Suchergebnisse

Improved child health and survival are considered universal humanitarian goals. In this respect, understanding the nutritional status of children has far-reaching implications for the better development of future
generations. The present study assessed, first, the nutritional status of children below 5 years using the three anthropometric measures weight-for-age, height-for-age and weight-for-height in two states of India, Kerala and Goa. Secondly, it examined the confounding factors that influence the nutritional status of children in these states. The NFHS-I data for Kerala and Goa were used. The results showed that the relative prevalence of under-weight and wasting was high in Kerala, but the prevalence of stunting was medium. In Goa, on the other hand, the relative prevalence of wasting and underweight was very high, and that of stunting was high. Both socio-economic and family planning variables were significantly associated with malnutrition in these states, but at varied levels. The study recommends more area-specific policies for the development of nutritional intervention
programmes.

AbstractBackgroundArmed conflicts are associated with an increased risk of food insecurity, the leading cause of malnutrition in low-and-middle-income countries. Multiple studies have uncovered significant influences of childhood malnutrition on children's overall health and development. As a result, it is increasingly important to understand how childhood experience of armed conflict intersects with childhood malnutrition in conflict-prone countries like Nigeria. This study examined the association between different measures of childhood experiences of armed conflicts and the nutritional health outcomes of children aged 36–59 months.MethodsWe used data from the Nigeria Demographic and Health Survey linked with Uppsala Conflict Data Program Geo-Referenced Events Dataset using geographic identifiers. Multilevel regression models were fitted on a sample of 4226 children aged 36–59 months.ResultsThe prevalence of stunting, underweight and wasting was 35%, 20% and 3%, respectively. Armed conflicts were mostly recorded in the North-eastern states of Borno (222 episodes) and Adamawa (24 episodes). Exposure to armed conflicts ranged from 0 (no experience of armed conflict) to 3.75 conflicts per month since the child's birth. An increase in the frequency of armed conflicts is associated with increased odds of childhood stunting [AOR = 2.52, 95%CI: 1.96–3.25] and underweight [AOR = 2.33, 95%CI: 1.19–4.59] but not wasting. The intensity of armed conflict was only marginally associated with stunting and underweight but not wasting. Longer conflicts that occurred in the last year were also associated with the odds of stunting [AOR = 1.25, 95%CI: 1.17–1.33] and underweight [AOR = 1.19, 95%CI: 1.11–1.26] but not wasting.ConclusionChildhood exposure to armed conflict is associated with long-term malnutrition in children aged 36–59 months in Nigeria. Strategies that aim to end childhood malnutrition could target children exposed to armed conflicts.

INTRODUCTION: Childhood undernutrition is a crucial public health problem globally. The objective of this study is to measure the prevalence of childhood undernutrition and assess the distinct role of various factors on childhood undernutrition in Bangladesh. METHODS: This study utilized the latest cross-sectional data from Bangladesh Demographic and Health Survey 2014. A total of 7256 data on children younger than 5 years old were analyzed. The undernutrition status of children was assessed by stunting (height-for-age), wasting (weight-for-height), and underweight (weight-for-age), while bivariate and multivariate analyses were performed to identify various individual-, household-, and community-level factors of childhood undernutrition. RESULTS: The prevalence of stunting, wasting, and underweight were 36.5%, 14.6%, and 32.5%, respectively. Along with various individual- and household-level factors (eg, age, recent diarrheal disease, fever, number of under-5 children in the household, mother's education and nutritional status, and wealth status), community index, particularly regional and geographic variation of community, had significant role for childhood undernutrition in Bangladesh. CONCLUSION: Childhood undernutrition is an overwhelming public health issue in Bangladesh. In order to improve the nutritional status of under-5 children, interventions should take into account the various predictors discussed in this study. Indeed, a joint effort by the government, nongovernmental organizations, and the community is necessary to improve the childhood nutritional status in Bangladesh.

SummaryThis study assessed whether agricultural and household incomes were the same across different agro-ecological environments in Bangladesh. An in-depth analysis of the effect of unfavourable ecologies on maternal and child malnutrition was carried out. Data were from a longitudinal data set comprising a nationally representative data sample collected in 2014 and the Food Security Nutrition Surveillance Project (FSNSP) conducted in 2011 and 2012. Anthropometric indices were used to assess the nutritional status of mothers and under-five children. The key variables of interest were food seasonality and geographical location. Data were analysed using the General Linear Model and multinomial and binary logistic regression analysis. Panel data analysis showed that household income was not equal across agro-ecological zones, indicating that the fragility of the environment affects a household's ability to access food, and thus the nutritional status of mothers and children. Coastal areas of Bangladesh were found to be less dependent on agriculture, particularly cultivation, which had diminished during last few decades.Per capitaincome has been increasing in coastal areas of Bangladesh, led by remittance (money sent home by migrant workers) growing at 8% per year against 6% in other areas. Regression analysis showed that a household in a coastal zone earned 19% less than one in more favourable zones. Although the income from farm practices was found to be lower in unfavourable areas, the deficiency was compensated by increased non-farm incomes. The results from the FSNSP data showed that overall the rates of stunting and wasting among under-five children were 37% and 11.7%, respectively, and nearly 28% of mothers suffered from undernutrition. A highly significant regional heterogeneity in undernutrition was found, with alarmingly high levels in the Haor Basin and coastal belt areas. There were significantly higher rates of underweight and wasting in the monsoon season compared with the two harvest seasons among children under the age of five. The findings stress the importance of bringing geographical location and seasonality thinking into debates on hunger and nutrition in Bangladesh.

BACKGROUND: The geographical differences that cause anaemia can be partially explained by the variability in environmental factors, particularly nutrition and infections. The studies failed to explain the non-linear effect of the continuous covariates on childhood anaemia. The present paper aims to investigate the risk factors of childhood anaemia in India with focus on geographical spatial effect. METHODS: Geo-additive logistic regression models were fitted to the data to understand fixed as well as spatial effects of childhood anaemia. Logistic regression was fitted for the categorical variable with outcomes (anaemia (Hb < 11) and no anaemia (Hb ≥ 11)). Continuous covariates were modelled by the penalized spline and spatial effects were smoothed by the two-dimensional spline. RESULTS: At 95% posterior credible interval, the influence of unobserved factors on childhood anaemia is very strong in the Northern and Central part of India. However, most of the states in North Eastern part of India showed negative spatial effects. A U-shape non-linear relationship was observed between childhood anaemia and mother's age. This indicates that mothers of young and old ages are more likely to have anaemic children; in particular mothers aged 15 years to about 25 years. Then the risk of childhood anaemia starts declining after the age of 25 years and it continues till the age of around 37 years, thereafter again starts increasing. Further, the non-linear effects of duration of breastfeeding on childhood anaemia show that the risk of childhood anaemia decreases till 29 months thereafter increases. CONCLUSION: Strong evidence of residual spatial effect to childhood anaemia in India is observed. Government child health programme should gear up in treating childhood anaemia by focusing on known measurable factors such as mother's education, mother's anaemia status, family wealth status, child health (fever), stunting, underweight, and wasting which have been found to be significant in this study. Attention should also be ...

Abstract
Background
Protracted, internal conflicts with geographic variations within countries, are an important understudied community exposure for adverse child health outcomes.

Methods
Violent events from the Uppsala Conflict Data Program (UCDP) between January 2016–December 2020 and January 2010–December 2015, were included as exposure events for children sampled in National Family Health Surveys (NFHS) 5 (2019–21) and NFHS 4 (2015–16), respectively. Geocoded data from UCDP were merged with residential clusters from NFHS, to identify children living in villages or urban blocks situated at <= 50 km from conflict sites. Within these clusters, which we defined as conflict exposed, we studied risks of stunting, underweight and wasting in children, prenatally, and in 0–3 years. We assessed sensitivity on a subsample of siblings with discordant conflict exposures.

Results
For NFHS 5, exposure to violence between 0 and 3 years was associated with 1.16 times (95% CI 1.11–1.20) higher risks of stunting, 1.08 (1.04, 1.12) times higher risks of underweight, and no change in wasting. In-utero violence exposure was associated with 1.11 times (95% CI 1.04–1.17) higher risks of stunting, 1.08 (95% CI 1.02–1.14) times higher risks of underweight, and no change in wasting, among children <= 2 years. In 17,760 siblings of 8333 mothers, exposure to violence during 0–3 years, was associated with a 1.19 times higher risk of stunting (95% CI − 0.24 to 0.084). Incremental quartiles of violence exposure had higher risks of stunting and underweight until quartile 3.

Conclusion
In-utero and early childhood indirect exposure to protracted conflicts were associated with increased stunting and underweight in India. Given the continued exposures of such historically and contextually rooted internal conflicts in many LMICs, chronic violence exposures should be targeted in public health policies as important social and political determinant of child health.

Best of GradCon Award Winner: Poster Presentations - Humanities and Social Sciences Purpose: Infant and child growth is understood as an important indicator of nutritional status and health in populations. Stunting, wasting, and being underweight are the indicators used to measure child growth and reflect nutritional imbalance resulting in undernutrition. The World Health Organization has cited Indonesia as one of five countries that have child stunting higher than both the regional and global averages, making this a priority issue for the government as well as clinics across the country including Alam Sehat Lestari (ASRI) Clinic located in Sukadana, Borneo. The aim of this study is to gain information on the target population to inform a tailored intervention within the capacity and existing programming of the clinic. Methods and Materials: A health assessment survey was implemented in the clinic and in the surrounding community to measure differences in malnutrition outcomes based on household factors, access to quality health care, issues during pregnancy, maternal and child health, breastfeeding and complementary feeding practices, and quality of child diet. Results: Out of a rich variety of results, some factors were associated with higher rates of malnutrition outcomes or were otherwise noteworthy. Rates of stunting and underweight were 32% and 48% respectively in households with smoking exposure in the home compared to 14% and 27% respectively in households with no smoking. There was a difference in rates of stunting and underweight children from mothers who reported having a cough during their pregnancies (31% and 44% respectively) compared to mothers who reported not having a cough (20% and 34% respectively). Additionally, there was a 13% difference in stunting and an 11% difference in wasted and an 11% difference in underweight in children who had a cough in the last month. Although almost all mothers breastfed their child at some point, initiating and maintaining breastfeeding did not always follow best practices. Stunting and underweight were 23% and 15% higher, respectively, in children that received liquids or food other than breastmilk under 6 months compared to those 6 months or older. Additionally, stunting and underweight were 50% and 31% higher, respectively, in children who first received solid foods under 6 months. The majority of mothers did not believe that stunting was an issue in the community or identified specific causes. Mothers also held the belief that a multitude of foods should be avoided during and after pregnancy to prevent convulsions and luge (weak disease). Significance: ASRI Clinic can address childhood stunting and malnutrition outcomes in Sukadana and Simpang Hilir by investing in community education focusing on tobacco cessation, breastfeeding and nutrition. Within the clinic, ASRI can implement policies and procedures to support patients in smoking cessation and best breastfeeding practices. In addition, the clinic can partner with Puskesmas to continue education and monitoring outside of the clinic. Originality: This is the first time that ASRI clinic has investigated malnutrition outcomes in their community and has partnered with the University of Montana to assess a health disparity.

Introduction: Early childhood is often called the golden age that is an active individual with rapid growth and development so the nutritional needs must be met and balanced. Every parent would want a balance between physical growth and optimal mental development in their child. In reality, there are still some cases of under-nutrition, stunting, and wasting in some areas of Bali Province. This is certainly a challenge for governments, especially health providers to reduce and prevent that situation because the lack of nutrients that occur in this golden period is irreversible. The less nutritional status will decrease the cognitive abilities development, the child easily sick and low competitiveness. This study aims to know the description of the nutritional status and the incidence of stunting children in early childhood in Bali Province.Method: This research was observational with cross-sectional design, involving 53 children in early childhood programs which are scattered in several regencies in Bali Province such as Bangli, Gianyar, Singaraja, and Denpasar. The nutritional status of children was assessed by comparing body weight with age, whereas stunting incidence was evaluated by comparing height with age using an anthropometric standard of child nutritional status assessment based on Minister of Health Decree No. 1995/MENKES/SK/XII/2010.Result: This research showed that 35.85% sample were underweight, 60.38% well nourished, and 3.77% overweight. The data after Height/Age measurement has shown that 9.43% sample were short, 73.58% normal, and 16.98% tall. Conclusion: This study has concluded most of the sample were well nourished (60.38%), nevertheless there was still underweight and overweight sample. According to the Height/Age index can be concluded that most of the sample was normal 73.8%. Also, some of the samples were short and tall.Â

Background: Malnutrition is a public health problem, as wasting affects 7.5% of children worldwide. The harmful effects of severe acute malnutrition (SAM) can last a lifetime, but how SAM in childhood affects later breastfeeding ability is not clear. In the present study, we assessed the human milk output and body composition among mothers with a history of childhood SAM. Methods: This retrospective cohort study was carried out in Miti-Murhesa Health Zone (Democratic Republic of Congo) from January 15 to March 17, 2020. We selected lactating mothers with breastfed infants aged 2–12 months. Two categories of mothers were included: those who had been treated for SAM during their childhood (years 1988–2003; n = 39) and a community control with no history of SAM (n = 40). The weight, height, and mid-upper arm circumference were measured and body mass index (BMI) calculated as weight/height2. Body composition and human milk output were assessed using standard deuterium dilution methods. Student t and chi2 tests ware applied to compare two groups. Results: The mean age ± standard deviation of the mothers was 24.4 ± 5.1 and 26.0 ± 6.1 years for the SAM and control groups, respectively (p = 0.186). The age of their infants was 5.4 ± 2.3 months in both groups (p = 0.962). In the SAM and control groups, the mean maternal BMI was 23.8 ± 2.3 and 23.6 ± 3.7 kg/m2 (p = 0.849), mean Fat Mass 27.1% ± 5.0 and 27.1% ± 5.8% (p = 0.708), and the mean Fat Free mass 72.9% ± 5.0 and 72.9% ± 5.8% (p = 0.998), respectively. Human milk output was 833.7 ± 152.1 g/d in SAM group and 827.4 ± 171.4 g/d in the control group (p = 0.864). Conclusions: We found no significant difference in human milk output and body composition in mothers treated for SAM during childhood compared to community controls. ; SCOPUS: ar.j ; info:eu-repo/semantics/published

BACKGROUND: Malnutrition is a public health problem, as wasting affects 7.5% of children worldwide. The harmful effects of severe acute malnutrition (SAM) can last a lifetime, but how SAM in childhood affects later breastfeeding ability is not clear. In the present study, we assessed the human milk output and body composition among mothers with a history of childhood SAM. METHODS: This retrospective cohort study was carried out in Miti-Murhesa Health Zone (Democratic Republic of Congo) from January 15 to March 17, 2020. We selected lactating mothers with breastfed infants aged 2–12 months. Two categories of mothers were included: those who had been treated for SAM during their childhood (years 1988–2003; n = 39) and a community control with no history of SAM (n = 40). The weight, height, and mid-upper arm circumference were measured and body mass index (BMI) calculated as weight/height(2). Body composition and human milk output were assessed using standard deuterium dilution methods. Student t and chi(2) tests ware applied to compare two groups. RESULTS: The mean age ± standard deviation of the mothers was 24.4 ± 5.1 and 26.0 ± 6.1 years for the SAM and control groups, respectively (p = 0.186). The age of their infants was 5.4 ± 2.3 months in both groups (p = 0.962). In the SAM and control groups, the mean maternal BMI was 23.8 ± 2.3 and 23.6 ± 3.7 kg/m(2) (p = 0.849), mean Fat Mass 27.1% ± 5.0 and 27.1% ± 5.8% (p = 0.708), and the mean Fat Free mass 72.9% ± 5.0 and 72.9% ± 5.8% (p = 0.998), respectively. Human milk output was 833.7 ± 152.1 g/d in SAM group and 827.4 ± 171.4 g/d in the control group (p = 0.864). CONCLUSIONS: We found no significant difference in human milk output and body composition in mothers treated for SAM during childhood compared to community controls.

AbstractThis study used a series of individual-level datasets from National Family Health Surveys conducted in 1998–99, 2005–06 and 2015–16 to assess the factors behind the reduction in childhood stunting and underweight in India between the years 1998–99 and 2015–16. A multivariable decomposition regression analysis was performed. Results showed that the prevalence of childhood stunting declined from 49.4% in 1998–99 to 34.9% in 2015–16. Over the same period, the prevalence of childhood underweight declined from 41.9% in 1998–99 to 33.1% in 2015–16. The reduction in the prevalence of stunting was found to be contributed largely by a reduction in the combined prevalence of stunting and underweight (60%), followed by stunted only (21%) and the combined prevalence of stunting, underweight and wasting (19%). Likewise, the reduction in the prevalence of underweight was contributed by a reduction in the combined prevalence of stunting and underweight and the combined prevalence of stunting, underweight and wasting. Results of the decomposition analysis showed that over the period 1998–99 to 2015–16, improvement in wealth status and maternal education led to 13% and 12% declines, respectively, in childhood stunting and to 31% and 19% declines, respectively, in childhood underweight. Furthermore, reductions in childhood stunting and underweight were due to an increased average number of antenatal care visits, lower average birth order, decreased share of children with below-average birth size, increased use of clean fuel for cooking and a reduction in the practice of open defecation. These findings suggest that further reduction in the prevalence of childhood stunting and underweight could be attained through more equitable household economic growth, investment in girl's education, greater access to improved toilet facilities, more widespread use of clean fuel for cooking, reduction in average birth order, increased antenatal care visits and greater consumption of IFA tablets by pregnant women. Policymakers need to prioritize these measures to further reduce malnutrition among Indian children.

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.