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Tchuente BRT, Nguedjo MW, Ngoumen DJN, De Wandji GCF, Tene Mouafo H, Tambe BA, Medoua GN, Ndomo Tsamo V. Prevalence and associated factors of coexisting forms of malnutrition in children under 5 years age in a rural area of Cameroon. PLoS One 2024; 19:e0303611. [PMID: 38857288 PMCID: PMC11164324 DOI: 10.1371/journal.pone.0303611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 04/28/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Malnutrition of children under 5 years of age is persistent in Cameroon principally in rural areas. Moreover, there is limited knowledge of coexisting forms of malnutrition (CFM) among children of this age. Therefore, the aim of this study was to assess the prevalence of CFM in a cohort of children under 5 years and to identify the associated factors. METHODS A cross-sectional study was conducted in the Health Districts of the locality of Dschang in the West region of Cameroon between June 2021 to November 2021. Data were collected from 200 under-five children of both sexes and an interviewer-administered questionnaire was administered to consented children's mothers/guardians. Malnutrition in children was assessed by WHO growth standards (weight-for-height, weight-for-age, height-for-age and body mass index-for-age). The different CFM were defined by the presence of two autonomous forms of malnutrition in the same child. Logistic regression analyses were done to identify factors associated to different coexisting forms of malnutrition. RESULTS The results obtained showed prevalences of 4.20% for the coexistence of underweight with wasting, 7.8% for the coexistence of underweight with stunting and 14.8% for the coexistence of stunting with overweight. Lower maternal age (15-24 years old; OR = 0.09; p = 0.05) and lower education level (primary education, OR = 23.33; p = 0.00) were associated with the coexistence of underweight with wasting. Marital status (single mother, OR = 0.28; p = 0.00) was associated to the coexistence of stunting with overweight/obesity. CONCLUSION The findings of this study provide evidence on the coexistence of different forms of malnutrition among children below five years of age in rural area of Cameroon. These finding would guide future research, policies, and programs on the management of malnutrition in rural areas of Cameroon.
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Affiliation(s)
- Boris Ronald Tonou Tchuente
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plant Studies, Yaounde, Cameroon
| | - Maxwell Wandji Nguedjo
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plant Studies, Yaounde, Cameroon
| | | | | | - Hippolyte Tene Mouafo
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plant Studies, Yaounde, Cameroon
| | - Betrand Ayuk Tambe
- Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Gabriel Nama Medoua
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plant Studies, Yaounde, Cameroon
| | - Vigny Ndomo Tsamo
- Nkong-Ni Subdivisionnnal Medical Center, Menoua Division, West Region of Cameroon, Dschang, Cameroon
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Nassar MF, Abdel-Wahed MA, Abdelhaleem BA, Ahmed AK, ElKholy HE. Nutritional rehabilitation of malnourished children detected by Screening Tool for Assessment of Malnutrition in Pediatric: Urban versus rural settings. Clin Nutr ESPEN 2023; 57:749-754. [PMID: 37739733 DOI: 10.1016/j.clnesp.2023.08.026] [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: 02/14/2023] [Revised: 07/24/2023] [Accepted: 08/23/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Malnutrition presents a major global health burden. In Egypt, it remains an important issue in children under 5 years especially in rural communities. AIM OF THE STUDY The aim of the study was to screen 2-5 years old children enrolled from Egyptian hospitals in rural and urban areas for the risk of malnutrition using Screening Tool for Assessment of Malnutrition in Pediatric (STAMP) and to evaluate the effectiveness of nutritional intervention programs. SUBJECTS AND METHODS This cross-sectional study was conducted on 90 patients recruited from two hospitals in urban and rural Cairo, Dietary history and anthropometric measurements were assessed. Patients at intermediate and severe risk of malnutrition according to STAMP were given tailored nutritional programs. RESULTS In the rural hospital, 4.4% of the screened children were underweight, 22.2% were marginally underweight, and 73.3% had normal weight. Regarding the urban hospital, 15.6% were marginally underweight, 84.4% had normal weight and no underweight patients. Among the rural group 35.6% were at high risk according to STAMP score results compared to 20% in the urban group. Nevertheless, the only significant differences were the more stunting and higher BMI in rural hospital patients. After nutritional intervention, high-risk category patients decreased in both groups coupled by significant improvement in the anthropometric parameters and nutrition data with no significant differences between them. CONCLUSION Nutritional education and prompt implementation of nutritional rehabilitation program for malnourished children detected by screening tools result in improvement in their nutritional status disregards their location whether urban or rural.
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Affiliation(s)
- M F Nassar
- Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - M A Abdel-Wahed
- Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - B A Abdelhaleem
- Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - A K Ahmed
- Ministry of Health and Population, Egypt.
| | - H E ElKholy
- Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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Lawal SA, Okunlola DA, Adegboye OA, Adedeji IA. Mother's education and nutritional status as correlates of child stunting, wasting, underweight, and overweight in Nigeria: Evidence from 2018 Demographic and Health Survey. Nutr Health 2023:2601060221146320. [PMID: 36591921 DOI: 10.1177/02601060221146320] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Aim: This study examined the nexus between mother's education and nutritional status and their relationships with child stunting, wasting, underweight, and overweight. Methods: The data of 34,193 under-five (U-5) children from the 2018 Nigeria Demographic and Health Survey (NDHS) were analyzed using descriptive statistics, and binary and complementary log-logistic regression models. Results: The prevalence of child stunting, wasting, underweight, and overweight were 36.51%, 6.92%, 21.73%, and 2.05%, respectively. Compared to children born to mothers with at least secondary education, uneducated women's children (odds ratio (OR) = 1.55; 95% confidence interval (CI) = 1.32-1.82) and those of women with primary education (OR = 1.49; 95% CI = 1.28-1.72) were more likely to be stunted. Similarly, children born to uneducated women (OR = 1.51; 95% CI = 1.24-1.83) were more likely to be underweight than women with at least secondary education. The likelihood of child underweight (OR = 1.71; 95% CI = 1.45-2.01) and wasting (rate ratio (RR) = 1.82; 95% CI = 1.47-2.26) were higher among underweight mothers, respectively, than those with normal body mass index (BMI). The likelihood of child stunting (OR = 0.75; 95% CI = 0.67-0.84) and underweight (OR = 0.66; 95% CI = 0.57-0.77) were lower among obese/overweight mothers compared to those with normal BMI, but their children were more likely to be overweight (RR = 1.77; 95% CI = 1.27-2.48). Conclusion: Attainment of higher education by mothers should be promoted to prevent childhood nutritional imbalances, and sensitization on healthy dietary habits and lifestyles should be promoted among women, especially the overweight/obese, to reduce their risk of having overweight children.
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Affiliation(s)
- Saheed Akinmayowa Lawal
- Department of Public Health, School of Public and Allied Health Babcock University, Ilishan-Remo, Nigeria
| | - David Aduragbemi Okunlola
- Department of Sociology, College of Social Sciences and Public Policy, Florida State University, Tallahassee, FL, USA
- 605694Viable Knowledge Masters, Abuja, Nigeria
| | - Oyelola A Adegboye
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
- Australia Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Isaac A Adedeji
- Department of Public Health, School of Public and Allied Health Babcock University, Ilishan-Remo, Nigeria
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Breastfeeding Practices, Infant Formula Use, Complementary Feeding and Childhood Malnutrition: An Updated Overview of the Eastern Mediterranean Landscape. Nutrients 2022; 14:nu14194201. [PMID: 36235853 PMCID: PMC9572091 DOI: 10.3390/nu14194201] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND With increasing global rates of overweight, obesity and non-communicable diseases (NCDs) along with undernutrition and micronutrient deficiencies, the Eastern Mediterranean Region (EMR) is no exception. This review focuses on specific nutrition parameters among under five years children, namely ever breastfed, exclusive breastfeeding, mixed milk feeding, continued breastfeeding, bottle feeding, introduction of solid, semi-solid, or soft foods and malnutrition. METHODOLOGY PubMed, Google Scholar, United Nations International Children's Emergency Fund (UNICEF) databases, World Health Organization (WHO) databases, the World Bank databases and the Global Nutrition Report databases were explored between 10 January and 6 June 2022, to review the nutrition situation among under five years children in the EMR. RESULTS The regional average prevalence of ever breastfed, exclusive breastfeeding, mixed milk feeding, continued breastfeeding, bottle feeding, introduction of solid, semi-solid, or soft foods was estimated at 84.3%, 30.9%, 42.9%, 41.5%, 32.1% and 69.3%, respectively. Iran, Iraq, Libya and Palestine have seen a decline over time in the prevalence of exclusive breastfeeding. Lebanon, Egypt, Kuwait and Saudi Arabia reported early introduction of infant formula. Moreover, Lebanon, Pakistan, Saudi Arabia and United Arab Emirates were seen to introduce food early to the child, at between 4-6 months of age. The estimated weighted regional averages for stunting, wasting and underweight were 20.3%, 8.9% and 13.1%, respectively. Of concern is the increasing prevalence of stunting in Libya. As for overweight and obesity, the average prevalence was reported to be 8.9% and 3%, respectively. Lebanon, Libya, Kuwait and Palestine showed an increased trend throughout this time. CONCLUSIONS In this review, the suboptimal infant and young child feeding patterns and the twofold incidence of malnutrition in the EMR are highlighted and we urge the prioritizing of measures to improve children's nutrition.
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Concurrence of stunting and overweight/obesity among children: Evidence from Ethiopia. PLoS One 2021; 16:e0245456. [PMID: 33449970 PMCID: PMC7810347 DOI: 10.1371/journal.pone.0245456] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 01/02/2021] [Indexed: 12/11/2022] Open
Abstract
Background Nutrition transition in many low- and middle-income countries (LMICs) has led to shift in childhood nutritional outcomes from a predominance of undernutrition to a double burden of under- and overnutrition. Yet, policies that address undernutrition often times do not include overnutrition nor do policies on overweight, obesity reflect the challenges of undernutrition. It is therefore crucial to assess the prevalence and determinants of concurrence stunting and overweight/obesity to better inform nutrition programs in Ethiopia and beyond. Methods We analyzed anthropometric, sociodemographic and dietary data of children under five years of age from 2016 Ethiopian Demographic and Health Survey (EDHS). A total of 8,714 children were included in the current study. Concurrence of stunting and overweight/obesity (CSO) prevalence was estimated by basic, underlying and immediate factors. To identify factors associated with CSO, we conducted hierarchical logistic regression analyses. Results The overall prevalence of CSO was 1.99% (95% CI, 1.57–2.53). The odds of CSO was significantly higher in children in agrarian region compared to their counter parts in the pastoralist region (AOR = 1.51). Other significant factors included; not having improved toilet facility (AOR = 1.94), being younger than 12 months (AOR = 4.22), not having history of infection (AOR = 1.83) and not having taken deworming tablet within the previous six months (AOR = 1.49). Conclusion Our study provided evidence on the co-existence of stunting and overweight/obesity among infants and young children in Ethiopia. Therefore, identifying children at risk of growth flattering and excess weight gain provides nutrition policies and programs in Ethiopia and beyond with an opportunity of earlier interventions through improving sanitation, dietary quality by targeting children under five years of age and those living in Agrarian regions of Ethiopia.
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Min J, Zhao Y, Slivka L, Wang Y. Double burden of diseases worldwide: coexistence of undernutrition and overnutrition-related non-communicable chronic diseases. Obes Rev 2018; 19:49-61. [PMID: 28940822 PMCID: PMC5962023 DOI: 10.1111/obr.12605] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/13/2017] [Accepted: 08/02/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This systematic examination and meta-analysis examined the scope and variation of the worldwide double burden of diseases and identified related socio-demographic factors. DESIGN We searched PubMed for studies published in English from January 1, 2000, through September 28, 2016, that reported on double disease burden. Twenty-nine studies from 18 high-income, middle-income and low-income countries met inclusion criteria and provided 71 obesity-undernutrition ratios, which were included in meta-regression analysis. RESULTS All high-income countries had a much higher prevalence of obesity than undernutrition (i.e. all the obesity/undernutrition ratios >1); 55% of the ratios in lower middle-income and low-income countries were <1, but only 28% in upper middle-income countries. Meta-analysis showed a pooled obesity-undernutrition ratio of 4.3 (95% CI = 3.1-5.5), which varied by country income level, subjects' age and over time. The average ratio was higher in high-income rather than that in lower middle-income and low-income countries (β [SE] = 10.8 [2.6]), in adults versus children (7.1 [2.2]) and in data collected since 2000 versus before 2000 (5.2 [1.5]; all P values < 0.05). CONCLUSIONS There are considerable differences in the obesity versus undernutrition ratios and in their prevalence by country income level, age groups and over time, which may be a consequence of the cumulative exposure to an obesogenic environment.
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Affiliation(s)
- Jungwon Min
- Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, Muncie, IN, USA
| | - Yaling Zhao
- Global Health Institute, Health Science Center, Xi'an Jiaotong University, Xi'an, China.,School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Lauren Slivka
- School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA
| | - Youfa Wang
- Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, Muncie, IN, USA.,Global Health Institute, Health Science Center, Xi'an Jiaotong University, Xi'an, China.,School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.,Department of Nutrition and Health Sciences, College of Health, Ball State University, Muncie, IN, USA
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Atsu BK, Guure C, Laar AK. Determinants of overweight with concurrent stunting among Ghanaian children. BMC Pediatr 2017; 17:177. [PMID: 28750614 PMCID: PMC5531099 DOI: 10.1186/s12887-017-0928-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 07/19/2017] [Indexed: 11/10/2022] Open
Abstract
Background Malnutrition (undernutrition and overnutrition) is a major public health problem in Ghana –affecting growth and development of individuals and the nation. Stunting and overweight are of particular interest, as recent national surveys show a rising trend of overnutrition and stubbornly high burden of stunting among Ghanaian children. There are currently no data on the simultaneous occurrence of overweight and stunting within individuals in Ghana. This paper presents the burden, the individual-level, and contextual determinants of overweight with concurrent stunting among Ghanaian children. Methods This study analyzed data set of the fourth round of the Ghana Multiple Indicator Cluster Survey (MICS4). Bivariate analyses were used to describe selected characteristics of survey respondents and their children. Hierarchical modelling approach facilitated identification of significant distal, intermediate and proximal factors/determinants of concurrent stunting and overweight. Both crude and adjusted prevalence ratios via a multivariable Poison regression model with their corresponding 95% Confidence Intervals (CI) are reported. Variables with p ≤ 0.25 at the bivariate level were included in the multivariable analysis. An alpha value of 5% was used to indicate significance. Results Of 7550 cases (children) analyzed, the prevalence of stunting was 27.5%; underweight was 17.3%; and wasting was 7.7%. The prevalence of overweight and concurrent overweight and stunting were respectively 2.4% and 1.2%. Children who belonged to the fourth wealth quintile, were more likely to be overweight and concurrently stunted as against children belonging to the poorest quintile (aPR = 1.010; 95% CI, 1.003–1.017). Compared to religious (Christians/Muslim/Traditionalist) household heads, children whose household heads did not belong to any religion had 2 times the rates of the Overweight with concurrent stunting (PR = 2.024; 95% CI, 1.016–4.034). Children with mothers aged 20–34 and 35–49 had an increased though insignificant prevalence ratio of association (aPR = 1.001; 95% CI, 0.994–1.005) and (aPR = 1.001; 95% CI, 0.998–1.012) respectively. Conclusion This analysis determined the prevalence of concurrent stunting and overweight among Ghanaian children to be 1.2%. Four contextual variables (breastfeeding status, religion, geographic region, and wealth index quintile) were associated with overweight with concurrent stunting. We conclude that, only contextual factors are predictive of DBM among children under five living in Ghana.
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Affiliation(s)
- Benedicta K Atsu
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Chris Guure
- Department of Biostastics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Amos K Laar
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
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Chowdhury MRK, Rahman MS, Khan MMH, Mondal MNI, Rahman MM, Billah B. Risk Factors for Child Malnutrition in Bangladesh: A Multilevel Analysis of a Nationwide Population-Based Survey. J Pediatr 2016; 172:194-201.e1. [PMID: 26858194 DOI: 10.1016/j.jpeds.2016.01.023] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 12/15/2015] [Accepted: 01/07/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To identify the prevalence and risk factors of child malnutrition in Bangladesh. STUDY DESIGN Data was extracted from the Bangladesh Demographic Health Survey (2011). The outcome measures were stunting, wasting, and underweight. χ(2) analysis was performed to find the association of outcome variables with selected factors. Multilevel logistic regression models with a random intercept at each of the household and community levels were used to identify the risk factors of stunting, wasting, and underweight. RESULTS From the 2011 survey, 7568 children less than 5 years of age were included in the current analysis. The overall prevalence of stunting, wasting, and underweight was 41.3% (95% CI 39.0-42.9). The χ(2) test and multilevel logistic regression analysis showed that the variables age, sex, mother's body mass index, mother's educational status, father's educational status, place of residence, socioeconomic status, community status, religion, region of residence, and food security are significant factors of child malnutrition. Children with poor socioeconomic and community status were at higher risk of malnutrition. Children from food insecure families were more likely to be malnourished. Significant community- and household-level variations were found. CONCLUSIONS The prevalence of child malnutrition is still high in Bangladesh, and the risk was assessed at several multilevel factors. Therefore, prevention of malnutrition should be given top priority as a major public health intervention.
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Affiliation(s)
- Mohammad Rocky Khan Chowdhury
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh; Department of Public Health, Faculty of Health Science, First Capital University of Bangladesh, Chuadanga, Bangladesh
| | - Mohammad Shafiur Rahman
- Department of Public Health, Faculty of Health Science, First Capital University of Bangladesh, Chuadanga, Bangladesh; Department of Global Health Policy, School of International Health, The University of Tokyo, Tokyo, Japan
| | | | | | - Mohammad Mosiur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh; International Health Section, Division of Public Health, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Baki Billah
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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Sheriff DS, Elsharri F. If gluttony is the culprit of adiposity is gourmet the panacea of health? A lesson from Indian cuisine. Libyan J Med 2010; 5. [PMID: 21483570 PMCID: PMC3066779 DOI: 10.3402/ljm.v5i0.5294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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