1
|
Akhtar A, Masood R, Ibrahim M, Gurmani N, Abdullah M, Ali A, Kareem T. Exploring the Multifaceted Influences on Childhood Nutritional Status: A Study Conducted in South Punjab, Pakistan. Cureus 2024; 16:e64329. [PMID: 39130973 PMCID: PMC11316499 DOI: 10.7759/cureus.64329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2024] [Indexed: 08/13/2024] Open
Abstract
Introduction The double burden of malnutrition (DBM) in Pakistan is a rising concern affecting school-going children, marked by coexisting under- and over-nutrition within the same population. Key influences include shifts in dietary habits, socioeconomic status, and lifestyle changes due to rapid urbanization. With a focus on Multan, Pakistan, the study seeks to assess the proportion of underweight and overweight students while identifying the risk factors and sociodemographic characteristics associated with this incidence. The aim is to guide future health interventions addressing this multidimensional health challenge. Materials and methods This study, adopting a descriptive cross-sectional research design, collected data from female teenage students through interviews and anthropometric measurements. A total of 300 participants were randomly selected from a comprehensive school list representing diverse urban and rural settings. Participants' weight and height were measured to calculate their body mass index (BMI), categorizing them into underweight, normal weight, and overweight groups. The relevant risk factors were collected through an interview questionnaire. Collected data were analyzed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States), with the results stratified according to socioeconomic, dietary, and psychosocial factors and compared across different weight categories. Results The study collected data from 300 students, revealing a correlation between socioeconomic status, dietary habits, and BMI. Parental occupation significantly affected nutritional status, with children of laborers primarily falling within normal and underweight categories. Dietary habits like frequency of fast food and milk or dairy consumption showed notable associations with nutritional status. Psychosocial factors such as peer or teacher comments about weight and outdoor sports participation also influenced the students' nutritional status. However, factors like family income, video game hours, and the presence of pets at home did not show significant associations with nutritional status. Conclusions The study illustrates a multi-faceted association between socioeconomic status, dietary habits, and BMI among schoolchildren in Multan, Pakistan, emphasizing the need for comprehensive interventions.
Collapse
Affiliation(s)
- Aiman Akhtar
- National Institute of Health, Health Services Academy, Islamabad, PAK
| | - Rabiya Masood
- Community Medicine, Nishtar Medical University, Multan, PAK
| | | | - Neelab Gurmani
- Preventive Medicine, Integrated Reproductive, Maternal, Newborn and Child Health (IRMNCH) Program, Multan, PAK
| | - Muhammad Abdullah
- Surgery, Shifa College of Medicine, Shifa Tameer-E-Millat University, Islamabad, PAK
| | - Abdullah Ali
- Surgery, Shifa College of Medicine, Shifa Tameer-E-Millat University, Islamabad, PAK
| | - Talha Kareem
- General Surgery and Vascular Surgery, Indus Hospital, Indus Hospital and Health Network, Muzaffargarh, PAK
- General Surgery, Nishtar Medical University, Multan, PAK
| |
Collapse
|
2
|
Khan MN, Harris ML, Hassen TA, Bagade T, Shifti DM, Feyissa TR, Chojenta C. Effects of short birth interval on child malnutrition in the Asia-Pacific region: Evidence from a systematic review and meta-analysis. MATERNAL & CHILD NUTRITION 2024; 20:e13643. [PMID: 38530129 PMCID: PMC11168362 DOI: 10.1111/mcn.13643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/16/2024] [Accepted: 02/28/2024] [Indexed: 03/27/2024]
Abstract
Child malnutrition remains a significant concern in the Asia-Pacific region, with short birth intervals recognised as a potential risk factor. However, evidence of this association is inconclusive. This study aimed to systematically review the existing evidence and assess the summary effects of short birth interval on child malnutrition in the Asia-Pacific region. Five electronic databases were searched in May 2023 to identify relevant studies reporting the association between short birth interval and child malnutrition, including stunting, wasting, underweight, anaemia and overall malnutrition, in Asia-Pacific region between September 2000 and May 2023. Fixed-effects or random-effects meta-analysis was performed to estimate the summary effects of short birth interval on child malnutrition. Out of 56 studies meeting the inclusion criteria, 48 were included in quantitative synthesis through meta-analysis. We found a slightly higher likelihood of stunting (n = 25, odds ratio [OR] = 1.13; 95% confidence interval [CI]: 0.97-1.32) and overall malnutrition (n = 3, OR = 2.42; 95% CI: 0.88-6.65) among children born in short birth intervals compared to those with nonshort intervals, although the effect was not statistically significant. However, caution is warranted due to identified heterogeneity across studies. Subgroup analysis demonstrated significant effects of short birth intervals on child malnutrition in national-level studies and studies with larger sample sizes. These findings underscore short birth intervals as a significant contributor to child malnutrition in the Asia-Pacific region. Implementing effective policies and programs is vital to alleviate this burden, ultimately reducing child malnutrition and associated adverse outcomes, including child mortality.
Collapse
Affiliation(s)
- Md Nuruzzaman Khan
- Department of Population ScienceJatiya Kabi Kazi Nazrul Islam UniversityMymensinghBangladesh
- Centre for Women's Health Research, School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Melissa L. Harris
- Centre for Women's Health Research, School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Tahir A. Hassen
- Centre for Women's Health Research, School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Tanmay Bagade
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Desalegn M. Shifti
- Centre for Women's Health Research, School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Child Health Research CentreThe University of QueenslandBrisbaneAustralia
| | - Tesfaye R. Feyissa
- Deakin Rural Health, School of Medicine, Faculty of HealthDeakin UniversityBurwoodVictoriaAustralia
| | - Catherine Chojenta
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
| |
Collapse
|
3
|
Tyagi J, Beri D, Ingale S, Sinha P, Bhaumik S. Occupational health hazards of bidi workers and their families in India: a scoping review. BMJ Glob Health 2023; 8:e012413. [PMID: 37918876 PMCID: PMC10626877 DOI: 10.1136/bmjgh-2023-012413] [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: 03/27/2023] [Accepted: 08/29/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Bidi workers and their families are exposed to harmful substances during bidi rolling, thereby jeopardising their health. We aimed to assess existing evidence on health conditions of bidi workers and their families in India. METHODS We searched nine databases and relevant websites, and conducted citation screening to identify primary studies assessing occupational health hazards of bidi workers and their families. Two authors independently conducted screening and data extraction. We synthesised the findings narratively in a structured fashion. RESULTS We found 3842 studies, out of which 95 studies met our eligibility criteria. High prevalence of disease conditions across all organ systems of the body was reported in bidi workers. Studies on female bidi workers showed decreased fertility (n=2), increased frequency of miscarriages (n=1) and higher risk of cervical cancer (n=1). Pregnant bidi workers were at an increased risk of anaemia and pregnancy-induced hypertension (n=2), higher frequency of neonatal deaths (n=1), stillbirths (n=1) and premature births (n=1) in comparison with non-bidi workers. Babies born to bidi workers reported low birth weight (n=5). Evidence from cohort studies suggests causal nature of the exposure to the disease condition. CONCLUSION Our review shows that bidi rolling leads to numerous occupational health hazards in bidi workers and their family members. It is essential to provide alternative livelihoods, and safe and protective working environment, and cover bidi workers under various social security provisions to alleviate the deleterious effect of bidi making at home. It is also important to shift bidi making away from home and strengthen existing regulations and promulgation of new provisions, including India's Occupational Safety, Health, and Working Conditions Code 2020.
Collapse
Affiliation(s)
- Jyoti Tyagi
- Meta-Research and Evidence Synthesis, The George Institute for Global Health, New Delhi, Delhi, India
| | - Deepti Beri
- Injury Division, The George Institute for Global Health, New Delhi, Delhi, India
| | - Samiksha Ingale
- Meta-Research and Evidence Synthesis, The George Institute for Global Health, New Delhi, Delhi, India
| | - Praveen Sinha
- Non-Communicale Disease Division, WHO Country Office for India, New Delhi, Delhi, India
| | - Soumyadeep Bhaumik
- Meta-Research and Evidence Synthesis, The George Institute for Global Health, New Delhi, Delhi, India
| |
Collapse
|
4
|
Saif S, Anwar S. Unraveling the South Asian enigma: concurrent manifestations of child anthropometric failures and their determinants in selected South Asian countries. BMC Nutr 2023; 9:120. [PMID: 37904239 PMCID: PMC10614331 DOI: 10.1186/s40795-023-00771-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 09/28/2023] [Indexed: 11/01/2023] Open
Abstract
Malnutrition among children is pervasive in South Asia and there are also reports of overnutrition. To better understand this phenomenon, we need a composite measure. However, the existing measures such as CIAF (Composite Index of Anthropometric Failure) and its revised version have ignored the overnutrition aspect of the phenomenon. This study proposes an extended version of CIAF which also considers overnutrition. This new measure was compared with the existing measures by using data from 1990 to 2018 for three selected South Asian countries including Pakistan, India and Bangladesh. We also examined the effects of socioeconomic and environmental variables on the outcome variable. The results reveal that the new measure (ECIAF) is better at measuring the phenomena. The burden of overall malnutrition has been decreased in the region. However, an increase in the concomitant prevalence of wasting and underweight is observed in both Pakistan and India and stunting and overweight is observed only in India. Besides, political stability, prevalence of undernourishment, anemia in children, mother's education, household size, dependency ratio, air pollution and unimproved sanitation are significantly correlated with childhood malnutrition. The findings also testified to long-run cointegrating relationship among the variables.
Collapse
Affiliation(s)
- Sabeen Saif
- Department of Economics, Government College University, Faisalabad, Pakistan.
| | - Sofia Anwar
- Department of Economics, Government College University, Faisalabad, Pakistan
| |
Collapse
|
5
|
Singh SK, Chauhan A, Sharma SK, Puri P, Pedgaonkar S, Dwivedi LK, Taillie LS. Cultural and Contextual Drivers of Triple Burden of Malnutrition among Children in India. Nutrients 2023; 15:3478. [PMID: 37571415 PMCID: PMC10420920 DOI: 10.3390/nu15153478] [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: 05/31/2023] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 08/13/2023] Open
Abstract
This study examines malnutrition's triple burden, including anaemia, overweight, and stunting, among children aged 6-59 months. Using data from the National Family Health Survey-5 (2019-2021), the study identifies risk factors and assesses their contribution at different levels to existing malnutrition burden. A random intercept multilevel logistic regression model and spatial analysis are employed to identify child, maternal, and household level risk factors for stunting, overweight, and anaemia. The study finds that 34% of children were stunted, 4% were overweight, and 66% were anaemic. Stunting and anaemia prevalence were higher in central and eastern regions, while overweight was more prevalent in the north-eastern and northern regions. At the macro-level, the coexistence of stunting, overweight, and anaemia circumstantiates the triple burden of childhood malnutrition with substantial spatial variation (Moran's I: stunting-0.53, overweight-0.41, and anaemia-0.53). Multilevel analysis reveals that child, maternal, and household variables play a substantial role in determining malnutrition burden in India. The nutritional health is significantly influenced by a wide range of determinants, necessitating multilevel treatments targeting households to address this diverse group of coexisting factors. Given the intra-country spatial heterogeneity, the treatment also needs to be tailor-made for various disaggregated levels.
Collapse
Affiliation(s)
- Shri Kant Singh
- International Institute for Population Sciences, Mumbai 400088, India; (S.P.); (L.K.D.)
| | - Alka Chauhan
- International Food Policy Research Institute (IFPRI), Delhi 110012, India;
| | - Santosh Kumar Sharma
- The George Institute for Global Health, New Delhi 110025, India; (S.K.S.); (P.P.)
| | - Parul Puri
- The George Institute for Global Health, New Delhi 110025, India; (S.K.S.); (P.P.)
| | - Sarang Pedgaonkar
- International Institute for Population Sciences, Mumbai 400088, India; (S.P.); (L.K.D.)
| | - Laxmi Kant Dwivedi
- International Institute for Population Sciences, Mumbai 400088, India; (S.P.); (L.K.D.)
| | - Lindsey Smith Taillie
- Carolina Population Center, Department of Nutrition, University of North Carolina, Chapel Hill, NC 27516, USA;
| |
Collapse
|
6
|
Vastrad P, Neelopant S, Prasad UV, Kirte R, Chandan N, Barvaliya MJ, Hatnoor S, Shashidhar SB, Roy S. Undernutrition among rural school-age children: a major public health challenge for an aspirational district in Karnataka, India. Front Nutr 2023; 10:1209949. [PMID: 37502723 PMCID: PMC10368874 DOI: 10.3389/fnut.2023.1209949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
Background For school-age children, a healthy transition from childhood to adolescence and adulthood depends on proper nutrition. Globally, most nutritional surveys focus on preschool and adolescents, neglecting school-age children. Recent studies have shown the prevalence of thinness among adolescents to be 26.5% in Karnataka. Similarly, among children aged < 5 years in the Raichur district, the prevalence of stunting, wasting, and being underweight was 39.8, 23.2, and 40.7%, respectively. The present study aimed to bridge the data gap between < 5 years of children and adolescents through a nutritional survey of school-going children in Raichur, one of the aspirational districts of India. Materials and methods A cross-sectional survey was conducted from January to March 2020 among rural school-age children (n = 2700) in 30 villages of the Raichur district of Karnataka, India. The school children were selected through a multi-stage cluster sampling technique. The WHO Anthro-plus software was used for calculating the age and sex-specific Z-scores for weight-for-age (WAZ), height-for-age (HAZ), and BMI-for-age (BAZ). Results Of the 2,700 school-age children surveyed, the mean weight and height were 22.2 kg (+5.8) and 124.9 cm (+11.6), respectively. The prevalence of children having weight-for-age Z-scores < -2 SD (Underweight) was 45.3% (95% CI: 42.7%-47.8%). The magnitude of stunting and severe stunting was 19.5% (95% CI: 18.0%-21.0%) and 7.6% (95% CI: 6.6%-8.6%), respectively. The proportion of children with BMI for age Z-scores < -2SD (thinness) was 43% (95% CI: 41.1%-44.9%), with sub-district Sindhanur having a dual burden of malnutrition. Conclusion Despite many flagship programs, the prevalence of undernutrition in school-age children remains a considerable public health problem in the aspirational district of Raichur, India. Furthermore, exploratory studies are recommended to identify the factors associated with undernutrition among school-age children and strategize evidence-based intervention.
Collapse
Affiliation(s)
- Phaniraj Vastrad
- Model Rural Health Research Unit, Department of Health Research (Government of India), Sirwar, Raichur, Karnataka, India
| | | | - U. Venkateswara Prasad
- Model Rural Health Research Unit, Department of Health Research (Government of India), Sirwar, Raichur, Karnataka, India
| | - Rahul Kirte
- Model Rural Health Research Unit, Department of Health Research (Government of India), Sirwar, Raichur, Karnataka, India
- Raichur Institute of Medical Sciences, Raichur, Karnataka, India
| | - N. Chandan
- National Institute of Traditional Medicine, Indian Council of Medical Research (ICMR), Belagavi, Karnataka, India
| | - Manish J. Barvaliya
- National Institute of Traditional Medicine, Indian Council of Medical Research (ICMR), Belagavi, Karnataka, India
| | - Shivappa Hatnoor
- Raichur Institute of Medical Sciences, Raichur, Karnataka, India
| | - S. B. Shashidhar
- Raichur Institute of Medical Sciences, Raichur, Karnataka, India
| | - Subarna Roy
- Model Rural Health Research Unit, Department of Health Research (Government of India), Sirwar, Raichur, Karnataka, India
- National Institute of Traditional Medicine, Indian Council of Medical Research (ICMR), Belagavi, Karnataka, India
| |
Collapse
|
7
|
Veiga GRS, da Silva GAP, Padilha BM, Lima MDC. Determining factors of child linear growth from the viewpoint of Bronfenbrenner's Bioecological Theory. J Pediatr (Rio J) 2022; 99:205-218. [PMID: 36572387 DOI: 10.1016/j.jped.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/28/2022] [Accepted: 10/28/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To analyze the factors associated with children's linear growth, according to the different subsystems of the 6Cs model and Bronfenbrenner's Bioecological Theory. DATA SOURCES Narrative review, carried out in the Scielo, Lilacs, Pubmed, and Science Direct databases, based on research using the terms Bioecological Theory, child growth, and risk factors, combined with the use of Boolean operators. SUMMARY OF FINDINGS According to the 6Cs model, proposed based on Bronfenbrenner's Bioecological Theory, the determining factors of children's linear growth are in six interrelated subsystems - cell, child, clan, community, country/state and culture. The empirical studies included in this review made it possible to analyze protection and risk factors within the subsystems. Among the protective factors: are adequate birth weight and satisfactory weight gain, breastfeeding for six months or more; proper hygienic habit of hand washing, proper elimination of feces, and access to clean water. As risk factors: low, birth weight and size, prematurity, multiple deliveries, short interval between deliveries, non-exclusive breastfeeding until the 3rd month, frequency and severity of infectious processes and anemia, little parental education, short maternal statur, inadequate maternal nutritional status, domestic violence, family poverty, food, and nutritional insecurity, living in rural areas or at high altitudes. CONCLUSION Children's linear growth is determined by interrelated factors that encompass aspects prior to the child's birth, as well as socioeconomic, political, family and community issues.
Collapse
Affiliation(s)
- Gabriela Rossiter Stux Veiga
- Universidade Federal de Pernambuco, Pós-graduação em Saúde da Criança e do Adolescente, Recife, PE, Brazil; Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, Brazil.
| | | | | | - Marilia de Carvalho Lima
- Universidade Federal de Pernambuco, Pós-graduação em Saúde da Criança e do Adolescente, Recife, PE, Brazil
| |
Collapse
|
8
|
Janpeang J, Suwannapoom C, Anukunwathaka N. Nutritional status and related factors among ethnic preschool children in Northern Thailand: a cross-sectional study. CHILD HEALTH NURSING RESEARCH 2022; 28:176-186. [PMID: 35953067 PMCID: PMC9371800 DOI: 10.4094/chnr.2022.28.3.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/30/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose: This study investigated the nutritional status of ethnic (belonging to minority groups) preschool children in Northern Thailand.Methods: In this cross-sectional descriptive study, the sample group included 147 parents and 147 preschool children (2-6 years old). Participants volunteered to complete a questionnaire on the personal information of children and parents, as well as family- and school-related factors. Data were analyzed using descriptive statistics, a nutritional status calculator, and logistic regression analysis.Results: A birth weight of less than 2,500 g was related to weight-for-age and weight-for-height. Not having been breastfed and having been breastfed for less than 6 months were related to weight-for-height. An elementary school education level among parents was related to children's height-for-age. Familial unhealthy food consumption for 1-2 days per week was related to weight-for-age and height-for-age.Conclusion: This study reflects the importance of nutritional care for children at the beginning of pregnancy and continuing to the preschool age, as well as the importance of breastfeeding. Families were found to be a key factor in supporting good nutrition among children.
Collapse
Affiliation(s)
| | - Chatmongkon Suwannapoom
- Associate Professor, School of Agriculture and Natural Resources, University of Phayao, Phayao, Thailand
| | - Natnaree Anukunwathaka
- Nursing Instructor, School of Nursing, University of Phayao, Phayao, Thailand
- Corresponding author Natnaree Anukunwathaka School of Nursing, University of Phayao, 19, Moo 2, Mae Kha, Muang, Phayao 56000, Thailand TEL: +66-91-851-4832 FAX: +66-54-466-666 E-MAIL:
| |
Collapse
|
9
|
Keikha M, Kelishadi R. Letter to the editor: Comments on- Determinants of malnutrition among children: A systematic review. Nutrition 2022; 102:111722. [DOI: 10.1016/j.nut.2022.111722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/22/2022] [Indexed: 11/29/2022]
|