Temporal Trends in the Prevalence of Child Undernutrition in China From 2000 to 2019, With Projections of Prevalence in 2030: Cross-Sectional Analysis.

BACKGROUND: Although the problem of malnutrition among children in China has greatly improved in recent years, there is a gap compared to developed countries, and there are differences between provinces. Research on long-term comprehensive trends in child growth failure (CGF) in China is needed for further improvement. OBJECTIVE: The purpose of this study was to examine trends in stunting, wasting, and underweight among children younger than 5 years in China from 2000 to 2019, and predict CGF till 2030. METHODS: We conducted a cross-sectional analysis using data from the local burden of disease (LBD) database. Using Joinpoint Regression Software, we examined trends in CGF among children younger than 5 years in China from 2000 to 2019, and predicted the trends of prevalence in 2030, using the Holt-Winters model with trends but without seasonal components. The assessment was performed with Stata 17 (StataCorp). Data were analyzed from October 17, 2023, to November 22, 2023. RESULTS: In 2019, the prevalences of stunting, wasting, and underweight decreased to 12%, 3%, and 4%, respectively (decreases of 36.9%, 25.0%, and 42.9%, respectively, compared with the values in 2000). The prevalence of CGF decreased rapidly from 2000 to 2010, and the downward trend slowed down after 2010. Most provinces had stagnated processes of trends after 2017. The age group with the highest stunting prevalence was children aged 1 to 4 years, and the highest prevalence of wasting and underweight was noted in early neonatal infants. From 2000 to 2019, the prevalence of CGF declined in all age groups of children. The largest relative decrease in stunting and underweight was noted in children aged 1 to 4 years, and the largest decrease in wasting was noted in early neonatal infants. The prevalences of stunting, wasting, and underweight in China are estimated to decrease to 11.4%, 3.2%, and 4.1%, respectively, by 2030. China has nationally met the World Health Organization's Global Nutrition Targets for 2030 for stunting but not for wasting. CONCLUSIONS: This study provides data on the prevalence and trends of CGF among children younger than 5 years and reports declines in CGF. There remain areas with slow progress in China. Most units have achieved the goal for stunting prevalence but not wasting prevalence.

A premarital services education model of preventing stunting among prospective newlyweds from North Sumatera, Indonesia.

Stunting, attributed to insufficient nutrition during the critical first 1000 days of life, remains a pressing public health issue in North Sumatera, Indonesia. This study investigates the influence of pre-marital education on prospective couples' knowledge and nutritional status as a stunting prevention strategy. Employing a quantitative, cross-sectional design, the study involved 1000 prospective couples across 10 districts. Data were collected through structured questionnaires and analyzed using Structural Equation Modeling (SEM). The findings demonstrate that pre-marital education significantly enhances knowledge of nutrition, family planning, and stunting prevention, leading to improved nutritional status. However, increased knowledge of stunting was inversely related to nutritional status. The study concludes that comprehensive pre-marital education is vital for effective stunting prevention. It recommends a thorough revision of pre-marital educational content, emphasizing a tailored and integrative approach to health and nutrition, to address specific regional challenges and enhance overall program efficacy.

Le retard de croissance, attribué à une nutrition insuffisante au cours des 1 000 premiers jours critiques de la vie, reste un problème de santé publique urgent dans le nord de Sumatera, en Indonésie. Cette étude examine l'influence de l'éducation prénuptiale sur les connaissances et l'état nutritionnel des futurs couples en tant que stratégie de prévention du retard de croissance. Utilisant une conception quantitative et transversale, l'étude a porté sur 1 000 couples potentiels dans 10 districts. Les données ont été collectées au moyen de questionnaires structurés et analysées à l'aide de la modélisation d'équations structurelles (SEM). Les résultats démontrent que l'éducation prénuptiale améliore considérablement les connaissances en matière de nutrition, de planification familiale et de prévention du retard de croissance, conduisant ainsi à une amélioration de l'état nutritionnel. Cependant, une meilleure connaissance du retard de croissance était inversement liée à l'état nutritionnel. L'étude conclut qu'une éducation prénuptiale complète est essentielle pour une prévention efficace du retard de croissance. Il recommande une révision approfondie du contenu éducatif prénuptial, en mettant l'accent sur une approche adaptée et intégrative de la santé et de la nutrition, pour relever les défis régionaux spécifiques et améliorer l'efficacité globale du programme.

Childhood stunting in Indonesia: assessing the performance of Bayesian spatial conditional autoregressive models.

Stunting continues to be a significant health issue, particularly in developing nations, with Indonesia ranking third in prevalence in Southeast Asia. This research examined the risk of stunting and influencing factors in Indonesia by implementing various Bayesian spatial conditional autoregressive (CAR) models that include covariates. A total of 750 models were run, including five different Bayesian spatial CAR models (Besag-York-Mollie (BYM), CAR Leroux and three forms of localised CAR), with 30 covariate combinations and five different hyperprior combinations for each model. The Poisson distribution was employed to model the counts of stunting cases. After a comprehensive evaluation of all model selection criteria utilized, the Bayesian localised CAR model with three covariates were preferred, either allowing up to 2 clusters with a variance hyperprior of inverse-gamma (1, 0.1) or allowing 3 clusters with a variance hyperprior of inverse-gamma (1, 0.01). Poverty and recent low birth weight (LBW) births are significantly associated with an increased risk of stunting, whereas child diet diversity is inversely related to the risk of stunting. Model results indicated that Sulawesi Barat Province has the highest risk of stunting, with DKI Jakarta Province the lowest. These areas with high stunting require interventions to reduce poverty, LBW births and increase child diet diversity.

Reducing stunting and underweight through mother's birth spacing: evidence from Ghana.

BACKGROUND: Researchers over the years have underscored the role of birth spacing on maternal health, however, inadequate maternal repletion due to shorter birth intervals could also affect the health of the child. Even so, limited studies exist on the linkage between birth spacing and child nutrition. This study examines the association between birth spacing and child stunting and underweight using the 2014 Ghana Demographic and Health Survey. METHODS: The study sourced data on 1, 904 children less than 59 months from the 2014 Ghana Demographic and Health Survey. The study employed bivariate analysis and logistic regressions to establish the association between birth spacing, and child stunting and underweight. RESULTS: The analyses reveal that childbirth spacing between 24 and 35 months (OR = 0.62, 95% CI: 0.38-0.99; p < 0.05), 36 to 47 months (OR = 0.42, 95% CI: 0.25-0.70; p < 0 0.01), and beyond 47 months (OR = 0.47, 95% CI: 0.28-0.78; p < 0.01) have lower odds of child stunting than children with birth spacing less than 24 months. Children with birth spacing between 24 and 35 months (OR = 0.53, 95% CI: 0.29-0.98; p < 0.05), 36 to 47 months (OR = 0.44, 95% CI: 0.22-0.90; p < 0.01) and beyond 47 months (OR = 0.49, 95% CI: 0.26-0.94; P < 0.05) have lower odds of being underweight than those with birth spacing less than 24 months. CONCLUSION: The study reveals that mothers with a birth spacing of at least two to three years compared to their counterparts with less than two years of birth spacing have lower odds of having a stunted and underweight child under age five. The study recommends that Ghana Health Service and other healthcare providers should educate mothers on the gains of birth spacing of at least two years on their children.

Determinants of stunting among adolescent girls in schools of Digo Tsion Town, Northwest Ethiopia: Unmatched case control study.

INTRODUCTION: Stunting is a height-for-age (Z-score) less than minus two standard deviations below the mean of reference standard. It is the most important sign of long-term chronic undernutrition and public health problem in Ethiopia. However, little information was known regarding determinants of stunting among adolescents since it had mostly been investigated in late infancy, especially among children under the age of five. Therefore, identifying determinants of stunting among adolescent girl is still crucial. OBJECTIVE: To identify determinants of stunting among adolescent girls in schools of Digo Tsion Town, Northwest Ethiopia, 2022. METHODS AND MATERIALS: Case-control study was conducted among 417 adolescent girls (104 cases and 313 controls) in schools of Digo Tsion Town with computer generated simple random sampling technique. World Health Organization Anthroplus 2007 software was used for analyzing anthropometrics data. Data was collected by epicollect5 mobile application through interview by using structured questionnaire. The data was entered in epi data 4.6 and exported into Statistical Package for Social Science version 26. Variables with p- value ≤ 0.25 in bivariable analysis were candidate for multivariable analysis. Model fitness was checked by Hosmer and Lemon Show fitness of test. Variables having a P-value < 0.05 in multivariable analysis were declared as statistically significant at 95% Cl. The result was presented by statement, figures, and tables. RESULTS: A total of 409 (100 cases and 309 controls) adolescent girls participated, with a response rate of 96% for cases and 98.72% for controls. Food insecurity (AOR = 2.13, CI [1.15, 3.93]), low dietary diversity score (AOR = 1.99, CI [1.06, 3.73]), drinking coffee/tea immediately while eating meals (AOR = 2.19, CI [1.22, 3.95]), not getting nutritional counsel (AOR = 2.07, CI [1.17, 3.66]), chronic illness (AOR = 3.78, CI [1.16, 12.3]), and not visited by health extension workers at home (AOR = 1.85, CI [1.03, 3.31]) were statistically significant determinants of stunting. CONCLUSION: Stunting among adolescents is influenced by a low dietary diversity score, a food-insecure household, drinking coffee or tea immediately while eating a meal, not receiving nutritional counseling, having a chronic illness, and not being visited by health extension workers at home. Future researchers would do better to undertake prospective studies. Health extension workers are better able to provide nutritional counsel for adolescent.

The relationship between the ages and stages questionnaire, 3rd edition scores in early childhood and future cognitive abilities in young Nepalese children.

BACKGROUND: The Ages and Stages Questionnaire 3rd edition (ASQ-3) could be a feasible tool in resource-poor settings. Little is known on the relationship between scores on the ASQ-3 and later intellectual abilities in these settings. AIMS: To examine the relationship between ASQ-3 scores during the first and second year of life and intellectual abilities at 4 years of age in Nepalese children. METHODS: In a cohort of 600 children at-risk of stunting, the ASQ-3 was performed at 6-11 and 18-23 months, and the Wechsler Preschool and Primary Scales of Intelligence, fourth edition (WPPSI-IV) at 4 years. We examined the relationship between the ASQ-3 scores and WPPSI-IV full scale IQ (FSIQ) using Spearman correlation coefficients and linear regression models. RESULTS: Correlations between ASQ-3 total scores and FSIQ was 0.17 (95% CI 0.07, 0.27) at 6-11 and 0.34 (95% CI 0.26, 0.44) at 18-23 months explaining 2 and 12% of the variance respectively. Except for the communication subscale at 18-23 months with moderate correlations, correlations between the ASQ-3 subscales and FSIQ were weak. CONCLUSION: Our findings suggest a modest relationship between ASQ-3 scores in early childhood and intellectual abilities at 4 years.

Dairy Consumption at Breakfast among Southeast Asian Children: Associations with Nutrient Intake from the South East Asian Nutrition Surveys II (SEANUTS II).

BACKGROUND: Children's rapid growth requires adequate nutrient intake, with breakfast, especially when incorporating dairy, playing an important role. This study examined associations between dairy consumption at breakfast and energy and nutrient intake among children in Southeast Asia. METHODS: Utilizing the cross-sectional South East Asian Nutrition Surveys II dataset, using a 24 h dietary recall and questionnaires distributed among 10,286 children aged 2 to 12 years from Malaysia, Thailand, Indonesia, and Vietnam, we investigated the impact of dairy consumption at breakfast on nutrient intake and examined associations between breakfast consumption and the prevalence of stunting and overweight/obesity among 10,135 children. RESULTS: Although most of the children consumed breakfast, only 37%, 27%, 16%, and 18% in Malaysia, Thailand, Indonesia, and Vietnam, respectively, included dairy in this meal, with younger children being significantly more likely to consume dairy at breakfast (p < 0.001). Dairy consumers had significantly higher intakes of vitamins A, B12, and D and calcium both at breakfast and throughout the day (p < 0.001). Breakfast skippers had a 29% increased risk of being overweight/obese. CONCLUSIONS: Dairy consumption at breakfast was associated with enhanced nutrient intake and overall diet quality among Southeast Asian children. The association between breakfast habits and anthropometric outcomes highlights the need to address nutritional deficiencies and promote healthy growth and development.

The Role of Complementary Feeding Practices in Addressing the Double Burden of Malnutrition among Children Aged 6-23 Months: Insight from the Vietnamese General Nutrition Survey 2020.

Background/Objectives: Optimal infant and young child feeding (IYCF) practices are crucial to addressing the double burden of malnutrition (DBM), encompassing undernutrition (including micronutrient deficiencies) and overnutrition. This study examined the demographic and socioeconomic determinants of IYCF practices, and their impacts on the DBM among 2039 Vietnamese children aged 6-23 months from the General Nutrition Survey 2020. Methods: Thirteen IYCF indicators recommended by the WHO/UNICEF were evaluated. Associations between IYCF indicators and outcome variables were assessed using logistic regressions. Results: The prevalence of stunting, underweight, and overweight subjects was 10.9%, 5.6%, and 3.1%, respectively. Low serum zinc affected 56.7% of children, while 14.3% had low serum retinol, 31.2% had anemia, and 34.6% had iron deficiency (ID). Only 36.7% of children achieved minimum dietary diversity (MDD), and 29.0% achieved the minimum acceptable diet (MAD). Children from the younger age group (6-11 months), ethnic minorities, those living in rural/mountainous regions, and poorer wealth quintiles had reduced odds of meeting IYCF criteria, including MDD and MAD. Infants meeting MDD had reduced odds of stunting [adjusted odds ratio (95% confidence intervals): 0.61 (0.41, 0.92)], and ID [0.69 (0.54, 0.88)]. Children meeting MAD had reduced odds of anemia [0.72 (0.57, 0.91)], ID [0.66 (0.52, 0.84)], and low serum retinol [0.63 (0.41, 0.99)]. Continued breastfeeding (12-23 months) reduced the odds of being underweight [0.50 (0.27, 0.92)] and of having low serum zinc [0.70 (0.52, 0.96)]. Adequate minimum milk feeding frequency had increased odds of being overweight [3.33 (1.01, 11.09)]. Conclusions: Suboptimal IYCF practices were significant predictors of the DBM among Vietnamese children, with evident age-specific, geographical, and socioeconomic disparities.

Women's exposure to intimate partner violence and its association with child stunting: findings from a population-based study in rural Rwanda.

BACKGROUND: Child stunting is a significant challenge for most districts in Rwanda and much of sub-Saharan Africa and persists despite multisectoral efforts. There is a notable lack of population-based studies examining the correlation between violence against women and child stunting in Rwanda. OBJECTIVE: We aimed to investigate the association between Rwandan women's exposure to intimate partner violence (IPV) and child stunting in children under 3 years of age. METHODS: In December 2021, a population-based cross-sectional study was conducted in the Northern Province of Rwanda, including 601 women and their children <3 years of age. The World Health Organization (WHO) Women's Health and Life Experiences Questionnaire for IPV research was utilized. Child stunting was assessed using the WHO criteria for low height for age. Multivariable logistic regression was used to examine the association between IPV and child stunting before and during pregnancy. RESULTS: Of 601 women, 47.4% (n = 285) experienced any form of IPV during pregnancy. The prevalence rates of the types of IPV associated with child stunting varied: 33% for psychological, 31.4% for sexual, and 25.7% for physical violence. Exposure to physical violence before pregnancy and sexual violence during pregnancy was associated with higher odds of child stunting; the adjusted odds ratios were 1.29 (95% CI, 1.01-2.03) and 1.25 (95% CI, 1.04-2.01), respectively. CONCLUSION: Women's exposure to physical and psychological violence is associated with an increased risk of child stunting. Urgent targeted interventions and support systems are needed to address the complex relationship between women's exposure to IPV and adverse effects on child growth.

Main findings: Intimate partner violence against women correlates with child stunting, exhibiting varying prevalence rates for different forms of violence occurring both before and during pregnancy.Added knowledge: This study enriches the current literature by incorporating a temporal dimension of intimate partner violence occurring before and during pregnancy, while also shedding light on contextual factors within rural African settings where violence against women persists.Global health impact for policy and action: Improved comprehension of the types, frequency, and timing of women's exposure to intimate partner violence is crucial for designing and implementing interventions aimed at mitigating the adverse impacts of violence on child growth, particularly in resource-constrained countries such as Rwanda.

Policy for transitioning childhood-onset growth hormone deficiency from pediatric to adult endocrine care in Belgium.

Growth hormone (GH) deficiency (GHD) in children and adolescents can vary in severity and origin, with GH replacement therapy proving effective in achieving genetic target height. Optimal outcomes are seen in those treated early and with higher doses. As patients approach adult height, priorities shift towards optimizing metabolic effects, maintaining body composition, and enhancing bone mass and muscle strength. Transitioning from pediatric to adult care presents challenges, including accurately identifying candidates for continued GH therapy, reevaluating persistent GHD, and preventing treatment discontinuation. Assessing readiness for transition and self-management skills is crucial. This Policy and Practice Review provides a comprehensive overview of current policies, regulations, and guidelines pertinent to managing GHD transition in Belgium. We integrate perspectives from national academic and nonacademic clinical stakeholders in pediatric and adult endocrine care to provide an updated policy framework. This framework underscores the importance of sustained GH therapy during transition, particularly for individuals with persistent GHD, with the goal of optimizing practices and improving outcomes during this critical period.

Spatial variation and risk factors of the dual burden of childhood stunting and underweight in India: a copula geoadditive modelling approach.

India has one of the highest burdens of childhood undernutrition in the world. The two principal dimensions of childhood undernutrition, namely stunting and underweight can be significantly associated in a particular population, a fact that is rarely explored in the extant literature. In this study, we apply a copula geoadditive modelling framework on nationally representative data of 104,021 children obtained from the National Family Health Survey 5 to assess the spatial distribution and critical drivers of the dual burden of childhood stunting and underweight in India while accounting for this correlation. Prevalence of stunting, underweight and their co-occurrence among under 5 children were 35.37%, 28.63% and 19.45% respectively with significant positive association between the two (Pearsonian Chi square = 19346, P-value = 0). Some of the factors which were significantly associated with stunting and underweight were child gender (Adjusted Odds Ratio (AOR) = 1.13 (1.12) for stunting (underweight)), birthweight (AOR = 1.46 (1.64) for stunting (underweight)), type of delivery (AOR = 1.12 (1.19) for stunting (underweight)), prenatal checkup (AOR = 0.94 (0.96) for stunting (underweight)) and maternal short-stature (AOR = 2.19 (1.85) for stunting (underweight)). There was significant spatial heterogeneity in the dual burden of stunting and underweight with highest prevalence being observed in eastern and western states while northern and southern states having relatively lower prevalence. Overall, the results are indicative of the inadequacy of a "one-size-fits-all" strategy and underscore the necessity of an interventional framework that addresses the nutritional deficiency of the most susceptible regions and population subgroups of the country.

Addressing Health Illiteracy and Stunting in Culture-Shocked Indigenous Populations: A Case Study of Outer Baduy in Indonesia.

This research aims to determine the factors, impacts, and solutions for health literacy in the Outer Baduy hamlets of Kanekes Village, Indonesia. The method used in this research is qualitative, which produces an in-depth explanation of the existing problems. Data were collected through interviews and documentation. Interviews were conducted with key figures, including two female Baduy residents with stunted children, one retainer, the head of the NGO SRI, a midwife who works in the Baduy village, and the head of the Lebak social service. Apart from that, secondary data in the form of recordings of community service talk shows conducted by the University of Indonesia to overcome stunting in Baduy were also analysed. The results show that the factors associated with the low health literacy of the Baduy community are literacy, writing and reading, taboos on eating certain foods, people spending too much time in the fields, people learning by imitating their parents, demanding access to villages, lack of consistency from external parties in providing health programs, and gender segregation in Baduy society. The impact of the low health literacy of the Baduy community is fatalism, high maternal and child mortality rates, and high health costs. The proposed strategies for increasing the health literacy of the Baduy community based on the findings of this research include developing health literacy by targeting community leaders, managing information-technology-based health-information groups, and always presenting at least one health worker among the residents who provides an example of healthy living, encouraging collective reflection. when health cases occur, and balancing gender communication.

Determinants of stunting in children aged 0-59 months in three regions of Burkina Faso.

The Sahel is a region particularly characterized by undernutrition in several forms. In Burkina Faso, where several interventions have been carried out across the past several years, the nutritional situation of children under five years of age is still characterized by persistent stunting in the Est, Sahel, and Cascades regions. This study aims to understand the factors associated with the high prevalence of chronic malnutrition in these regions. National nutrition survey data as well as data from the Ministry of Water and Sanitation were used for bivariate and multivariate statistical analyses to identify factors statistically associated with stunting in children aged 0-59 months who participated in the national nutritional surveys from 2009 to 2019. Around one in ten mothers in all regions had no schooling at all. The improving of IYCF practice has a positive impact on the reduction of the prevalence of chronic malnutrition among children in the Cascades, Est and Sahel regions. In the three target regions, gender and province were significantly associated with stunting. Fever, diarrhea, vitamin A supplementation, household size, and maternal education level were also associated with stunting but only in the Sahel and Cascades regions. Overall, the results of the study show that the fight against stunting must be carried out in a multisectoral approach and target certain provinces particularly because stunting is not uniformly present in all provinces.

Effect of the COVID-19 pandemic on malnutrition in socially vulnerable children in Brazil. / Efeito da pandemia da COVID-19 sobre a má nutrição em crianças em vulnerabilidade social, no Brasil.

This article aims to evaluate the effect of the COVID-19 pandemic on malnutrition among children under two years of age enrolled in the Bolsa Família Program (BFP). Ecological study of interrupted time series (ITS), with low weight for age, stunting, and overweight as time-dependent variables of malnutrition, extracted monthly (Jan/2008 to June/2021) from the Food and Nutrition Surveillance System. The COVID-19 pandemic was the exposure, dichotomized into pre-pandemic and pandemic. In RStudio, the trend was obtained by Prais-Winsten regression, and the effect of the pandemic on the time-dependent variables was determined by SARIMA modeling, estimating the regression coefficients (RC) adjusted for trend and seasonality (α = 5%). The pandemic was associated with an increase in: i) low weight for age in the South (RC = 0.94; p < 0.001) and Southeast (RC = 1.97; p < 0.001); ii) height deficit in the Midwest (RC = 2.4; p = 0.01), South (RC = 2.15; p < 0.001) and Southeast (RC = 2.96; p < 0.001); and iii) and overweight in the North (RC = 1.51; p = 0.04), Midwest (RC = 2.29; p = 0.01), South (RC = 2.83; p < 0.001), and Southeast (RC = 0.72; p = 0.04). The pandemic increased underweight in the South and Southeast, and the double burden of malnutrition in the Midwest, South, and Southeast. In the Northeast and North, higher rates of malnutrition still persist.

O objetivo do artigo é avaliar o efeito da pandemia de COVID-19 sobre a má nutrição em crianças menores de dois anos inscritas no Programa Bolsa Família. Estudo ecológico de série temporal interrompida, tendo o baixo peso por idade, o déficit de estatura e o excesso de peso como variáveis tempo-dependentes de má nutrição, extraídas mensalmente (jan/2008 a junho/2021) do Sistema de Vigilância Alimentar e Nutricional. A pandemia de COVID-19 foi a exposição, dicotomizada em pré e pandemia. No programa RStudio, a tendência foi obtida pela regressão de Prais-Winsten, e o efeito da pandemia sobre as variáveis tempo-dependentes, pela modelagem SARIMA, calculando-se coeficientes de regressão (CR) ajustados para tendência prévia e sazonalidade (α = 5%). A pandemia se associou ao aumento do: i) baixo peso por idade no Sul (CR = 0,94; p < 0,001) e Sudeste (CR = 1,97; p < 0,001); ii) déficit de estatura no Centro-Oeste (CR = 2,4; p = 0,01), Sul (CR = 2,15; p < 0,001) e Sudeste (CR = 2,96; p < 0,001); e iii) excesso de peso no Norte (CR = 1,51; p=0,04), Centro-Oeste (CR = 2,29; p = 0,01), Sul (CR = 2,83; p < 0,001) e Sudeste (CR = 0,72; p = 0,04). A pandemia aumentou o baixo peso no Sul e Sudeste e a dupla carga de má nutrição no Centro-Oeste, no Sul e no Sudeste. No Nordeste e no Norte persistem taxas mais altas de má nutrição.

Determination of appropriate policy targets to reduce the prevalence of stunting in children under five years of age in urban-poor communities in Indonesia: a secondary data analysis of the 2022 Indonesian national nutritional status survey.

OBJECTIVE: Based on previous studies, urban-poor societies are very vulnerable to stunted children under five. The study aims to determine the appropriate policy targets to reduce the prevalence of stunted under-five children in urban-poor communities in Indonesia. DESIGN: A study was conducted using a secondary data analysis. The study analysed existing data from the 2022 Indonesian National Nutritional Status Survey. SETTING AND PARTICIPANTS: At the national level, Indonesia encompassed 43 284 toddlers. INTERVENTIONS: Non-intervention study. PRIMARY AND SECONDARY OUTCOMES: The study's eight independent factors were the mother's age, education, marital status, employment, wealth, antenatal care (ANC), children's age and sex, with nutritional status as the dependent variable. We employed a binary logistic regression test for the most recent exam. RESULTS: Maternal age was related to stunted toddlers in communities of urban poor in Indonesia. The lower the education, the higher the possibility of having stunted kids. Unemployed mothers were 1.153 times more likely than employed mothers to have stunted under-five children (95% CI 1.145 to 1.160). The poorest were 1.235 times more likely to get stunted under-five than the poorer (95% CI 1.227 to 1.242). Mothers without ANC during pregnancy were 1.212 times more likely to get stunted kids than those with ANC during pregnancy (95% CI 1.186 to 1.240). All kids' ages were more probable than 0-11 to be stunted. Boys were 1.099 times more likely to be stunted than girls (AOR 1.099; 95% CI 1.093 to 1.105). CONCLUSION: The appropriate policy targets to reduce the prevalence of stunted under-five children in urban-poor communities in Indonesia were younger mothers, those with poor education, those unemployed, the most impoverished, those without ANC, those with older under-five and those with boy kids.

Influence of non-directional errors in anthropometric measurements and age estimation on anthropometric prevalence indicators.

Anthropometric prevalence indicators such as stunting, wasting, and underweight are widely-used population-level tools used to track trends in childhood nutrition. Threats to the validity of these data can lead to erroneous decision making and improper allocation of finite resources intended to support some of the world's most vulnerable populations. It has been demonstrated previously that aggregated prevalence rates for these indicators can be highly sensitive to biases in the presence of non-directional measurement errors, but the quantitative relationship between the contributing factors and the scale of this bias has not been fully described. In this work, a Monte Carlo simulation exercise was performed to generate high-statistics z-score distributions with a wide range of mean and standard deviation parameters relevant to the populations in low- and middle-income countries (LMIC). With the important assumption that the distribution's standard deviation should be close to 1.0 in the absence of non-directional measurement errors, the shift in prevalence rate due to this common challenge is calculated and explored. Assuming access to a given z-score distribution's mean and standard deviation values, this relationship can be used to evaluate the potential scale of prevalence bias for both historical and modern anthropometric indicator results. As a demonstration of the efficacy of this exercise, the bias scale for a set of 21 child anthropometry datasets collected in LMIC contexts is presented.

The role of parental education and occupation on undernutrition among children under five in Bangladesh: A rural-urban comparison.

Bangladesh continues to face the persistent issue of child malnutrition. This study aims to investigate the influence of parental characteristics on undernutrition among children under the age of five in both urban and rural areas of Bangladesh. This study utilizes data from the Bangladesh Demographic and Health Survey (BDHS) 2017-18, which includes 7806 children under the age of five and their parents. The effects of parental education and occupation on undernutrition (e.g., stunting, underweight, and wasting) are examined using the binary probit regression technique. Among rural children, 32.6% are stunted, 22.5% are underweight, and 8.1% are wasted. The corresponding figures for urban children are 25.3%, 18.9%, and 8.9%, respectively. In all forms of undernutrition, children living in rural areas face greater challenges than those living in urban areas. The prevalence of stunting and underweight is low among children, irrespective of their rural or urban background, when both parents have the same level of education. The prevalence is also low when fathers are employers or traders and mothers are homemakers, or when highly educated fathers are employers or traders and highly educated mothers are homemakers. In both rural and urban areas, the risk of stunting, underweight and all forms of malnutrition among children decreases as parents' education levels increase. Children whose fathers work in service or business activities are less likely to experience stunting, being underweight, or wasting compared to children whose fathers work in agriculture or other professions in both areas. In urban areas, children born to mothers with lower levels of education are more vulnerable to wasting than children whose mothers have at least secondary education. To reduce child undernutrition nationwide, it is recommended that both parents have at least a secondary school education and that the father has a stable and sufficient income.

Identification of Enteric Pathogen Reservoirs and Transmission Pathways Associated with Short Childhood Stature in the Kolkata Indian Site of the Global Enteric Multicenter Study.

Age-stratified path analyses modeled associations between enteric pathogen reservoirs, transmission pathways and height-for-age z-scores (HAZ) to identify determinants of childhood growth in the Kolkata, India site of the Global Enteric Multicenter Study (GEMS). Models tested direct associations of potential pathogen reservoirs with HAZ at 60-day follow-up in separate moderate and severe diarrhea (MSD) case and control cohorts or indirectly when mediated by enteric infections. In the MSD cohort, rotavirus and typical EPEC (tEPEC) infections among children 0-11 months of age and ST-ETEC infections among children 12-23 months of age were associated with lower HAZ. Handwashing after defecating and before cooking reduced impaired growth through reductions in rotavirus and tEPEC infections. Water storage increased rotavirus and ST-ETEC infection risks, resulting in increased impaired growth, but was reduced with reported child feces disposal. The GII norovirus variant was inversely associated with HAZ among children 12-59 months of age in the control cohort. Reported handwashing before the handling of children reduced GII infections and impaired growth. Boiling water and the disposal of children's feces mediated by stored water were positively associated with HAZ. The targeting of pathogen-specific reservoirs and transmission pathways may more effectively improve childhood linear growth in South Asian urban communities.

Malnutrition among Children under Age Five in Panama: Results of the ENSPA 2019.

Background: Malnutrition has important short- and long-term consequences in children under age five. Malnutrition encompasses undernutrition, overnutrition, and the coexistence of both of them, known as the double burden of malnutrition (DBM). Objective: The aim of this study was to estimate the prevalence of undernutrition, overnutrition, and the DBM among these children at the national level and by living area in Panama. Methods: Data from the National Health Survey of Panama (ENSPA, Spanish acronym), a population-based, cross-sectional study carried out in 2019 were used. Stunting, wasting, overweight, and obesity were defined according to the cut-off points of the World Health Organization Growth Standards. Undernutrition was defined as being stunted only, wasted only or both; overnutrition was defined as being overweight only or obese only; and the DBM was defined as the co-occurence of stunting and overweight/obesity in the same child. Prevalence and general characteristics at the national level and by living area were weighted. Findings: The prevalence of undernutrition was 15.3% (95% confidence interval (CI) 13.4-17.3) at the national level and 36.6% (CI: 30.1-43.5) in indigenous areas. The prevalence of overnutrition was 10.2% (8.2-12.6) at the national level and 11.9% (CI: 8.5-16.3), 8.4% (CI: 6.5-10.7) and 8.7% (CI: 5.2-14.3) in urban, rural and indigenous areas, respectively. The DBM prevalence was 1.4% (CI: 1.0-2.1) at the national level and 2.7% (CI: 1.4-5.1) in indigenous areas. Conclusions: Undernutrition is still the most prevalent malnutrition condition in our country. Panama has the highest prevalence of overnutrition in Central America. The highest prevalence of undernutrition and DBM was found among children living in indigenous areas.

Stunting and its association with feeding problem among under five children: a case-control study in Kuantan district, Malaysia.

INTRODUCTION: Stunting is the most prevalent form of malnutrition among infants and young children population, both globally and locally. It refers to low height-for-age children and is primarily caused by chronic under nutrition. The objective of this study is to determine the association between stunting and feeding problems and to explore the risk factors for stunting among children aged 6 to 59 months attending health clinics in the Kuantan district. MATERIALS AND METHODS: A case-control study involving 160 children that attended six health clinics in Kuantan from August to October 2021 with a ratio of 1 case: 3 controls. Data were collected from mothers using a questionnaire consisting of sociodemographic and feeding assessment adapted from a validated World Health Organization (WHO) integrated management of childhood illness (IMCI) assessment form. The data was analysed using IBM SPSS version 26.0. Binary logistic regression analysis was used to identify factors associated with stunting. The odds ratio was used to measure the strength of the association between outcome and predictor variables. The significance value was set at p<0.05. RESULTS: Children with identified feeding problems have more than four-time significantly higher risk of becoming stunted (Odds Ratios, OR: 4.2; 95% Confidence Intervals, 95%CI: 1.4, 12.8) as compared to children with no feeding problems. Specifically, children with inadequacy in feeding components; amount, variety and frequency of meal each have significantly six-time higher risk (OR: 6.2; 95%CI: 2.7, 14.5), four-time higher risk (OR: 4.2; 95%CI: 1.4, 12.3), and three-time higher risk (OR: 2.8; 95%CI: 1.1, 6.9), of becoming stunted as compared to children with adequate feeding. Additionally, with a decrease of one week in delivery week, one kilogram in birth weight and one centimetre in maternal height, there is a respectively significant 40.0% (OR: 0.6; 95%CI: 0.4, 0.9), 80.0% (OR: 0.2; 95%CI: 0.1, 0.7) and 11.0% (OR: 0.89; 95%CI: 0.82, 0.98) increase in the risk of become stunted among children. CONCLUSION: Feeding problems specifically inadequate food amount, food variety and meal frequency not following the recommendation contribute to stunting in young children. Other factors identified are lower maternal height and children with lower birth weight and delivery week. This highlights the need for more excellent detection and intervention of nutritional concerns and risk factors to prevent stunting.