Nutritional and health status of a cohort of school-age children born to mothers treated for severe acute malnutrition in their childhood in The Democratic Republic of Congo

Prevalence of malnutrition and its associated factors among 18,503 Chinese children aged 3-14 years

Background

Child malnutrition places a major burden on global public health. We aimed to estimate the prevalence of child malnutrition and identify its potential factors among children aged 3-14 years from Beijing and Tangshan.

Methods

We cross-sectionally recruited 18,503 children aged 3-14 years from September 2020 to January 2022, according to a stratified cluster random sampling strategy. Child malnutrition was defined according to the World Health Organization criteria. Data were analyzed by STATA software and R language.

Results

The prevalence of malnutrition among 18,503 children was 10.93%. After multivariable adjustment, seven factors significantly associated with child malnutrition were parental education (adjusted odds ratio, 95% confidence interval, p: 1.52, 1.40 to 1.67, <0.001), family income (1.23, 1.16 to 1.30, <0.001), fast food intake frequency (1.14, 1.06 to 1.21, <0.001), night meals intake frequency (1.09, 1.04 to 1.15, <0.001), eating speed (1.01, 1.01 to 1.02, <0.001), maternal obesity (0.97, 0.95 to 0.99, <0.001), and paternal obesity (0.97, 0.96 to 0.98, <0.001). The seven significant factors had better prediction performance (area under the receiver operating characteristic, 0.956) for child malnutrition.

Conclusion

Approximately 10% of Chinese children aged 3-14 years were in malnutrition status, and seven factors were found to be significant predictors for child malnutrition.

Association between diagnostic criteria for severe acute malnutrition and hospital mortality in children aged 6-59 months in the eastern Democratic Republic of Congo: the Lwiro cohort study

Background

Few studies have assessed the relationship between weight-for-height (WHZ) and mid-upper arm circumference (MUAC) with hospital mortality considering confounders. The particularity of MUAC for age (MUACZ) is less documented.

Objective

This study aims to investigate this relationship in a region endemic for severe acute malnutrition (SAM).

Methods

This is a retrospective cohort based on a database of children admitted from 1987 to 2008 in South Kivu, eastern DRC. Our outcome was hospital mortality. To estimate the strength of the association between mortality and nutritional indices, the relative risk (RR) with its 95% confidence interval (95% CI) was calculated. In addition to univariate analyses, we constructed multivariate models from binomial regression.

Results

A total of 9,969 children aged 6 to 59 months were selected with a median age of 23 months. 40.9% had SAM (according to the criteria WHZ < -3 and/or MUAC<115 mm and/or the presence of nutritional edema) including 30.2% with nutritional edema and 35.2% had both SAM and chronic malnutrition. The overall hospital mortality was 8.0% and was higher at the beginning of data collection (17.9% in 1987). In univariate analyses, children with a WHZ < -3 had a risk almost 3 times higher of dying than children without SAM. WHZ was more associated with in-hospital mortality than MUAC or MUACZ. Multivariate models confirmed the univariate results. The risk of death was also increased by the presence of edema.

Conclusion

In our study, WHZ was the indicator more associated with hospital death compared with MUAC or MUACZ. As such, we recommend that all criteria shall continue to be used for admission to therapeutic SAM programs. Efforts should be encouraged to find simple tools allowing the community to accurately measure WHZ and MUACZ.