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Vankayalapati A, Wamwere-Njoroge G, Fujita M. Effects of household composition on infant feeding and mother-infant health in northern Kenya. Am J Hum Biol 2024; 36:e23993. [PMID: 37767929 DOI: 10.1002/ajhb.23993] [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: 12/06/2022] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Households with alloparents, individuals other than the mother who care for an infant, can shift members' roles and affect mother-infant health. AIMS To investigate how household composition relates to infant feeding and infectious disease risk in mother-infant dyads, the team utilized data from breastfeeding dyads (n 208) surveyed during a prolonged drought and food scarcity in northern Kenya. METHODS Households were classified by the presence/absence of potential alloparents, distinguishing non-siblings and siblings of the infant. Regression models for breastfeeding frequency, complementary feeding status, and recent infections (n 83) evaluated these outcomes' associations with household type while accounting for food insecurity, adjusted for infant age, infant sex, and maternal age. RESULTS Household type was unassociated with breastfeeding frequency, but the presence of non-sibling alloparents interacted with food insecurity, predicting increasing breastfeeding frequency as food insecurity intensified among dyads living with non-sibling alloparents. Households with non-sibling alloparents were also inversely associated with complementary feeding but had no association with infection. Households with siblings were inversely associated with (protective against) infant and maternal infection. CONCLUSION Further research is needed to understand the interactive influence of household social and food ecologies on mother-infant diet and health under diverse cultural rules and norms for alloparenting.
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Affiliation(s)
- A Vankayalapati
- Lyman Briggs College, Michigan State University, East Lansing, Michigan, USA
- Biomarker Laboratory for Anthropological Research, Michigan State University, East Lansing, Michigan, USA
| | | | - M Fujita
- Biomarker Laboratory for Anthropological Research, Michigan State University, East Lansing, Michigan, USA
- Department of Anthropology, Michigan State University, East Lansing, Michigan, USA
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Kusumawardani HD, Laksono AD, Hidayat T, Supadmi S, Latifah L, Sulasmi S, Ashar H, Musoddaq MA. Stunting Among Children Under Two Years in the Islands Areas: A Cross-sectional Study of the Maluku Region in Indonesia, 2021. J Res Health Sci 2023; 23:e00597. [PMID: 38315912 PMCID: PMC10843314 DOI: 10.34172/jrhs.2023.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/28/2023] [Accepted: 12/03/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The Maluku region encompasses thousands of islands. The study analyzed factors related to stunting among children under two years old in the Maluku Region of Indonesia. Study Design: A cross-sectional study. METHODS This cross-sectional study examined 4764 children under two years. In addition to nutritional status (stature), the study analyzed ten independent variables (province, residence, maternal age, marital status, maternal education, employment, wealth, children's age, gender, and early initiation of breastfeeding [EIBF]). Finally, the contribution of various factors to stunting was examined using logistic regression. RESULTS Children in Maluku province were 1.13 times more likely than those in North Maluku province to become stunted. In addition, children aged 12-13 months were 4.09 times more likely than<12 months, and boys were 1.87 times more likely than girls to have the patterns of stunting. Children in rural areas were 1.10 times more likely to become stunted than those in urban areas (95% confidence interval: 1.06, 1.14). Divorced/widowed mothers were 1.88 times more likely than married mothers. Mothers of all education levels were more likely than those without formal education, and unemployed mothers were 1.07 times more likely than employed mothers to have stunted children. The possibility of becoming stunted was lower when the children were wealthier. CONCLUSION Nine variables were related to stunted incidence, including province, residence, maternal age, marital status, maternal education, employment, wealth, children's age, and gender.
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Affiliation(s)
| | - Agung Dwi Laksono
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
| | - Taufik Hidayat
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
| | - Sri Supadmi
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
| | - Leny Latifah
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
| | - Sri Sulasmi
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
| | - Hadi Ashar
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
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Lesiapeto M, Shults J, Mmunyane M, Matshaba M, Lowenthal ED. Stunted Growth Is Associated With Dyslipidemia in Young Adults With Perinatal HIV Infection. J Acquir Immune Defic Syndr 2023; 93:343-350. [PMID: 37071712 PMCID: PMC10625796 DOI: 10.1097/qai.0000000000003209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/27/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND HIV increases the risk of atherosclerosis and cardiovascular diseases (CVD). This risk maybe even higher in adult survivors of perinatal HIV infection because of prolonged exposure to HIV and its treatments. Nutritional deprivation in early life may further increase CVD risk. SETTING Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone. METHODS This study examined dyslipidemia in 18- to 24-year olds with perinatally-acquired HIV with and without linear growth retardation ("stunting"). Anthropometry and lipid profiles were measured following a minimum 8-hour fast. Stunting was defined by a height-for-age z-score of <2 SDs below the mean. Dyslipidemia was defined by non-high-density lipoprotein cholesterol (HDL-C) of ≥130 mg/dL, low-density lipoprotein cholesterol (LDL-C) of ≥100 mg/dL, or HDL of <40 mg/dL for male subjects and <50 mg/dL for female subjects. We used logistic regression to determine whether dyslipidemia was associated with stunting while adjusting for demographic and HIV treatment variables. RESULTS Of 107 young adults (46 males; 61 females) enrolled, 36 (33.6%) were stunted. Prevalence of dyslipidemia was 11.2%, 24.3%, and 65.4% for high non-HDL-C, high LDL-C, and low HDL-C, respectively. In univariable analysis, being stunted was associated with elevated LDL-C (odds ratio [OR], 2.52; 95% confidence interval [CI] =1.02 to 6.25) but not with elevated non-HDL-C (OR = 2.17; 95% CI: = 0.65 to 7.28) or with low HDL-C (OR = 0.75; 95% CI: = 0.33 to 1.73). The association between stunting and elevated LDL-C (OR = 4.40; 95% CI: = 1.49 to 12.98) remained significant after controlling for measured confounders. CONCLUSION Dyslipidemia was common among perinatally HIV-infected youth and those with evidence of early nutritional deprivation who were more likely to have elevated LDL-C.
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Affiliation(s)
- Maemo Lesiapeto
- Centre for Child and Adolescent Nutrition, Princess Marina Hospital, Gaborone, Botswana
- University of Pennsylvania, Philadelphia, US
| | - Justine Shults
- University of Pennsylvania, Philadelphia, US
- The Children’s Hospital of Philadelphia
| | - Mogakolodi Mmunyane
- Botswana-Baylor Children’s Clinical Centre of Excellence (BBCCCOE), Gaborone, Botswana
| | - Mogomotsi Matshaba
- Botswana-Baylor Children’s Clinical Centre of Excellence (BBCCCOE), Gaborone, Botswana
- Baylor College of Medicine, Houston, Texas, US
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Supariasa IDN, Fajar I, Khairuddin K, Adelina R. Analyzing Nutritional Factors that Affect Toddler’s Stunting in Malang Regency, Indonesia. Open Access Maced J Med Sci 2023. [DOI: 10.3889/oamjms.2023.10199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND: The proportion of short and very short toddlers in Indonesia is 30.8%. East Java is among the 18 provinces with high prevalence (30%–<40%), having made Malang Regency included among the 100 regencies/cities prioritized for intervention.
AIM: This study aimed to analyze sociodemographic and nutritional factors affecting toddler’s stunting in Malang Regency, Indonesia.
DESIGN AND METHODS: A case–control analytic survey research with retrospective approach was used: An epidemiologic observation design to study the effect of exposures to diseases or other health problems occurrences. The investigation was conducted during July to August time period through observation, weight measurement and interview in order to collect the data about mother’s knowledge, childcare practices, household food security, healthcare services, access to clean water, economic and socio-cultural background, parenting practices, and causes of stunting. The data were processed using SPSS 16.0, bivariate analysis (Chi-square), and multivariate analysis using multiple logistic regression testing with odds ratio and confidence interval calculation.
RESULTS: Parenting practices of the toddlers were not ideal, with only 60% of mothers had good knowledge about stunting. About 76% of the stunted toddlers’ households had insecure food availability and security. Up to 98% of the mothers with stunted toddlers received blood-boosting tablets during pregnancy from health-care services; however, interview results disclosed that they were not consumed. As many as, 98% of the households got access to clean water from Malang Municipal Waterworks and 2% from closed well. A total of 96% of the households made income fewer than Malang Regency’s minimum wage. The stunted toddlers’ households who had eating restrictions during pregnancy and breastfeeding were 13%. Most stunted toddlers as many as 76% were taken care of by their biological mothers, while the remaining 24% by grandmothers or other relatives. Thus, the causes of stunting from the most to the least dominant were as follows: Household’s income, exclusive breastfeeding, household size, father’s education, mother’s nutritional knowledge, household’s food security, mother’s level of education, toddler’s energy intake, appropriate feedings of weaning food, toddler’s fat intake, toddler’s history of infectious diseases, sociocultural background, toddler’s protein intake, mother’s occupation, household’s nutritional awareness behavior, and the completeness of immunization.
CONCLUSION: Stunting main risk factors are household income, size, history of breastfeeding, father’s education and occupation. Factors which are not significantly related to stunting include household nutritional awareness and behavior, hygiene, socio-economic status, energy and micronutrients intake, toddler’s food and vitamin A compliment, toddler’s status and characteristics, and maternal health services.
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Keddy KH, Saha S, Kariuki S, Kalule JB, Qamar FN, Haq Z, Okeke IN. Using big data and mobile health to manage diarrhoeal disease in children in low-income and middle-income countries: societal barriers and ethical implications. THE LANCET INFECTIOUS DISEASES 2022; 22:e130-e142. [DOI: 10.1016/s1473-3099(21)00585-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 08/23/2021] [Accepted: 08/31/2021] [Indexed: 12/28/2022]
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Housing and Child Health in South Africa: The Value of Longitudinal Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052497. [PMID: 35270189 PMCID: PMC8909575 DOI: 10.3390/ijerph19052497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/01/2022] [Accepted: 02/10/2022] [Indexed: 02/01/2023]
Abstract
Research investigating the link between housing and health often produces mixed results. It does not always prove that good housing improves health. The results suggest a complex set of factors play a role, and the findings are sometimes contradictory. Two ways of addressing these concerns are longitudinal research, where the relationship between housing and health is measured in the short and medium terms, and a focus on children. We use the children’s housing and health data from the five waves of the National Income and Distribution Survey (NIDS) survey in South Africa, 2008 to 2017. We investigate the effect that continued living in informal housing over the five waves has had on these children’s health. Our results show a statistically significant relationship between prolonged residence in poor housing and poor health outcomes for some health indicators. The results call for a closer understanding of health issues in housing policy in South Africa.
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Usman MA, Kornher L, Sakketa TG. Do non-maternal adult female household members influence child nutrition? Empirical evidence from Ethiopia. MATERNAL & CHILD NUTRITION 2021; 17 Suppl 1:e13123. [PMID: 34241954 PMCID: PMC8269146 DOI: 10.1111/mcn.13123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/09/2020] [Accepted: 11/24/2020] [Indexed: 11/29/2022]
Abstract
Child malnutrition is an enormous public health problem in low- and middle-income countries (LMICs). In this paper, we study the relationship between non-maternal adult female household members (AFHMs) and under-5 child nutritional outcomes using nationally representative Ethiopian Demographic and Health Survey data, 2016. Because most of the primary inputs that go into the production of child health are intensive in maternal time, having additional AFHMs may ease the time constraints of the child's mother. We use anthropometric measures such as height-for-age z-scores (HAZ) and weight-for-age z-scores (WAZ) to measure stunting and underweight, respectively, as objective indicators of child nutritional status. Among our sampled households, we find that 40% of the children are stunted, 18% severely stunted, 27% underweight and 8% severely underweight. Furthermore, about 20% of the sampled children live with at least one extra non-maternal AFHM. The multivariate regression results suggest that an additional AFHM is associated with significantly higher HAZ and WAZ scores and less likelihood of severe stunting compared with children living with fewer AFHMs. Finally, the paper discusses the potential pathways through which non-maternal AFHMs can influence child nutritional status.
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Affiliation(s)
| | - Lukas Kornher
- Center for Development Research (ZEF), University of Bonn, Bonn, Germany
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Aubel J, Martin SL, Cunningham K. Introduction: A family systems approach to promote maternal, child and adolescent nutrition. MATERNAL & CHILD NUTRITION 2021; 17 Suppl 1:e13228. [PMID: 34241950 PMCID: PMC8269145 DOI: 10.1111/mcn.13228] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/19/2021] [Indexed: 11/26/2022]
Abstract
In all cultures, women and children are embedded in family systems that determine roles, relationships, patterns of communication and authority between family members. Especially in non-western societies, maternal and child nutrition practices are determined not only by the biological parents but also by other influential family members. Most maternal and child nutrition research and interventions do not consider the constellation of family roles and influence on women and children and continue to focus on the mother-child dyad and individual knowledge, attitudes and practices. There is growing agreement on the need to adopt an ecological framework to address public health issues, including those dealing with maternal and child nutrition. This special issue presents examples of research from a variety of settings that employed an ecological, family systems approach either to investigate maternal, child or adolescent nutrition issues or to design interventions that engaged various actors within family settings. These 11 articles contribute to a growing body of evidence supporting the relevance of a wider family systems perspective for nutrition research and interventions. Key themes across studies include the limitations of using a nuclear family model for research and intervention design, the need for formative research that comprehensively explores family systems, increasing recognition of the extensive involvement and support provided by grandmothers, and the importance of engaging men in culturally appropriate ways based on community dialogue and women's perspectives. Future maternal and child nutrition research and interventions can be strengthened by systems thinking that acknowledges that individuals are situated within family and community systems.
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Affiliation(s)
- Judi Aubel
- Grandmother Project—Change through CultureRomeItaly
| | - Stephanie L. Martin
- Department of Nutrition, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Carolina Population CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Kenda Cunningham
- Helen Keller InternationalNew YorkNew YorkUSA
- Department of Population Health, Faculty of Epidemiology, London School of Hygiene and Tropical MedicineLondonEngland
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Palacios AM, Freeland-Graves JH, Dulience SJL, Delnatus JR, Iannotti LL. Differences in factors associated with anemia in Haitian children from urban and rural areas. PLoS One 2021; 16:e0247975. [PMID: 33822795 PMCID: PMC8023464 DOI: 10.1371/journal.pone.0247975] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 02/16/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In Haiti, differences in the prevalence of anemia between urban and rural areas have been observed. OBJECTIVE To identify moderating factors that may help explain the difference in the prevalence of anemia in children from poor urban vs. rural areas of Haiti. METHODS This cross-sectional study used secondary data from urban and rural school-based trials that assessed the effectiveness of a nutrition intervention. The study was registered at ClinicalTrials.gov as NCT02747524. A total of 300 rural- and 981 urban- children between 2.5-13 years of age were included in this analysis. Effect modification in a binary logistic generalized linear mixed model was conducted using sample weights in SPSS® version 26. Models were adjusted for age and income. School cluster was included as random effect. RESULTS In rural areas, stunting was more prevalent in children with anemia vs. no anemia, (16.6%, and 6.3%, P = 0.008), respectively. Also, rural children with anemia lived with fewer adults vs. rural children with no anemia, ([Formula: see text] = 2.83±1.29, and 3.30±1.54, P = 0.005), respectively. In poor urban areas, helminth morbidities were more frequent in children with anemia vs. no anemia, (21.9% vs. 13.9, P = 0.011), respectively. In the combined sample, stunting, [AOR = 2.05; 95%CI (1.32-3.18)], age [AOR = 0.89; 95%CI (0.85-0.93)], and households with more adults [AOR = 0.77; 95%CI (0.67-0.87)] were associated with anemia. Effect modification by place of residence was observed in households with more adults (t = 3.83, P<0.001). No other nutritional, dietary, sanitation or morbidity factors or effect modifiers were observed. CONCLUSIONS In this sample, factors associated with anemia differed in poor urban and rural children from Haiti including family structure and helminth morbidities. Stunting and lower age increased the odds of anemia in the combined sample. Family structure appears to have an important role in anemia, and further research understanding the influence of family structures in anemia is needed.
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Affiliation(s)
- Ana M. Palacios
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States of America
| | - Jeanne H. Freeland-Graves
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States of America
| | | | | | - Lora L. Iannotti
- Institute for Public Health, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri, United States of America
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Leepile TT, Mokomo K, Bolaane MMM, Jones AD, Takada A, Black JL, Jovel E, Karakochuk CD. Anemia Prevalence and Anthropometric Status of Indigenous Women and Young Children in Rural Botswana: The San People. Nutrients 2021; 13:1105. [PMID: 33800575 PMCID: PMC8066262 DOI: 10.3390/nu13041105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 11/16/2022] Open
Abstract
In Botswana, there is limited data available on the health and nutritional status of the San People (also known as the Basarwa or Bushmen), an Indigenous minority group primarily living in the Ghanzi District. Our aim in this study was to assess anemia prevalence among and anthropometric indices of women and young children in Ghanzi District through a cross-sectional survey. We recruited 367 mother-child pairs (women 15-49 years and children 6-59 months) in nine randomly selected areas. A capillary blood sample was collected, and weight and height were measured. Hemoglobin (Hb) concentration was measured with use of a hemoglobinometer (HemoCue, AB), as per global recommendations. Overall, adjusted anemia prevalence was 12% in non-pregnant women (Hb < 120 g/L), 26% in pregnant women (Hb < 110 g/L), and 42% in children (Hb < 110 g/L), but it varied widely depending on whether or not the controversial factor of ethnicity was adjusted for (range of 6-26%, 22-30%, and 35-68% prevalence, respectively). Thirty-nine percent (n = 133/344) of non-pregnant women and 52% (n = 12/23) of pregnant women were underweight (BMI < 18.5 kg/m2). In children aged 6-23 months, 41% were underweight (weight-for-age z-score < -2 SD), 13% were wasted (weight-for-height z-score < -2 SD), and 65% were stunted (height-for-age z-score < -2 SD); in children aged 24-59 months, 57% were underweight, 13% were wasted, and 66% were stunted. Fifty-six percent (n = 205/367) of women self-reported smoking in any form (rolled cigarettes or snuffing). The high prevalence of smoking among women, underweight status among pregnant women, and anemia, stunting, and wasting among children is of the highest concern for public health and should be addressed in future health and nutrition programming.
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Affiliation(s)
- Tebogo T. Leepile
- Integrated Studies in Land and Food Systems, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (T.T.L.); (J.L.B.); (E.J.)
- BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | | | - Maitseo M. M. Bolaane
- San Research Centre, Botswana and the Department of History, University of Botswana, Gaborone, Botswana;
| | - Andrew D. Jones
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA;
| | - Akira Takada
- Centre for African Area Studies, Kyoto University, Kyoto 606-8304, Japan;
| | - Jennifer L. Black
- Integrated Studies in Land and Food Systems, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (T.T.L.); (J.L.B.); (E.J.)
- Department of Food, Nutrition, and Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- The Peter Wall Institute for Advanced Studies, University of British Columbia, Vancouver, BC V6T 1Z2, Canada
| | - Eduardo Jovel
- Integrated Studies in Land and Food Systems, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (T.T.L.); (J.L.B.); (E.J.)
| | - Crystal D. Karakochuk
- BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
- Department of Food, Nutrition, and Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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