Malnutrition among under-five children of kadukuruba tribe: need to reach the unreached

Social Determinants of Child Undernutrition in Adivasi Population in Northern Kerala: A Study Using Syndemic Framework

OBJECTIVES

To understand the complex interaction of structural inequalities, co-occurring health conditions, and child undernutrition among the Adivasi population in North Kerala, India.

METHODS

A mixed-method approach was employed in this study, which combined a cross-sectional survey and a case study design. A multistage cluster sampling method was used to select 167 children aged 24 to 60 mo from the study population. The mothers of these children were interviewed using a structured questionnaire to assess individual, parental, and household-level factors associated with child undernutrition. Two Paniya settlements, one with a high prevalence of child undernutrition (HPS) and the other with a low prevalence (LPS), were chosen as the primary units of the case study.

RESULTS

The study found that the absence of a kitchen garden with fruits and vegetables [adjusted odds ratio (AOR) 2.85; 95% confidence interval (CI): 1.04-7.81] and a history of cough and fever (AOR 2.93; 95% CI: 1.24-6.93) were both associated with a higher risk of undernutrition in children. The case studies revealed that Adivasi children are undernourished due to a complex set of factors that persist throughout their lives, including unequal access to social capital, healthcare, and food security, as well as differences in hygiene practices due to the lack of access to clean water and sanitation.

CONCLUSIONS

The findings underscore the need for social interventions to complement the current focus almost entirely on food supplementation programmes. Equitable action on Adivasi child malnutrition requires urgent policy and programmatic attention to social inequalities and access to basic amenities in Adivasi areas.

Effect of nutritional counselling for using anthropometric indices among Indians

Malnutrition in children under 5 years is a major public health problem in developing countries. Malnutrition complex comprises of under-nutrition including multiple conditions like acute, chronic malnutrition, micronutrient deficiencies and nutrition related to obesity. Therefore, it is of interest to report data on the individualized nutritional counselling on nutritional status among mild to moderately malnourished children aged 2 - 5 years at one, three and six month follow up. Their dietary habits will help to determine the aetiology of mild/moderate malnutrition.150 Children attending outpatient department of the Department of Paediatrics of D Y Patil Medical College and admitted with mild/moderate malnutrition were included in the study after taking informed consent from their parents. The children were randomly allocated into 4 groups (group 1 - 4). The groups consisted of children where dedicated nutritional counselling was provided at 1 month, 1 and 3 month follow up and where-in no dedicated counselling was provided. A diet chart was provided with counselling. Group 4 followed up with routine care without any dietary intervention. Detailed dietary, socio economic history, clinical examination with anthropometry was done followed-up at 1, 3, 6 months from date of inclusion. Majority (57.3%) belonged to lower socio-economic class according to Kuppuswamy scale. The mean birth weight was 2.4 kg, age 34.5 months and age of weaning 7.6 months. Data shows that 70% children had mild malnutrition and 30% moderate malnutrition. At 6 month follow up amongst 105 children with mild malnutrition, 82 still had mild malnutrition, 4 normal, 19 had moderate malnutrition. Under-five childhood malnutrition is highly prevalent in poor socioeconomic strata of the society. Nutritional counselling provided by trained healthcare providers in existing settings are effective in improving nutritional status, daily calorie/protein intake, prevention of malnutrition. Prevention/treatment of co-existing illness bears equal importance.

Determinants of Nutritional Status among Under-Five Children in the Tribal Population of The Nilgiris, Southern India: A Cross-Sectional Study

Background

The tribal populations in The Nilgiris of Tamil Nadu are identified as particularly vulnerable tribal groups (PVTGs) and are "high risk" in terms of health and nutrition.

Objectives

The objective of the study is, among the under-five tribal children, to determine the prevalence of undernutrition and the factors associated with it.

Materials and Methods

This community-based cross-sectional study was conducted between March and June 2019 among 605 under-five tribal children. The prevalence of underweight, stunting, and wasting was expressed as proportion; the association with determinants was assessed using log-binomial regression model.

Results

The prevalence of underweight, stunting, and wasting was 63% (95% confidence interval [CI] 57-70), 62% (95% CI 54-70), and 31% (95% CI 24-38), respectively. Among them, 29%, 35%, and 10% were severely underweight, stunted, and wasted, respectively. Among 605 participants, 80% utilized supplementary nutrition program of the Integrated Child Development Services; only 21% of whom utilized it as per the ICDS recommended quantities prescribed for different category of beneficiaries. Male child, age >2 years, and illiteracy of father were significantly associated with underweight. Age >2 years and illiteracy of mother were significantly associated with stunting. Male child and low family income were significantly associated with wasting.

Conclusion

Nearly three out of four children in the community were undernourished. Poverty alleviation programs are required to combat undernutrition among backward communities.

Assessment of Nutritional Status of Children between 6 Months and 6 Years of Age in Anganwadi Centers of an Urban Area in Tumkur, Karnataka, India

Objectives:

Nutritional status is the sensitive indicator of a child's health, and they constitute the most vulnerable segment of any community. Undernutrition causes a great deal of physical, mental, and emotional suffering. Anganwadi is a part of the Integrated Child Development Services program started to combat child hunger and child malnutrition. This study was undertaken to assess the nutritional status of the children (6 months–6 years) in Anganwadis and determine the sociodemographic factors associated with malnutrition and to assess their dietary intake.

Materials and Methods:

This cross-sectional study was undertaken among 580 children in Anganwadis in the urban field practice area of a Medical college in Tumkur.

Results:

In this study, the overall prevalence of underweight, stunting, and wasting was found to be 34.14%, 45.52%, and 35.52%, respectively. Age, socioeconomic status, immunization status, religion, and mother's education was associated with undernutrition. The deficient intake of calorie and protein was seen in 90% and 64.8% of the study participants.

Conclusion:

The present study showed that there is still a high prevalence of undernutrition among the Anganwadi children aged 6–72 months. Socioeconomic factors have a significant role in child nutrition, which manifests itself as poor development.

Nutritional Status and its Relationship with Dental Caries among 3-6-year-old Anganwadi Children

AIM

The purpose of this study is to determine dental caries status in 3-6-year-old malnourished children.

MATERIALS AND METHODS

A total of 500 children aged 3-6 years enrolled in anganwadi were selected for this study. The nutritional status was evaluated by anthropometric measurements such as body weight and height [body mass index (BMI)-for-age]. Dental caries status was recorded according to WHO criteria. The obtained data were subjected to statistical analysis.

RESULTS

The prevalence of underweight was 41% and prevalence of dental caries was 61%.

CONCLUSION

Low BMI-for-age is a risk factor for dental caries.

CLINICAL SIGNIFICANCE

Inclusion of BMI-for-age calculation in routine case history pro forma helps in timely diagnosis, prevention, and treatment of children suffering from malnutrition.

HOW TO CITE THIS ARTICLE

Madhusudhan KS, Khargekar N. Nutritional Status and its Relationship with Dental Caries among 3-6-year-old Anganwadi Children. Int J Clin Pediatr Dent 2020;13(1):6-10.

The prevalence of under-nutrition among the tribal children in India: a systematic review

Tribal population of India constitutes 8.6% of the total population. They are more susceptible to undernutrition which is recognized as a prevalent health problem mainly because of their uncertainty of food supply, which has serious long term consequences for the child and adversely influences the development of the nation. The assessment of nutritional status is paramount importance because it impels to identify malnutrition which is an aggravation of morbidity and mortality. This review was aimed to find out the overall nutritional status of tribal preschool children. It also seek the major socio-cultural causes which influence the nutritional status from bio-cultural perspectives among the tribal children in India in order to make foundation of new research. In the present review, 41 papers on nutritional status of tribal preschool children published from January 1st 2000 till date, have been identified and included for analysis. To analyze the data, meta-analysis was done using MedCalc software.

The meta-analysis revealed the average rate of prevalence of underweight, stunting and wasting among the preschool tribal children of India was 42.96%; 44.82% and 23.69%. Among the 41 different studies these rates vary among the different tribal groups of different states associated with their socio-economic status (10%), their cultures of food consumption (10%), maternal education (15%), child feeding practices (20%), dietary deficit during pregnancy (25%) and poor nutrition of the child (52%).

Prevalence rate of under-nutrition and stunting is relatively high in comparison to WHO in India whereas, rate of wasting was lower in comparison to national level which reflect that immediate nutritional status was poor but chronic deficiency of nutrition was less. Nutritional education and short term appropriately planned nutritional intervention programs may also be useful for enhancing their nutritional status.

Non-metric traits, physiological stress indicators and paleopathological lesion on human skeletal remains from an early modern cemetery in Wyszyński Street, Wrocław, Poland (15th–18th centuries AD)

The anthropological analysis and assessment of the living conditions of historical populations should be comprehensive. Due to the scarcity of the well-preserved skeletal remains of a population buried at the cemetery in Wyszyński Street, Wrocław, each piece of information is particularly important in providing the complementary information about living and health conditions of late medieval and early modern inhabitants of Wrocław. This study aims to assess the living conditions of the late medieval and early modern Wrocław inhabitants. This aim was reached by analyzing the frequency of non-metrical cranial and postcranial traits, physiological stress indicators, and pathological lesions. The importance of these traits for population studies is also discussed. For 98 skeletons (22.4% male and 37.8% female) from a cemetery located in Wyszyński Street, (15th –18th centuries AD), the frequencies (p) of the following traits were analyzed: 38 non-metric cranial and 9 post-cranial traits, the morphological indicators of physiological stress (i.e. cribra orbitalia and enamel hypoplasia), caries and pathological lesions on bones. Among the non-metric cranial traits, only nine (23.7%) were not observed. The most frequent (from p= 0.30 to p=0.65) were foramen parietale, incisura frontalis accesoria seu foramen frontale accesorius, foramen supraorbitale, M3 mandibulare, ossicula suturae lambdoideae, and foramen mastoideum extrasuturale. Only three non-metric post-cranial traits were observed, but with low frequency (p=0.01 and 0.02). Cribra orbitalia was present in 37.0% of the skeletons while enamel hypoplasia was present in only 2.6%. Susceptibility to caries occurred in 68% of the cases while carries lesions occurred in 31.2%. Among pathological changes, the most frequent were degenerative changes (21.6%) and injuries (19.6%). Owing to the poorly preserved remains, the complete assessment of the living conditions of the population was difficult. The number of the observed traits would have probably increased, had the number of complete and well-preserved skeletons been higher. The results of the study suggest that the living conditions of the studied population were poor. It is hypothesized that the cemetery was a burial place for prisoners and victims of various epidemics that affected the city. But since the historical sources of this cemetery are scarce, it is hard to unequivocally state its purpose with certainty.

An Investigation of the Prevalence and Causes of Malnutrition in Iran: a Review Article and Meta-analysis

Malnutrition is one of the most important health issues in developing countries, which might have adverse effects on the physical and intellectual health of children. The search process was started to find Persian and English articles published until September 2017 regarding the prevalence of malnutrition in children under the age of six in Iran using national and international databases including SID, Magiran, Irandoc, IranMedex, PubMed, Medline, Scopus, and ISI Web of Science. The data were analyzed using meta-analysis methods and the random effects model. The heterogeneity of studies was analyzed using the I² index. The data were analyzed using R and STATA software (ver. 11.2). Twenty seven articles conducted from 2002 to 2016 were collected to be included in the meta-analysis process. The total sample size was 161,941 patients in an age range of 0-6 years. The final estimate of the prevalence of different forms of malnutrition through meta-analysis of data extracted from studies in Iran was as follows: severe underweight (1%; 95% confidence interval [CI], 1–1), moderate underweight (6%; 95% CI, 5–7), mild underweight (25%; 95% CI, 21–28), severe short stature (3%; 95% CI, 2–3), moderate short stature (8%; 95% CI, 6–9), mild short stature (21%; 95% CI, 17–24), severe slimness (1%; 95% CI, 1–1), moderate slimness (5%; 95% CI, 4–5) and mild slimness (20%; 95% CI, 17–24). Considering that the prevalence of malnutrition is relatively high in Iran, health authorities should plan to improve the nutritional status of children.

Prevalence, Demographic Characteristics and Associated Risk Factors of Malnutrition Among 0-5 Aged Children: A Cross-Sectional Study From Van, Eastern Turkey

Malnutrition in childhood is a dramatic indicator of poor socio-economical status worldwide. To recognize and reveal the socio-demographic features is crucial, especially for developing countries. Our aim was to investigate the prevalence and association with sociodemographic variables of malnutrition in 0-5 years old children in Van, Turkey. A total of 702 children are included in this cross-sectional study. Demographic features of subject including age, gender, family characteristics and other data were obtained. Nutritional assessment was done using anthropometric indices including weight-for-age, height-for-age, weight-for-height, head circumference and body mass index-for-age. Multivariate logistic regressions were carried out to assess malnutrition-associated factors. Prevalence of underweight, stunting and wasting were 19.7, 17.7 and 16.2%, respectively. Socio-demographic variables that statistical significantly in association with malnutrition were low monthly family income, educational level and employment status of father, parental consanguinity, number of pregnancies, regular intake of vitamin D and history of prematurity. The prevalence of children with head circumference-z score ≤2SD and body mass index-for-age ≤2SD were 9.8 and 16.3%, respectively. Multivariate analysis detected following risk factors for these indices; low monthly family income, history of prematurity, unemployed father and the period between pregnancies (1-2 years). We found that prevalence of malnutrition in the city of Van, was still higher than more developed regions of Turkey. The associated risk factors of malnutrition should be specifically interpreted by health professionals and also by government authorities that are responsible for making practical politics of public health.