1
|
Biyang YVS, Bisseye C, Saidou M, N Tchoreret A. Determinants of low birth weight in Franceville, Southeast Gabon. Pan Afr Med J 2024; 47:218. [PMID: 39247776 PMCID: PMC11380620 DOI: 10.11604/pamj.2024.47.218.40737] [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: 06/12/2023] [Accepted: 02/27/2024] [Indexed: 09/10/2024] Open
Abstract
Introduction birth weight is a critical indicator of neonatal health and predicts future developmental outcomes. Despite its importance, there is a notable lack of research on the determinants of low birth weight (LBW) in southeast Gabon. This study aims to fill this gap by identifying factors contributing to LBW at the Centre Hospitalier Universitaire Amissa Bongo in Franceville. Methods this retrospective analysis covered the period from February 2011 to May 2017, focusing on postpartum women and their infants. Data were analyzed using R software (version 4.3.2), employing both descriptive statistics and logistic regression. Statistical significance was determined at a p-value of less than 0.05. Results among the 877 births analyzed, the prevalence of LBW was 8.4%. Bivariate analysis identified several factors associated with an increased risk of LBW, including, primigravida women (COR (95%CI) =0.59 (0.36-0.98), P = 0.036), primiparous women (COR (95%CI) =0.58 (0.36-0. 94), P = 0.024), women with a gestational age <37 weeks (COR (95%CI) =0.07 (0.04-0.11), P<0.001), women with ≤2 antenatal visits (COR (95%CI) =0.39 (0.18-0.93), P= 0.021), and women who underwent cesarean delivery (COR (95%CI) =0.46 (0.26-0.84), P = 0.008). However, multivariate analysis showed that only gestational age (AOR (95%CI) = 0.07 (0.04-0.11), P<0.001) and cesarean delivery (AOR (95%CI) = 0.48 (0.25-0.95), P = 0.03) were significantly associated with LBW. Conclusion this study highlights the importance of gestational age and delivery method in the prevalence of LBW in southeast Gabon. These findings underscore the need for targeted interventions to address these risk factors, thereby improving neonatal health outcomes.
Collapse
Affiliation(s)
- Yann Vital Sima Biyang
- Laboratoire de Biologie Moléculaire et Cellulaire, Université des Sciences et Techniques de Masuku, Franceville, Gabon
- Centre Hospitalier Universitaire Amissa Bongo, Franceville, Gabon
| | - Cyrille Bisseye
- Laboratoire de Biologie Moléculaire et Cellulaire, Université des Sciences et Techniques de Masuku, Franceville, Gabon
| | | | | |
Collapse
|
2
|
Davies-Kershaw H, Fahmida U, Htet MK, Kulkarni B, Faye B, Yanti D, Shinta D, Zahra NL, Angelin TC, Madhari R, Pullakhandam R, Palika R, Dasi T, Fernandez Rao S, Banjara SK, Selvaraj K, Palepu DP, Yadev D, Diouf S, Lopez-Sall P, Diallo B, Mouissi P, Fall S, Diallo I, Djigal A, Immerzeel TDV, Tairou F, Diop A, Pradeilles R, Strout S, Momo Kadia B, Tata DT, Jobarteh ML, Allen S, Walker A, Webster JP, Haggarty P, Heffernan C, Ferguson E. Anthropometric, biochemical, dietary, morbidity and well-being assessments in women and children in Indonesia, India and Senegal: a UKRI GCRF Action Against Stunting Hub protocol paper. BMJ Paediatr Open 2024; 8:e001683. [PMID: 38417920 PMCID: PMC10910654 DOI: 10.1136/bmjpo-2022-001683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/28/2023] [Indexed: 03/01/2024] Open
Abstract
INTRODUCTION Child stunting has a complex aetiology, especially in the first 1000 days of life. Nutrition interventions alone have not produced expected impacts in reducing/preventing child stunting, indicating the importance of understanding the complex interplay between environmental, physiological and psychological factors influencing child nutritional status. This study will investigate maternal and child nutrition, health and well-being status and associated factors through the assessment of: (1) anthropometry, (2) biomarkers of nutrition and health status, (3) dietary intakes, (4) fetal growth and development, (5) infant morbidity, (6) infant and young child feeding (IYCF) and (7) perinatal maternal stress, depression and social support. METHODS This study will be conducted in a prospective pregnancy cohort in India, Indonesia and Senegal. Pregnant women will be recruited in the second (Indonesia, Senegal) and third (India) trimester of pregnancy, and the mother and infant dyads followed until the infant is 24 months of age. During pregnancy, anthropometric measures will be taken, venous blood samples will be collected for biochemical assessment of nutrition and health status, dietary intakes will be assessed using a 4-pass-24-hour dietary recall method (MP24HR), fetal ultrasound for assessment of fetal growth. After birth, anthropometry measurements will be taken, venous blood samples will be collected, MP24HR will be conducted, infant morbidity and IYCF practices will be assessed and a sample of breastmilk will be collected for nutrient composition analyses. Perinatal maternal stress, depression, social support and hair cortisol levels (stress) will be measured. The results from this study will be integrated in an interdisciplinary analysis to examine factors influencing infant growth and inform global efforts in reducing child stunting. ETHICS AND DISSEMINATION Ethical approval was granted by the Ethics Committee of the London School of Hygiene and Tropical Medicine (17915/RR/17513); National Institute of Nutrition (ICMR)-Ministry of Health and Family Welfare, Government of India (CR/04/I/2021); Health Research Ethics Committee, University of Indonesia and Cipto Mangunkusumo Hospital (KET-887/UN2.F1/ETIK/PPM.00.02/2019); and the Comité National d'Ethique pour la Recherche en Santé, Senegal (Protocole SEN19/78); the Royal Veterinary College (URN SR2020-0197) and the International Livestock Research Institute Institutional Research Ethics Committee (ILRI-IREC2020-33). Results will be published in peer-reviewed journals and disseminated to policy-makers and participating communities.
Collapse
Affiliation(s)
- Hilary Davies-Kershaw
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Umi Fahmida
- Regional Centre for Food and Nutrition, SEAMEO, University of Indonesia, Jakarta, Indonesia
| | - Min Kyaw Htet
- Regional Centre for Food and Nutrition, SEAMEO, University of Indonesia, Jakarta, Indonesia
| | - Bharati Kulkarni
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Babacar Faye
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Dwi Yanti
- Regional Centre for Food and Nutrition, SEAMEO, University of Indonesia, Jakarta, Indonesia
| | - Dewi Shinta
- Regional Centre for Food and Nutrition, SEAMEO, University of Indonesia, Jakarta, Indonesia
| | - Nur L Zahra
- Regional Centre for Food and Nutrition, SEAMEO, University of Indonesia, Jakarta, Indonesia
| | - Tiffany C Angelin
- Regional Centre for Food and Nutrition, SEAMEO, University of Indonesia, Jakarta, Indonesia
| | - Radhika Madhari
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Raghu Pullakhandam
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Ravindranadh Palika
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Teena Dasi
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Sylvia Fernandez Rao
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Santosh Kumar Banjara
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Kiruthika Selvaraj
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Dharani Pratyusha Palepu
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Dinesh Yadev
- Department of Public Health, London International Development Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Saliou Diouf
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Philomene Lopez-Sall
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Babacar Diallo
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Princillia Mouissi
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Sally Fall
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Ibrahima Diallo
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Aicha Djigal
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | | | - Fassia Tairou
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Assana Diop
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- UMR, MOISA, Montpellier, France
| | - Sara Strout
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Benjamin Momo Kadia
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Darius Tetsa Tata
- Department of Public Health, London International Development Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Modou Lamin Jobarteh
- Department of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Stephen Allen
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Alan Walker
- The Rowett Institute, University of Aberdeen, Aberdeen, UK
| | - Joanne P Webster
- Department of Pathobiology and Population Sciences, University of London, London, UK
| | - Paul Haggarty
- The Rowett Institute, University of Aberdeen, Aberdeen, UK
| | - Claire Heffernan
- Department of Public Health, London International Development Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Elaine Ferguson
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
3
|
Namiiro FB, Batte A, Rujumba J, Nabukeera-Barungi N, Kayom VO, Munabi IG, Serunjogi R, Kiguli S. Nutritional status of young children born with low birthweight in a low resource setting: an observational study. BMC Pediatr 2023; 23:520. [PMID: 37858130 PMCID: PMC10585881 DOI: 10.1186/s12887-023-04356-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 10/10/2023] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVE Every year, an estimated 20 million babies are born with low birthweight and this number is increasing globally. Survivors are at risk of lifelong morbidities like undernutrition. We assessed the growth and nutritional status for children born with low birthweight at Mulago Hospital, Uganda. METHODS We conducted a cross sectional study to describe the nutritional status of children aged between 22 and 38 months and born weighing ≤ 2000 g. Anthropometric measurements; weight for height, height for age and weight for age z-scores were generated based on the World Health Organization standards to define wasting, stunting and underweight respectively. Data was collected using a structured questionnaire and analysis was done using STATA version 14. RESULTS Of the 251 children, 129 (51.4%) were male, mean age was 29.7 months SD 4.5) and maternal mean age was 29.9 (SD 5.3). A total of 101(40.2%) had normal nutritional status. The prevalence of wasting, underweight and stunting were: 8 (3.2%), 36 (14.4%) and 106 (42.2%) respectively. CONCLUSION Six of ten children born with low birthweight were at risk of undernutrition in early childhood: underweight and stunting were higher than the national prevalence. Targeted interventions are needed for children with very low birth weight.
Collapse
Affiliation(s)
- Flaviah B Namiiro
- Department of Paediatrics & Child Health, Mulago National Referral Hospital, Kampala, Uganda.
| | - Anthony Batte
- Child Health and Development Center, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Joseph Rujumba
- Department of Paediatrics & Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Violet O Kayom
- Department of Paediatrics & Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ian G Munabi
- Department of Anatomy, Makerere University College of Health Sciences, Kampala, Uganda
| | - Robert Serunjogi
- Makerere University-John Hopkins University Institute, Kampala, Uganda
| | - Sarah Kiguli
- Department of Paediatrics & Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| |
Collapse
|
4
|
Thahir AIA, Li M, Holmes A, Gordon A. Exploring Factors Associated with Stunting in 6-Month-Old Children: A Population-Based Cohort Study in Sulawesi, Indonesia. Nutrients 2023; 15:3420. [PMID: 37571357 PMCID: PMC10421344 DOI: 10.3390/nu15153420] [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: 06/26/2023] [Revised: 07/30/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Stunting in children under the age of two is a significant global concern, particularly in low- and middle-income countries like Indonesia. Intervention efforts often come too late as many of the underlying causal factors have already occurred earlier. While antenatal multiple micronutrient supplements (MMS) have demonstrated positive effects on pregnancy outcomes, their impact on infant growth in the first six months remains inadequately explored in epidemiological studies. This study aims to identify factors associated with stunting at six months in infants whose mothers received MMS. A population-based cohort study was conducted in four subdistricts of Banggai, Indonesia. Pregnant women were recruited in their third trimester and followed up until their children were six months of age. Validated questionnaires were employed to gather data on social determinants of health and diet, and standardised methods were utilised for anthropometric measurements. Stunting was determined based on the WHO child growth standards. The analysis comprised data from 152 mother-child pairs. The prevalence of stunting during early infancy (first two months) was 18.4%, which decreased to 15.8% in later infancy (at six months). Factors such as small-for-gestational-age (AOR = 11.29; 2.73-46.66), preterm birth (AOR = 6.33; 1.25-31.97), short birth length (AOR = 4.31; 1.11-16.78), maternal mid-upper arm circumference (MUAC) below 23.5 cm, and female infants (AOR = 3.27; 95%CI: 1.04-10.27) were associated with stunting at six months. This study highlights that stunting in the first six months is present at birth, with small-for-gestational-age (SGA) as a strong predictor. In addition, there was a trend to improved growth (-0.30 [-0.79 to 0.18]) in infants born to mothers who received MMS supplementation pre-pregnancy rather than during pregnancy, although it was not statistically significant.
Collapse
Affiliation(s)
- Andi Imam Arundhana Thahir
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia;
- Department of Nutrition, Faculty of Public Health, Hasanuddin University, Makassar 90245, Indonesia
| | - Mu Li
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia;
| | - Andrew Holmes
- School of Life and Environmental Science, Faculty of Science, The University of Sydney, Sydney 2006, Australia;
- Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
| | - Adrienne Gordon
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia;
- Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
- The Royal Prince Alfred Hospital (RPA), Newborn Care, Sydney Local Health District, Sydney 2050, Australia
| |
Collapse
|
5
|
Rahmatika QT, Aditya RS, Yusuf A, Almutairi RL, Al Razeeni DM, Kotijah S, Sulistyorini A. We are facing some barriers: A qualitative study on the implementation of kangaroo mother care from the perspectives of healthcare providers. J Public Health Afr 2022. [PMID: 37497131 PMCID: PMC10367030 DOI: 10.4081/jphia.2022.2412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Health systems at all levels are under pressure to provide comprehensive and high quality of care based on the best evidencebased interventions. The kangaroo mother care (KMC) is one way to care for Low Birth Weight babies (LBW) especially in developing country where the rates of preterm and LBW neonates are higher and the resources are limited. The purpose of this paper is to explore healthcare providers’ perspectives of kangaroo mother care implementation in perinatology ward in the rural surgical hospital of East Java Province, Indonesia. We conducted an in-depth interviews to identify KMC implementations. Ten healthcare providers engaged with KMC were interviewed. Data was analyzed using a thematic analysis. Healthcare providers reported positives perceptions of KMC and acknowledged their important roles to give education. The barriers in implementing the KMC including the level of knowledge and the age of the mother of LBW babies. KMC as a method of treating LBW babies is effective intervention care of preterm and LBW babies. This research provides information regarding the need of supports from all levels in KMC implementation.
Collapse
|
6
|
Niragire F, Ndikumana C, Nyirahabimana MG, Mugemangango C. Child stunting and associated risk factors in selected food-insecure areas in Rwanda: an analytical cross-sectional study. Pan Afr Med J 2022; 43:111. [PMID: 36721473 PMCID: PMC9860091 DOI: 10.11604/pamj.2022.43.111.35100] [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: 04/24/2022] [Accepted: 06/24/2022] [Indexed: 02/02/2023] Open
Abstract
Introduction stunting rates among the under-five children are generally high in Rwanda. They are unexpectedly lower than the national average stunting rate in some districts where poverty rates are the highest in the country. This study aimed to ascertain the key factors that protect children from stunting in these poorest areas, where stunting rates are lower than expected. Methods we analysed cross-sectional data from 2019/2020 Rwanda Demographic and Health Survey (RDHS) for 477 under-five children from Karongi, Rulindo, Nyanza, and Gisagara districts. Univariate and bivariate statistical analyses were used to find out the factors to retain for multivariable analysis. We obtained the key risk factors of child stunting through a multivariable binary logistic regression analysis. Results the child stunting rate in the study districts was 30 percent, which is three percent lower than the national average rate. Child stunting was negatively associated with a birth weight of at least 2.5 kg (AOR = 0.393, 95% CI: 0.180 - 0.856), a high household economic status (AOR = 0.506, 95%CI: 0.273 - 0.937), urban residence (AOR = 0.467; 95% CI: 0.222 - 0.984), and health insurance coverage (AOR = 0.418; 95% CI: 0.228 -0.767). Children aged one year and above, as well as female-headed households, were associated with at least three times and two times greater odds of child stunting than children aged below 12 months and those from male-headed households respectively. Conclusion the nutritional performance of children in the study districts is substantially driven by the high uptake of health insurance, which fosters increased access to healthcare services. To address child-stunting gaps in low-income areas in Rwanda, child nutrition programs should improve the utilization of healthcare services, and leverage the potential high effect of nutrition education, especially during pregnancy and lactation.
Collapse
Affiliation(s)
- François Niragire
- Department of Applied Statistics, University of Rwanda, Kigali, Rwanda,,Corresponding author: François Niragire, Department of Applied Statistics, University of Rwanda, Kigali, Rwanda.
| | - Celestin Ndikumana
- Department of Governance and Public Administration, University of Rwanda, Kigali, Rwanda
| | | | - Cyprien Mugemangango
- African Centre of Excellence in Data Science, University of Rwanda, Kigali, Rwanda
| |
Collapse
|
7
|
Nsiah-Asamoah C, Adjei G, Agblorti S, Doku DT. Association of maternal characteristics with child feeding indicators and nutritional status of children under-two years in Rural Ghana. BMC Pediatr 2022; 22:581. [PMID: 36207712 PMCID: PMC9540729 DOI: 10.1186/s12887-022-03651-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 09/30/2022] [Indexed: 11/10/2022] Open
Abstract
Background Optimal nutrition during the first two years of a child’s life is critical for the reduction of morbidity and mortality. In Ghana, majority of children miss out on optimal nutrition and only few (13%) of children receive a Minimum Acceptable Diet (MAD). Several studies have investigated the influence of community-level factors on infants and young children feeding (IYCF) practices. However, little is known about the influence of maternal factors on IYCF practices in rural settings. Therefore, this study assessed the influence of maternal factors on the feeding indicators and nutritional status of children aged 6–23 months in two administrative districts in Ghana. Methods Data were collected among 935 mothers who had children aged 6–23 months and accessed 21 Child Welfare Clinics within the study area. The study involved a face- to-face interview using structured questionnaires to capture maternal characteristics, dietary intake and anthropometric measurements of children. Multivariate logistic regression was used to study the association between maternal factors and child nutrition outcomes (MAD, dietary diversity score (DDS) and anthropometric indicators) using Stata 16.0 software. Results Being employed (AOR = 3.07, 95% CI: 1.71—5.49, p < 0.001) and attaining secondary or higher education (AOR = 2.86, 95% CI: 1.42—5.78, p = 0.003) were significant predictors of children receiving MAD. Similarly, having an average decision-making autonomy increased the child’s odds of receiving MAD (AOR = 1.68, 95% CI: 1.02—2.76, p = 0.040). Children of mothers who attained secondary or a higher level of education (AOR = 0.59, 95% CI: 0.36 -0.97, p = 0.040) and those whose mothers were employed (AOR = 0.71, 95% CI: 0.47—1.07, p = 0.043) were associated with a reduced risk of underweight and stunting respectively. Children of mothers with average financial independence status were more likely to receive diversified meals (AOR = 1.55, 95% CI: 1.01–2.38, p = 0.045). Conclusions High educational level and being employed have positive influence on MAD, stunting and underweight of children. High decision-making power and average financial independence of mothers are good predictors of children receiving MAD. Family planning, women empowerment in decision-making, providing employment opportunities for mothers and promoting girl-child education are recommended.
Collapse
Affiliation(s)
| | - George Adjei
- Department of Community Medicine, University of Cape Coast, Cape Coast, Ghana
| | - Samuel Agblorti
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - David Teye Doku
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| |
Collapse
|
8
|
Shenavar R, Sajjadi SF, Farmani A, Zarmehrparirouy M, Azadbakht L. Improvement in Anthropometric Measurements of Malnourished Children by Means of Complementary Food and Nutritional Education in Fars Province, Iran: A Community-Based Intervention. Front Nutr 2022; 9:813449. [PMID: 35308266 PMCID: PMC8924542 DOI: 10.3389/fnut.2022.813449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/21/2022] [Indexed: 11/14/2022] Open
Abstract
Background Childhood malnutrition could have adverse impacts on the growth of child and eventually on fertility and general economic growth, and still, this issue remains a worldwide priority and a concern. This study aimed to evaluate the effectiveness of the national nutritional interventions program on the improvement and nutritional status of malnourished children children aged 6–59 months. Methods This community-based intervention study was conducted with 1288 acute and moderately malnourished children aged 6–59 months referred to health centers. Children received combined nutritional education and counseling with the provision of affordable complementary food for 10 months. Anthropometric measurements were assessed monthly according to the standard protocols. Results Our results showed the reduction in the risk of malnutrition among children after nutritional interventions for weight-for-height (WHZ) (P < 0.001), height-for-age (HAZ) (P < 0.001), and weight-for-age (WAZ) (P = 0.008). Total malnourished children indicated improvement in HAZ (<-3 SD: OR = 1.10, P = 0.026), WAZ (<-2SD: OR = 1.21, P < 0.001; <-3SD: OR = 1.60, P < 0.001), and WHZ (<-3SD: OR = 1.10, P = 0.030). Controlling potential confounders (socioeconomic status, childrens' birth supine length, and weight) showed a significant amelioration in HAZ (<-2 SD: OR = 6.20, P = 0.020; <-3 SD: OR = 9, P = 0.003) and WAZ (<-2 SD: OR = 5.85, P = 0.010; <-3 SD: OR = 7.50, P = 0.004). In urban areas, significant amelioration was observed in HAZ (<-3 SD: OR = 1.22, P = 0.010) and WAZ (<-2 SD: OR = 1.24, P = 0.003; <-3 SD: OR = 1.64, P < 0.001). In rural, considerable amelioration was observed in WAZ (<-2 SD: OR = 1.20, P = 0.010; <-3 SD: OR = 1.50, P < 0.001) and WHZ (<-3 SD: OR = 1.20, P = 0.020). Conclusion Nutritional training and counseling as well as complementary food intervention among the malnourished children significantly improved the nutritional status of children. So community-based intervention is recommended to reduce the malnutrition among children.
Collapse
Affiliation(s)
- Razieh Shenavar
- Department of Community Nutrition, Shiraz University of Medical Science, Shiraz, Iran
- Department of Community Nutrition, School of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyedeh Forough Sajjadi
- Department of Community Nutrition, Shiraz University of Medical Science, Shiraz, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Farmani
- Department of Community Nutrition, Shiraz University of Medical Science, Shiraz, Iran
| | - Mina Zarmehrparirouy
- Department of Community Nutrition, Shiraz University of Medical Science, Shiraz, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Leila Azadbakht
| |
Collapse
|
9
|
Bountogo M, Sié A, Zakané A, Compaoré G, Ouédraogo T, Lebas E, Brogdon J, Nyatigo F, Arnold BF, Lietman TM, Oldenburg CE. Antenatal care attendance and risk of low birthweight in Burkina Faso: a cross-sectional study. BMC Pregnancy Childbirth 2021; 21:825. [PMID: 34903190 PMCID: PMC8667364 DOI: 10.1186/s12884-021-04310-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 12/01/2021] [Indexed: 11/22/2022] Open
Abstract
Background Low birthweight is a major contributor to infant mortality. We evaluated the association between antenatal care (ANC) attendance and low birthweight among newborns in 5 regions of Burkina Faso. Methods We utilized data from the baseline assessment of a randomized controlled trial evaluating azithromycin distribution during the neonatal period for prevention of infant mortality. Neonates were eligible for the trial if the weighed at least 2500 g at enrollment and were 8–27 days of age. Data on ANC attendance and birthweight was extracted from each child’s carnet de santé, a government-issued health card on which pregnancy and birth-related data are recorded. We used linear and logistic regression models adjusting for potentially confounding variables to evaluate the relationship between ANC attendance (as total number of visits and ≥ 4 antenatal care visits) and birthweight (continuously and categorized into < 2500 g versus ≥2500 g). Results Data from 21,223 births were included in the analysis. The median number of ANC visits was 4 (interquartile range 3 to 5) and 69% of mothers attended at least 4 visits. Mean birthweight was 2998 g (standard deviation 423) and 8.1% of infants were low birthweight (< 2500 g). Birthweight was 63 g (95% CI 46 to 81 g, P < 0.001) higher in newborns born to mothers who had attended ≥4 ANC visits versus < 4 visits. The odds of low birthweight among infants born to mothers with ≥4 ANC visits was 0.71 (95% CI 0.63 to 0.79, P < 0.001) times the odds of low birthweight among infants born to mothers who attended < 4 ANC visits. Conclusions We observed a statistically significant association between ANC attendance and birthweight, although absolute differences were small. Improving access to ANC for all women may help improve birth outcomes. Trial registration The parent trial is registered at clinicaltrials.gov: NCT03682653; first registered 24 September 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04310-6.
Collapse
Affiliation(s)
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | | | | | - Elodie Lebas
- Francis I Proctor Foundation, University of California, 490 Illinois St, Floor 2, San Francisco, CA, 94143, USA
| | - Jessica Brogdon
- Francis I Proctor Foundation, University of California, 490 Illinois St, Floor 2, San Francisco, CA, 94143, USA
| | - Fanice Nyatigo
- Francis I Proctor Foundation, University of California, 490 Illinois St, Floor 2, San Francisco, CA, 94143, USA
| | - Benjamin F Arnold
- Francis I Proctor Foundation, University of California, 490 Illinois St, Floor 2, San Francisco, CA, 94143, USA.,Department of Ophthalmology, University of California, San Francisco, USA
| | - Thomas M Lietman
- Francis I Proctor Foundation, University of California, 490 Illinois St, Floor 2, San Francisco, CA, 94143, USA.,Department of Ophthalmology, University of California, San Francisco, USA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Catherine E Oldenburg
- Francis I Proctor Foundation, University of California, 490 Illinois St, Floor 2, San Francisco, CA, 94143, USA. .,Department of Ophthalmology, University of California, San Francisco, USA. .,Department of Epidemiology and Biostatistics, University of California, San Francisco, USA.
| |
Collapse
|
10
|
Carvalho RM, Ferreira IMDESR, Miranda Jr F. Protein malnutrition during lactation affects thoracic aortic tunica media thickness in Wistar rat pups. Acta Cir Bras 2021; 36:e361008. [PMID: 34852134 PMCID: PMC8650804 DOI: 10.1590/acb361008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/27/2021] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate the morphological effects of a low-protein diet during maternal lactation on the offspring's thoracic aorta. METHODS Two female Wistar rats were mated with male of the same species at 4 months of age. Until the birth of the pups, all animals received commercial rat chow. After giving birth, the puerperal females were divided into two groups and adjusted the litter to five puppies per group: a control group that received commercial feed, and an experimental group whose diet included the same amount of calories, but 8% lower protein content. All animals' masses were measured throughout the lactation period, and the pups were euthanized after weaning at 21 days of age. The thoracic aorta was removed, histologically processed and stained with Weigert's resorcin-fuchsin for histomorphometric analysis of tunica media thickness. RESULTS Although both groups were born with similar body mass, during the 21 days of lactation the restricted protein group gained only 39% of the body mass of the control group. Histomorphometric analysis revealed that the restricted protein group had a significantly lower mean tunica media thickness than the control group. CONCLUSIONS A low-protein diet for nursing mothers influences mass gain and aortic tunica media thickness in their offspring.
Collapse
|