confounders. The overall prevalence of stunting in children was 40.5%, among children 36.1% boys and 46.3% of girls were stunted. The prevalence of stunting in under-five children was 50.7%. Female children (OR=1.35, 95% CI:0.94-2.0), children aged 13-24 months (OR=6.5, 95% CI: 3.0-13.9), mothers aged 15-24 years (OR=4.4, 95% CI: 2.6-7.2), joint family (OR=2.1, 95% CI: 1.4-3.0) did not have access to improved drinking water (OR=3.3, 95% CI: 1.9-5.9), and the toilet facility (OR=2.8, 95% CI, 1.9-4.3), while the children from district Nowshera (OR=1.7, 95% CI: 0.9-3.2) were significantly (P<0.05) associated in univariate analysis. The regression model revealed that child age, maternal age, family type, quality of water, and toilet facility, were the significant (P<0.05) factors contributing to child stunting in the flood-hit areas. Identification of key factors might be helpful for policymakers in designing comprehensive community-based programs for the reduction of stunting in flood-affected areas. In disasters such as flood, the detrimental consequences of the stunting problem could be even more on children. Evidence-based education and care must be provided to the families in the flood-affected regions to reduce the stunting problem. The determinants of stunting should be targeted by making comprehensive policies regarding proper nutrition, livelihood, clean water, and sanitation facilities in flood-hit regions.
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Affiliation(s)
- I Ul Haq
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Z Mehmood
- Department of Math's, Stats & Computer Science, The University of Agriculture Peshawar, Pakistan
| | - T Afzal
- Basic Health Unit Rakhi Mounh, Tehsil Koh-e-Suleman, District Health Authority Dera Ghazi Khan, Pakistan
| | - N Khan
- Goat Production Research Station Charbagh Swat, Livestock and Dairy Development Research Department Khyber Pakhtunkhwa, Pakistan
| | - B Ahmed
- School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Nawsherwan
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, China
| | - L Ali
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
| | - A Khan
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - J Muhammad
- Department of Microbiology, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - E A Khan
- Institute of Nursing Sciences, Khyber Medical University, Peshawar, Pakistan
| | - J Khan
- Department of Agriculture, University of Swabi, Khyber Pakhtunkhwa, Pakistan
| | - S A Zakki
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - J Xu
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Y Shu
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
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Boulom S, Essink DR, Kang MH, Kounnavong S, Broerse JEW. Factors associated with child malnutrition in mountainous ethnic minority communities in Lao PDR. Glob Health Action 2021; 13:1785736. [PMID: 32741342 PMCID: PMC7480462 DOI: 10.1080/16549716.2020.1785736] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background Although in many low- and middle-income countries undernutrition is steadily decreasing, nutritional challenges persist in remote communities, such as those in mountainous areas of Lao PDR. Isolated, with limited access to food and to health care and other public services, local diets are low in both quantity and diversity. Data needed to guide policy and planning are lacking. Objectives The study aimed to identify the extent of malnutrition and associated factors among children aged 12–47 months in remote mountainous communities in Lao PDR. Methods A cross-sectional survey was conducted in Nong district, Savannakhet province, covering 173 households, involving heads of households, mothers and their children aged 12–47 months. Results The prevalence of undernutrition was very high among the 173 children studied: 72.8% were stunted, 50.3% underweight and 10.4% wasted. Key factors showing significant positive associations with nutritional status were assets (mobile phone or electric rice mill), collection of non-timber forest products, and household dietary diversity. Negative associations were found with experience of malaria and consuming high amounts of white roots and tubers. Immediate causes of malnutrition were prevalent; half the children had insufficient consumption of all micro- and macronutrients. Diseases were highly prevalent; 30% had recently experienced fever. The households in these villages were quite homogeneous. All scored high on causes of malnutrition; 90% of households experienced food insecurity, nearly all lived below the poverty line, and almost two-thirds of household heads and nearly all mothers had had no education. Conclusion This study identified multiple factors influencing child malnutrition, including low household food diversity, food insecurity, and poor feeding practices among ethnic minority people living in a difficult environment with limited resources. Child undernutrition in these poor communities is complex. Interventions are needed in different sectors, including agricultural production, knowledge on feeding and health services.
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Affiliation(s)
- Sayvisene Boulom
- Rural Economic and Food Technology Department, Faculty of Agriculture, National University of Laos , Vientiane, Lao PDR.,Athena Institute, Faculty of Science, Vrije Universiteit , Amsterdam, Netherlands
| | - Dirk R Essink
- Athena Institute, Faculty of Science, Vrije Universiteit , Amsterdam, Netherlands
| | - Myung-Hee Kang
- Rural Economic and Food Technology Department, Faculty of Agriculture, National University of Laos , Vientiane, Lao PDR
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Dinku AM, Mekonnen TC, Adilu GS. Child dietary diversity and food (in)security as a potential correlate of child anthropometric indices in the context of urban food system in the cases of north-central Ethiopia. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2020; 39:11. [PMID: 33298197 PMCID: PMC7771062 DOI: 10.1186/s41043-020-00219-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/16/2020] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To investigate the relation of child dietary diversity and household food insecurity along with other socio-demographic with child anthropometric indices in north-central Ethiopia, an area with a high level of food insecurity and inadequate diet quality. DESIGN A community-based cross-sectional study was used. SETTINGS The study was conducted in Dessie and Combolcha towns of north-central Ethiopia from April to May 2018. PARTICIPANTS Randomly selected 512 mother-child pairs with child's age range of 6-59 months. RESULTS The mean (± SD) scores of weight-for-height/length, height/length-for-age, weight-for-age, and BMI-for-age Z-scores were 1.35 (± 2.03), - 1.89 (± 1.79), 0.05 (± 1.54), and 1.39 (± 2.06), respectively. From all anthropometric indicators, stunting and overweight/obesity remained the severe public issues hitting 43% and 42% of the children, respectively. In the model, mothers' age and education and child's age, sex, and dietary diversity were significantly related with child height-for-age Z-score while place of residence, sex of household head, child's age, and dietary diversity score were the predictors of child BMI-for-age Z-score in the urban contexts of the study area. Nevertheless, food insecurity was not related to any of the child anthropometric indices. CONCLUSION The double burden of malnutrition epidemics (stunting and obesity) coexisted as severe public health concerns in urban settings. Anthropometric statuses of children were affected by multidimensional factors and seek strong integration and immediate intervention of multiple sectors.
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Affiliation(s)
- Amare Molla Dinku
- Researcher at the Department of Rural Development and Agricultural Extension, College of Agriculture, Wollo University, Dessie, Ethiopia
| | - Tefera Chane Mekonnen
- Researcher at the School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Getachew Shumye Adilu
- Researchr at the Department of Plant Science, College of Agriculture, Wollo University, Dessie, Ethiopia
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Tafese Z, Reta Alemayehu F, Anato A, Berhan Y, Stoecker BJ. Child Feeding Practice and Primary Health Care as Major Correlates of Stunting and Underweight among 6- to 23-Month-Old Infants and Young Children in Food-Insecure Households in Ethiopia. Curr Dev Nutr 2020; 4:nzaa137. [PMID: 32923922 PMCID: PMC7475004 DOI: 10.1093/cdn/nzaa137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/04/2020] [Accepted: 08/07/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Child undernutrition is a major public health problem in Ethiopia. Stunting is highest in food-insecure areas and insufficient evidence may impair the design of suitable interventions. OBJECTIVES This study aimed to identify key factors contributing to undernutrition among 6- to 23-mo-old children. METHODS A community-based cross-sectional study in food-insecure areas of Amhara and Oromia regions in April-June, 2018, enrolled 464 mother-child dyads. Bivariate and multivariate logistic regression analyses were conducted. RESULTS The prevalence of stunting (43.1%), wasting (12.3%), and underweight (27.3%) were high. Factors significantly associated with both stunting and underweight were child age of 12-23 mo (vs 6-11 mo), female, more siblings, lack of zinc supplement for diarrhea, inadequate diet diversity, and lack of iodized salt in complementary food. Conclusions: Our findings support the need to emphasize appropriate child feeding practices and iodized salt utilization. Improvement of primary health care services related to micronutrient supplementation and family spacing also are important to address child undernutrition in the study area.
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Affiliation(s)
- Zelalem Tafese
- School of Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia
| | - Fikadu Reta Alemayehu
- School of Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia
| | - Anchamo Anato
- School of Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia
| | - Yifru Berhan
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Barbara J Stoecker
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
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Pérez-Escamilla R, Vilar-Compte M, Gaitan-Rossi P. Why identifying households by degree of food insecurity matters for policymaking. GLOBAL FOOD SECURITY 2020. [DOI: 10.1016/j.gfs.2020.100459] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Weingarten SE, Dearden KA, Crookston BT, Penny ME, Behrman JR, Humphries DL. Are Household Expenditures on Food Groups Associated with Children's Future Heights in Ethiopia, India, Peru, and Vietnam? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4739. [PMID: 32630270 PMCID: PMC7370180 DOI: 10.3390/ijerph17134739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/16/2020] [Accepted: 06/24/2020] [Indexed: 11/16/2022]
Abstract
Household expenditure surveys, routinely conducted in low-and middle-income countries (LMICs), usually include questions pertaining to recent household expenditures on key food groups. When child anthropometrics are also available, such expenditure data can provide insights into household food purchasing patterns that are associated with subsequent child growth measures. We used data from 6993 children, born around 2001, from Ethiopia, India, Peru, and Vietnam, from the Young Lives younger cohort. We compared associations between two weeks of household food expenditures (in PPP-Purchasing Power Parity adjusted dollars) on food groups and child height-for-age-Z score (HAZ) at subsequent time points to assess longitudinal associations. Total food expenditures, rural/urban residence, maternal and paternal schooling, and child sex were included in our adjusted models because they may affect the relations between household food group expenditures and future child HAZ. In Ethiopia, India, and Peru every extra PPP$ spent on fats was associated with 0.02-0.07 higher future HAZ. In Vietnam every extra PPP$ spent on starches, was significantly associated with a 0.01 lower future HAZ. Across countries, different patterns of food expenditure and procurement may be differentially critical for predicting child HAZ. Our results demonstrate how expenditures on specific food groups can be associated with children's linear growth. This study provides additional evidence of the utility of longitudinal household food expenditure data in understanding child nutritional status.
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Affiliation(s)
- Sarah E. Weingarten
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510, USA;
| | | | | | - Mary E. Penny
- Instituto de Investigación Nutricional, La Molina 15024, Peru;
| | - Jere R. Behrman
- Departments of Economics and Sociology, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Debbie L. Humphries
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510, USA;
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Mahmood T, Abbas F, Kumar R, Somrongthong R. Why under five children are stunted in Pakistan? A multilevel analysis of Punjab Multiple indicator Cluster Survey (MICS-2014). BMC Public Health 2020; 20:952. [PMID: 32552812 PMCID: PMC7302159 DOI: 10.1186/s12889-020-09110-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 06/12/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Pakistan is facing a serious problem of child under-nutrition as about 38% of children in Pakistan are stunted. Punjab, the largest province by population and contributes high gross domestic product (GDP) share in economy has reported 27% moderately and 10% severely stunted children of less than 5 years. Thus, this study aims at examining the determinants of stunting (moderate and severe) at different level of hierarchy empirically in Punjab province of Pakistan. METHODOLOGY Data for this study is coming from Punjab Multiple Indicators Cluster Survey (MICS-2014), used two-stage, stratified cluster sampling approach. Sub-national level data covering urban and rural areas were used for this study consists of 25,067 children less than 5 year's ages, from nine administrative divisions and 36 districts of Punjab province of Pakistan. Descriptive statistics and multilevel hierarchical models were estimated. Multilevel data analyses have an advantage because it provides robust standard error estimates and helps in finding variation in the data at various levels. RESULTS Punjab has a stunting prevalence of about 27% moderately and 10% severely stunted children of less than 5 years. The results depict that increasing the age of the child, increasing birth order, illiterate mothers and fathers, lack of sanitation facilities and being poor are associated significantly with the likelihood of moderate and severe stunting. Surprisingly, there is a gender bias in stunting in Punjab, Pakistan and being a girl child is more likely associated with moderate and severe stunting, which shows the patriarchal nature of the society and a substantial prevalence of gender bias in household resource allocations. CONCLUSION This outcome of our analysis points towards targeting not only households (focus on girls) but also their families and communities.
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Affiliation(s)
- Tahir Mahmood
- Department of Economics, University of Chitral, Chitral, Pakistan
- American University of Beirut, Beirut, Lebanon
| | - Faisal Abbas
- Department of Economics, School of Social Sciences and Humanities (S3H), National University of Sciences and Technology (NUST), Islamabad, Pakistan
| | - Ramesh Kumar
- Health Systems & Policy Department, Health Services Academy, Islamabad, Pakistan
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Ratana Somrongthong
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
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Tahangnacca M, Amiruddin R, Ansariadi, Syam A. Model of stunting determinants: A systematic review. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2019.10.076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kassie GW, Workie DL. Determinants of under-nutrition among children under five years of age in Ethiopia. BMC Public Health 2020; 20:399. [PMID: 32220224 PMCID: PMC7099779 DOI: 10.1186/s12889-020-08539-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/17/2020] [Indexed: 11/05/2022] Open
Abstract
Background Ethiopia is one of the developing countries where child under-nutrition is prevalent. Prior studies employed three anthropometric indicators for identifying factors of children’s under-nutrition. This study aimed at identifying the factors of child under-nutrition using a single composite index of anthropometric indicators. Methods Data from Ethiopia’s Demographic and Health Survey 2016 was the base for studying under-nutrition in a sample of 9494 children below 59 months. A single composite index of under-nutrition was created from three anthropometric indices through principal component analysis recoded into an ordinal outcome. In line with World Health Organization 2006 Child Growth Standards, the three anthropometric indices involve z-score of height-for-age (stunting), weight-for-height (wasting) and weight-for-age (underweight). Partial proportional odds model was fitted and its relative performance compared with some other ordinal regression models to identify significant determinants of under-nutrition. Results The single composite index of anthropometric indicators showed that 49.0% (19.8% moderately and 29.2% severely) of sampled children were undernourished. In the Brant-test of proportional odds model, the null hypothesis that the model parameters equal across categories was rejected. Compared to ordinal regression models, partial proportional odds model showed an improved fit. A child with mother’s body mass index less than 18.5 kg, from poorest family and a husband without education, and male to be in a severe under-nutrition status was 1.4, 1.8 1.2 and 1.2 times more likely to be in worse under-nutrition status compared to its reference group respectively. Conclusion Authors conclude that the fitted partial proportional odds model indicated that age and sex of the child, maternal education, region, source of drinking water, number of under five children, mother’s body mass index and wealth index, anemic status of child, multiple births, fever of child before 2 months of the survey, mother’s age at first birth, and husband’s education were significantly associated with child under-nutrition. Thus, it is argued that interventions focus on improving household wealth index, food security, educating mothers and their spouses, improving maternal nutritional status, and increasing mothers’ health care access.
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Affiliation(s)
| | - Demeke Lakew Workie
- Department of Statistics, Bahir Dar University, P.O. Box: 79, Bahir Dar, Ethiopia.
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Prevalence and predictors of underweight and stunting among children under 2 years of age in Eastern Kenya. Public Health Nutr 2020; 23:1599-1608. [PMID: 31983378 DOI: 10.1017/s1368980019003793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate key risk factors associated with undernutrition in the first few years of life. DESIGN A cross-sectional household survey was conducted in January 2018 collecting anthropometric data and other information on household, caregiver and child characteristics. Crude and adjusted odds ratios were calculated to assess the association of these characteristics with stunting and underweight outcomes. SETTING Kitui and Machakos counties in south-east Kenya. PARTICIPANTS Caregivers and their children aged 0-23 months in 967 beneficiary households of the Government of Kenya's cash for orphans and vulnerable children (CT-OVC) social protection scheme. RESULTS Twenty-three per cent of the 1004 children with anthropometric data were stunted, 10 % were underweight and 6 % experienced wasting. The strongest predictors of stunting and underweight were being in the second year of life and being born with a low birth weight. Residing in a poor household and having more than one child under 2 years of age in the household were also significant risk factors for being underweight. Although 43 % of children did not receive the minimal acceptable diet, this was not a significant factor associated with undernutrition. When age was removed as a covariate in children aged 12-23 months, being male resulted in a significantly higher risk of being stunted. CONCLUSIONS While only 9 % of children were born with a low birth weight, these were four to five times more likely to be stunted and underweight, suggesting that preventive measures during pregnancy could have significant nutrition and health benefits for young children in this study area.
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Muthuuri JM, Some ES, Chege P. Adult characteristics of survivors of early life malnutrition in an impoverished population. Clin Nutr 2019; 39:2448-2454. [PMID: 31735539 DOI: 10.1016/j.clnu.2019.10.030] [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: 11/01/2018] [Revised: 05/08/2019] [Accepted: 10/25/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND & AIMS To determine the characteristics of adults who survived early life malnutrition (ELM) and the possible associated factors. The setting is an impoverished community in Kenya. The coastal region of Kenya has a high prevalence of acute protein-energy-malnutrition and stunting. METHODS Observational cross-sectional survey where 872 skeletally mature adults of African origin, were surveyed in a period of three months. A discrimination tool to detect ELM survivors was created. Personal, historical and family data were collected in a semi-structured questionnaire. Various observations and body measurements were done. The subjects were grouped into two, those with ELM (Group1), and those without (Group2). RESULTS Group1 had 242 participants, 49.8% males, mean age of 49.1 ± 8.7 years. Group2 had 630 participants, 48.3% males, mean age 41.0 ± 9.7 years. The phenotypic characteristics included height, BMI, and head circumference (P < 0.05). Developmental characteristics were duration of schooling, occupation and income (P < 0.001). Factors associated with malnutrition were County of origin, parental education, parental occupation, and family size (P < 0.001). CONCLUSIONS There are discernible phenotypic and developmental characteristics associated with adult survivors of ELM. The predisposing factors for ELM are location of birth, parental education and occupation, and family size.
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Affiliation(s)
- J M Muthuuri
- The Mombasa Hospital, P.O Box 84074-80100, Mombasa, Kenya.
| | - Eliab Seroney Some
- United States International University, P.O Box 46092-00100, Nairobi, Kenya.
| | - Peter Chege
- Department of Food, Nutrition and Dietetics, Kenyatta University, P.O Box 43844-00100, Nairobi, Kenya.
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Double burden of maternal and child malnutrition and socioeconomic status in urban Sri Lanka. PLoS One 2019; 14:e0224222. [PMID: 31639148 PMCID: PMC6805006 DOI: 10.1371/journal.pone.0224222] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 10/08/2019] [Indexed: 11/19/2022] Open
Abstract
Child malnutrition and maternal obesity are serious public health issues in Sri Lanka. This study explores the associations between socioeconomic status and the double burden of malnutrition among school-aged children and within their household. A total of 543 primary school children aged 5–10 years (204 boys and 339 girls) in Gampaha District, Sri Lanka, were included in the analysis. The nutritional statuses of thinness, normal, overweight, and obesity for children and mothers were defined according to WHO growth references and body mass index. Maternal education, household equivalent income, and maternal employment were used as socioeconomic status indicators. The proportion of child thinness and overweight was 19.3% and 13.4%, respectively, and that of maternal overweight (body mass index ≥ 25 kg/m2) was 36.5%. A positive correlation was found between maternal body mass index and the child’s body mass index for age z-score in older boys and younger girls. A multivariate stepwise logistic regression analysis showed that lower education of mothers posed a higher association with child thinness (adjusted odds ratio = 2.33, 95% confidence interval: 1.08–5.00). Mothers with overweight and obesity were less likely to have a child with thinness (adjusted odds ratio = 0.30, 95% confidence interval: 0.16–0.58). Maternal employment status and household equivalent income were not significantly, but marginally, associated with child overweight and obesity. Socioeconomic inequality combined with maternal nutritional status affected child malnutrition. These findings suggest that the underlying circumstances within households should be considered to improve child malnutrition.
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Demilew YM, Alem AT. Food security is not the only solution to prevent under-nutrition among 6-59 months old children in Western Amhara region, Ethiopia. BMC Pediatr 2019; 19:7. [PMID: 30616560 PMCID: PMC6323821 DOI: 10.1186/s12887-018-1386-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 12/27/2018] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND In spite of surplus food production, in Amhara region, a significant number of children had under-nutrition. Investigating factors associated with under-nutrition in food secured households is crucial to design preventive measures. Therefore, the objective of this study was to assess under-nutrition and associated factors among 6-59 months old children in food secured households in Western Amhara Region, Ethiopia. METHODS A community-based cross-sectional study was performed using interviewer-administered questionnaire on 6-59 months old children from Jun 01-30/ 2017. A multi-stage sampling strategy was used to select study participants. Prevalence of stunting, underweight, wasting and overweight/obesity were computed. Predictors were assessed using logistic regression analysis. RESULT The prevalence of stunting, underweight, wasting and overweight/obesity were 40%, 19.8%, 11.6%, and 2.7%, respectively. Having mother who have no formal education (AOR] =2.21, 95% CI: [1.5, 3.2]), taking less diversified food (AOR =1.7, 95% CI: [1.1, 2.5]), having mother who did not wash her hands before food preparation (AOR =1.46, 95% CI: [1.1, 2.0]) and living in the households where solid wastes managed by scattering in the field (AOR =1.6, 95% CI: [1.1, 2.1]) were predictors of stunting. Whereas, wasting was associated with having illness in the prior two weeks of data collection day (AOR =2.7, 95% CI: [1.6, 4.7]), lack of getting antenatal care (AOR =2.0, 95% CI: [1.1, 3.4]) and taking food less than four times per day (AOR =2.00, 95% CI: [1.2, 3.2]). CONCLUSION The prevalence of under-nutrition was very high. Therefore, health professionals and health extension workers should give nutrition counseling about the frequency and diversity of meal, environmental and personal hygiene by giving emphasis to mothers who have no formal education.
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Affiliation(s)
- Yeshalem Mulugeta Demilew
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.O.Box 79, Bahir Dar, Ethiopia
| | - Abiot Tefera Alem
- School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, P.O.Box 79, Bahir Dar, Ethiopia
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Asesefa Kisi M, Tamiru D, Teshome MS, Tamiru M, Feyissa GT. Household food insecurity and coping strategies among pensioners in Jimma Town, South West Ethiopia. BMC Public Health 2018; 18:1373. [PMID: 30547789 PMCID: PMC6295006 DOI: 10.1186/s12889-018-6291-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 12/03/2018] [Indexed: 11/25/2022] Open
Abstract
Background Ethiopia is currently facing new challenges related to food insecurity among the urban poor. Pensioners are segments of the population with reduced income and working capacity because of advancement of age and other related problems. There is no empirical evidence on Jimma Town pensioner’s household food insecurity and coping strategies. Methods A cross-sectional study was conducted among households in Jimma Town living on an income obtained from a pension from March 01–28, 2017. Data were collected from 399 randomly selected participants. Data were entered into EPi-Data version 3.1 and analyzed using SPSS Version 20.0. Variables with p ≤ 0.25 in the bivariate analyses were entered into a multivariable regression model to control for confounding variables. Results Nearly, 83.5% of households were food insecure. The odds of food insecurity among households with heads attending secondary school and above was 78% lower when compared to that of households with uneducated household heads (AOR = 0.22, 95% CI: 0.97 to 0.49). The odds of food insecurity among households headed by merchants was 91% lower when compared to that of households headed by guards (AOR = 0.09, 95% CI: 0.03, 0.29). Food insecure households were using coping strategies such as changing consumption patterns (44%), eating inexpensive foods (72.4%), reducing meal frequency (62.4%) and selling household assets, such as household food utensils (30.8%). The odds of food insecurity among households having large family size (≥ 7) was 3.74 times higher when compared to that of households with family size less than three (AOR = 3.74(1.27, 10.99). Conclusions Household food insecurity was associated with having households headed by uneducated, widowed and guard household heads and having large family size. Food insecure households used both consumption and asset-based coping strategies such as eating less preferred, lower quality or less expensive foods and receiving donation from relatives or friends. Government policies should consider revising the current social protection scheme for pensioners. Special attention should be given to widow pensioners and pensioners with low educational status and with large family sizes.
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Affiliation(s)
| | - Dessalegn Tamiru
- Department of Population and Family Health, Jimma University, Jimma, Ethiopia
| | | | - Meseret Tamiru
- Department of Health, Behaviour and Society, Jimma University, Jimma, Ethiopia
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Moradi S, Mirzababaei A, Mohammadi H, Moosavian SP, Arab A, Jannat B, Mirzaei K. Food insecurity and the risk of undernutrition complications among children and adolescents: A systematic review and meta-analysis. Nutrition 2018; 62:52-60. [PMID: 30852458 DOI: 10.1016/j.nut.2018.11.029] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 10/19/2018] [Accepted: 11/27/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVES This systematic review and meta-analysis was performed to examine the association between household food insecurity and the risk of being underweight, stunting, and wasting in children and adolescents. METHODS Pertinent studies were identified by searching PubMed, Web of Science, and Scopus databases up to June 2018. A total of 21 studies met the inclusion criteria to be included in the pooled analysis. The risk ratio of 55 173 individuals from 12 different countries were pooled in these studies for our meta-analysis. RESULTS It was found that food insecurity increased the risk of stunting (odds ratio [OR] = 1.17; 95% confidence interval [CI]: 1.09-1.25) and underweight (OR = 1.17; 95% CI: 1.01-1.36) but not of wasting (OR = 1.04; 95% CI: 0.96-1.12). Subgroup analysis by age indicated that food insecurity increased the risk of stunting (OR = 1.20; 95% CI: 1.02-1.39) and underweight (OR = 1.34; 95% CI: 1.02-1.77) in children older than 5 y. This association was significant just for stunting risk (OR = 1.14; 95% CI: 1.05-1.23) in children younger than 5 y. Furthermore, among children and adolescents, risk of stunting or being underweight increased by the intensification of the level of food insecurity in food-insecure households. Furthermore, subgroup analysis by country development levels showed that children and adolescents living in developing countries had higher risk of stunting (OR = 1.16; 95% CI: 1.05-1.27). CONCLUSIONS Household food insecurity appears to be associated with higher risk of stunting and being underweight among children and adolescents. In addition, the intensification of the level of food insecurity and the increased age of children may increase the risk of stunting or being underweight in food-insecure households. Also, the level of economic development is an important factor in the effects of food insecurity on risk of stunting.
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Affiliation(s)
- Sajjad Moradi
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Students Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyedeh Parisa Moosavian
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Kumar M, Amugune B, Madeghe B, Wambua GN, Osok J, Polkonikova-Wamoto A, Bukusi D, Were F, Huang KY. Mechanisms associated with maternal adverse childhood experiences on offspring's mental health in Nairobi informal settlements: a mediational model testing approach. BMC Psychiatry 2018; 18:381. [PMID: 30518351 PMCID: PMC6280351 DOI: 10.1186/s12888-018-1953-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 11/16/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) is a significant public health and social welfare problem in low-and middle income countries (LMICs). However, most ACEs research is based on developed countries, and little is known about mechanisms of early ACEs on adulthood health and offspring's wellbeing for populations in LMICs. This area is needed to guide social welfare policy and intervention service planning. This study addresses these research gaps by examining patterns of ACEs and understanding the role of ACEs on adulthood health (i.e., physical, mental health, experience of underage pregnancy) and offspring's mental health in Kenya. The study was guided by an Integrated Family Stress and Adverse Childhood Experiences Mediation Framework. METHODS Three hundred ninety four mothers from two informal communities in Kariobangi and Kangemi in Nairobi were included in this study. The Adverse Childhood Experiences International Questionnaire (ACE-IQ), the Kessler Psychological Distress Scale (K10), Overall Health and Quality of Life items, and Child Behavior Checklist were used to study research questions. Data was gathered through a one-time interview with mothers. Structural Equational Modeling (SEM) was applied for mediational mechanism testing. RESULTS Among 13 ACE areas, most mothers experienced multiple adversity during their childhood (Mean (SD) = 4.93 (2.52)), with household member treated violently (75%) as the most common ACE. SEM results showedthat all domains of ACEs were associated with some aspects of maternal health, and all three domains of maternal health (maternal mental health, physical health, and adolescent pregnancy) were significantly associated with development of offspring's mental health problems. CONCLUSION ACEs are highly prevalent in Kenyan informal settlements. Consistent with cross cultural literature on family stress model, maternal ACEs are robust predictors for poor child mental health. Preventive interventions for child mental health need to address maternal adverse childhood traumatic experiences as well as their current health in order to effectively promote child mental health.
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Affiliation(s)
- Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Research Department of Clinical Health and Educational Psychology, University College London, London, UK
| | | | - Beatrice Madeghe
- Department of Food and Nutrition Sciences, University of Nairobi, Nairobi, Kenya
| | - Grace Nduku Wambua
- Department of Clinical, Neuro- & Developmental Psychology, Vrije University of Amsterdam, Amsterdam, Netherlands
| | - Judith Osok
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | | | - David Bukusi
- Head VCT and HIV Care, Kenyatta National Hospital, Nairobi, Kenya
| | - Fred Were
- College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Keng-Yen Huang
- Department of Population Health, New York University School of Medicine, New York, USA
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Brabec M, Behrman JR, Emmett SD, Gibson E, Kidd C, Leonard W, Penny ME, Piantadosi ST, Sharma A, Tanner S, Undurraga EA, Godoy RA. Birth seasons and heights among girls and boys below 12 years of age: lasting effects and catch-up growth among native Amazonians in Bolivia. Ann Hum Biol 2018; 45:299-313. [PMID: 30328382 PMCID: PMC6191890 DOI: 10.1080/03014460.2018.1490453] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 05/28/2018] [Accepted: 06/04/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND Seasons affect many social, economic, and biological outcomes, particularly in low-resource settings, and some studies suggest that birth season affects child growth. AIM To study a predictor of stunting that has received limited attention: birth season. SUBJECTS AND METHODS This study uses cross-sectional data collected during 2008 in a low-resource society of horticulturists-foragers in the Bolivian Amazon, Tsimane'. It estimates the associations between birth months and height-for-age Z-scores (HAZ) for 562 girls and 546 boys separately, from birth until age 11 years or pre-puberty, which in this society occurs ∼13-14 years. RESULTS Children born during the rainy season (February-May) were shorter, while children born during the end of the dry season and the start of the rainy season (August-November) were taller, both compared with their age-sex peers born during the rest of the year. The correlations of birth season with HAZ were stronger for boys than for girls. Controlling for birth season, there is some evidence of eventual partial catch-up growth, with the HAZ of girls or boys worsening until ∼ age 4-5 years, but improving thereafter. By age 6 years, many girls and boys had ceased to be stunted, irrespective of birth season. CONCLUSION The results suggest that redressing stunting will require attention to conditions in utero, infancy and late childhood.
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Affiliation(s)
- Marek Brabec
- a Institute of Computer Science of the Czech Academy of Sciences, Department of Biostatistics and Informatics , National Institute of Public Health , Prague , Czech Republic
| | - Jere R Behrman
- b Department of Economics and Population Studies Center , University of Pennsylvania , Philadelphia , PA , USA
| | - Susan D Emmett
- c Department of Surgery, Division of Head and Neck Surgery & Communication Sciences , Duke University School of Medicine and Duke Global Health Institute , Durham , NC , USA
| | - Edward Gibson
- d Department of Psychology , University of California , Berkeley , Berkeley, CA , USA
| | - Celeste Kidd
- e Department of Psychology , , University of California , Berkeley, Berkeley , CA , USA
| | - William Leonard
- f Department of Anthropology , Northwestern University , Evanston , IL , USA
| | - Mary E Penny
- g Instituto de Investigación Nutricional , Lima , Peru
| | - Steven T Piantadosi
- e Department of Psychology , , University of California , Berkeley, Berkeley , CA , USA
| | - Abhishek Sharma
- h Royal Brisbane and Women's Hospital , Brisbane , Australia
| | - Susan Tanner
- i Anthropology , University of Georgia , Athens , GA , USA
| | - Eduardo A Undurraga
- j Pontificia Universidad Catolica de Chile, Escuela de Gobierno , Santiago , Chile
| | - Ricardo A Godoy
- k Heller School for Social Policy and Management , Brandeis University , Waltham , MA , USA
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Makamto Sobgui C, Kamedjie Fezeu L, Diawara F, Diarra H, Afari-Sefa V, Tenkouano A. Predictors of poor nutritional status among children aged 6-24 months in agricultural regions of Mali: a cross-sectional study. BMC Nutr 2018; 4:18. [PMID: 32153882 PMCID: PMC7050697 DOI: 10.1186/s40795-018-0225-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 04/04/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The right nutrition during the first 2 years of life can positively impact a child's ability to develop, grow, and learn. Malnutrition remains a public health problem in Mali and little is known about the factors affecting the nutritional status of children. This study aims to assess the magnitude and the predictors of undernutrition in children aged 6-24 months in the poor rural regions of Mali. METHODS A community-based cross-sectional study was conducted in the villages in the Sikasso and Mopti regions in Mali from January to March 2016, comprising of 959 boys and 856 girls aged 6-24 months. A structured interviewer administered a questionnaire that was used to collect data from the mothers living in 1764 households. Anthropometric measurements were performed using standardized methods in order to identify the factors associated with children suffering from undernutrition (stunting and wasting). Bivariate and multivariate logistic regression analyses were conducted. RESULTS The results of our study indicated that 23.9 and 28.4% children were underweight and stunted; the prevalence of wasting was 13.9% using the W/H measurement and 16.5% with the MUAC. Overall, the presence of diarrhea in the past 2 weeks (p < 0.001), higher child age (p < 0.001), male sex (p < 0.001), households with the lowest household amenity score (p < 0.002), and households with a low dietary diversity score (p < 001) were significantly associated with chronic malnutrition. The factors significantly associated with acute malnutrition were male sex (p < 0.01), preterm birth (p < 0.03), lower child age (0.001), a high number of siblings (p < 0.03), and living in a household with more months of inadequate food provisioning (p < 0.03). CONCLUSION Child undernutrition is a critical public health problem in the agricultural regions of Mali. Future efforts should be directed at addressing the food insecurity and at improving the yearlong household availability and accessibility of nutritious food, as well as taking diseases prevention into account.
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Affiliation(s)
| | - Leopold Kamedjie Fezeu
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France
| | - Fatou Diawara
- Agence National de Sécurité Alimentaire, Bamako, Mali
| | - Honafing Diarra
- World Vegetable Center, West and Central Africa, PO Box 320, Bamako, Mali
| | - Victor Afari-Sefa
- World Vegetable Center, West and Central Africa, PO Box 320, Bamako, Mali
| | - Abdou Tenkouano
- West and Central Africa Council for Agricultural Research and Development, 7 Avenue Bourguiba, PO Box 48, Dakar, Senegal
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Fentahun N, Belachew T, Coates J, Lachat C. Seasonality and determinants of child growth velocity and growth deficit in rural southwest Ethiopia. BMC Pediatr 2018; 18:20. [PMID: 29390985 PMCID: PMC5796588 DOI: 10.1186/s12887-018-0986-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/16/2018] [Indexed: 11/22/2022] Open
Abstract
Background Ethiopia faces cyclic food insecurity that alternates between pre- and post- harvest seasons. Whether seasonal variation in access to food is associated with child growth has not been assessed empirically. Understanding seasonality of child growth velocity and growth deficit helps to improve efforts to track population interventions against malnutrition. The aim of this study was assess child growth velocity, growth deficit, and their determinants in rural southwest Ethiopia. Method Data were obtained from four rounds of a longitudinal household survey conducted in ten districts in Oromiya Region and Southern Nations, Nationality and Peoples Region of Ethiopia, in which 1200 households were selected using multi-stage cluster sampling. Households with a child under 5 years were included in the present analyses (round 1 n = 579, round 2 n = 674, round 3 n = 674 and round 4 n = 680). The hierarchical nature of the data was taken into account during the statistical analyses by fitting a linear mixed effects model. A restricted maximum likelihood estimation method was employed in the analyses. Result Compared to the post-harvest season, a higher length and weight velocity were observed in pre-harvest season with an average difference of 6.4 cm/year and 0.6 kg/year compared to the post-harvest season. The mean height of children in post-harvest seasons was 5.7 cm below the WHO median reference height. The mean height of children increased an additional 3.3 cm [95% CI (2.94, 3.73)] per year in pre-harvest season compared to the post-harvest season. Similarly, the mean weight of children increased 1.0 kg [95% CI (0.91, 1.11)] per year more in the pre-harvest season compared to the post-harvest season. Children who had a low dietary diversity and were born during the lean season in both seasons had a higher linear growth deficit. Being member of a highly food insecure household was negatively associated with higher weight gain. Having experienced no illness during the previous 2 weeks was positively associated with linear growth and weight gain. Conclusion Child growth velocities and child growth deficits were higher in the pre-harvest season and post- harvest season respectively. Low dietary diversity and being part of a highly food insecure household were significantly risk factors for decreased linear growth and weight gain respectively.
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Affiliation(s)
- Netsanet Fentahun
- Department of Health Education and Behavioral Sciences, College of Health Sciences, Jimma University, Jimma, Ethiopia. .,Department of Food Safety and Food Quality, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium. .,School of Public Health Engineering, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Tefera Belachew
- Department of Population and Family Health, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Jennifer Coates
- Friedman School of Nutrition Science and Policy, Feinstein International Center at Tufts University, Boston, USA
| | - Carl Lachat
- Department of Food Safety and Food Quality, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
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Abebe Z, Zelalem Anlay D, Biadgo B, Kebede A, Melku T, Enawgaw B, Melku M. High Prevalence of Undernutrition among Children in Gondar Town, Northwest Ethiopia: A Community-Based Cross-Sectional Study. Int J Pediatr 2017; 2017:5367070. [PMID: 29387093 PMCID: PMC5745770 DOI: 10.1155/2017/5367070] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 10/18/2017] [Accepted: 10/31/2017] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE To assess undernutrition and associated factors among children aged 6-59 months in Gondar Town, northwest Ethiopia. METHODS A community-based cross-sectional study was conducted in 2014. Multistage sampling method was used to select study participants. Structured interviewer administered questionnaire and anthropometric measurements were used. Binary logistic regression was fitted to identify associated factors. RESULTS The prevalences of wasting and stunting were 6.8% and 45.7%, respectively. Higher odds of wasting were observed among children whose fathers were daily laborers (AOR = 2.63), children who had eating problem (AOR = 2.96), and those who were not exclusively breast-fed for the first six months (AOR = 5.63). Similarly, higher odds of stunting were found among female children (AOR = 1.65), children who lived in households having four to six families (AOR = 2.14), and children who did not start breast-feeding within one hour of birth (AOR = 0.67). CONCLUSION Childhood undernutrition was a significant problem. Child eating problem, paternal occupation, and exclusive breast-feeding were associated with wasting, whereas family size, child sex, and breast-feeding initiation time were associated with stunting. Therefore, strengthening of early initiation and exclusive breast-feeding, promoting healthcare seeking behavior, and designing social support programme for poor family are recommended to reduce undernutrition.
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Affiliation(s)
- Zegeye Abebe
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Degefaye Zelalem Anlay
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belete Biadgo
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Asemarie Kebede
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tsedalu Melku
- School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bamlaku Enawgaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Mulugeta Melku
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Ohnishi M, Leshabari S, Ambikile JS, Oishi K, Nakao Y, Nishihara M. Associations among anthropometric measures, food consumption, and quality of life in school-age children in Tanzania. J Rural Med 2017; 12:38-45. [PMID: 28593016 PMCID: PMC5458351 DOI: 10.2185/jrm.2924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 01/20/2017] [Indexed: 11/27/2022] Open
Abstract
Objectives: The factors associated with quality of life (QOL) and
anthropometric measurements as outcomes of food consumption were examined among school-age
children in Tanzania. Methods: A cross-sectional study was undertaken in September 2013 in
Tanzania. Anonymous self-administered questionnaire surveys were conducted in the
Kiswahili language among primary school children in the fifth and/or sixth grade aged
10–14 years. The survey probed sociodemographic characteristics such as age, gender,
living with family members, number of meals/snacks per day, food consumption in the
previous 24 hours, and QOL, as well as anthropometric measurements (height and weight).
The Rohrer index was calculated based on height and weight. After presenting the mean and
standard deviation (SD) of height, weight, and the Rohrer index score by age and gender,
the Rohrer index score was categorized into three groups (low weight, normal weight, and
overweight) and analyzed according to sociodemographic characteristics and food
consumption using the chi-square test. Furthermore, the QOL score was analyzed using the
t test. Multivariate linear regression analysis was used to analyze the
associations between the QOL score and sociodemographic characteristics and food
consumption. Results: A total of 694 children (male: 312; female: 382) participated in
this study. According to the Rohrer index, 273 (39.3%) children were classified as low
weight, 353 (50.9%) were normal weight, and 68 (9.8%) were overweight. A total of 459
(66.1%) children reported having had three or more meals and/or snacks on the day before
the study. In addition, 127 (18.3%) children had not eaten any protein-rich food on the
day before the study, although almost all had eaten at least one carbohydrate-rich food
per day. Regardless of region, location, gender, and age, living without parents was
associated with short stature (P = 0.010). A high QOL score was
associated with having three or more meals and/or snacks per day (P <
0.001). Conclusions: The security of physiological needs such as a guarantee of
three meals per day could contribute to higher QOL among underserved children.
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Affiliation(s)
- Mayumi Ohnishi
- Unit of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Sebalada Leshabari
- School of Nursing, Muhimbili University of Health and Allied Sciences, Tanzania
| | - Joel Seme Ambikile
- School of Nursing, Muhimbili University of Health and Allied Sciences, Tanzania
| | - Kazuyo Oishi
- Unit of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Yuko Nakao
- Unit of Nursing, Kagoshima University Graduate School of Health Sciences, Japan
| | - Mika Nishihara
- Unit of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Tamiru D, Argaw A, Gerbaba M, Ayana G, Nigussie A, Belachew T. Effect of integrated school-based nutrition education on optimal dietary practices and nutritional status of school adolescents in Southwest of Ethiopia: a quasi-experimental study. Int J Adolesc Med Health 2016; 29:/j/ijamh.ahead-of-print/ijamh-2016-0015/ijamh-2016-0015.xml. [PMID: 27977399 DOI: 10.1515/ijamh-2016-0015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 06/03/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Malnutrition and infection are major barriers to educational access and achievement in low-income countries and also work in conjunction with each other in deteriorating wellness and productivity of school adolescents. METHODS A quasi-experimental design was used to evaluate the effectiveness of school-based nutrition education using a peer-led approach, health promotion through school media and health clubs. Data were collected at baseline, midline and end line from sampled participants. To account for the effect of time trend, the difference was measured using a repeated measure analysis. Variables that have p≤0.25 in the bivariate analyses were entered into multivariables to determine the independent effect of interventions. RESULTS There is a significant difference in food variety between food secure and insecure households (p<0.01). A significant improvement of animal source dietary intake was observed among intervention schools (p<0.001) that was significantly associated with an intervention [adjusted odds ratio (AOR)=0.26, confidence interval (CI): 0.16, 0.42], male gender (AOR=0.48, CI: 0.31, 0.73) and household economic status (AOR=1.69, CI: 1.01, 2.84). The control group had high body mass index (BMI) at baseline, but a significant improvement was observed among the intervention schools, which positively associated with male gender (AOR=4.13, CI: 2.38, 7.15) and having a middle-income family (AOR=2.93, CI: 1.92, 6.15). CONCLUSION This study showed that by integrating a dietary intervention into school-based activities, there might be significant improvements in dietary intake of primary school adolescents. Therefore, school-based nutrition education programs should be a part of comprehensive school health programs to reach the students and potentially their families.
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Dominguez-Salas P, Alarcón P, Häsler B, Dohoo IR, Colverson K, Kimani-Murage EW, Alonso S, Ferguson E, Fèvre EM, Rushton J, Grace D. Nutritional characterisation of low-income households of Nairobi: socioeconomic, livestock and gender considerations and predictors of malnutrition from a cross-sectional survey. BMC Nutr 2016. [DOI: 10.1186/s40795-016-0086-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Finlay JE, Fink G, McCoy DC, Tavárez LC, Chai J, Danaei G, Ezzati M, Fawzi W, Fawzi MCS. Stunting risk of orphans by caregiver and living arrangement in low-income and middle-income countries. J Epidemiol Community Health 2016; 70:784-90. [DOI: 10.1136/jech-2015-206346] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 01/14/2016] [Indexed: 01/17/2023]
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