Impact of COVID-19 on child malnutrition, obesity in women and household food insecurity in underserved urban settlements in Sri Lanka: a prospective follow-up study.

OBJECTIVES: To determine changes and factors associated with child malnutrition, obesity in women and household food insecurity before and after the first wave of COVID-19 pandemic. DESIGN: A prospective follow-up study. SETTING: In 2019, the baseline Urban Health and Nutrition Study 2019 (UHNS-2019) was conducted in 603 households, which were selected randomly from 30 clusters to represent underserved urban settlements in Colombo. In the present study, 35 % of households from the UHNS-2019 cohort were randomly selected for repeat interviews, 1 year after the baseline study and 6 months after COVID-19 pandemic in Sri Lanka. Height/length and weight of children and women were re-measured, household food insecurity was reassessed, and associated factors were gathered through interviewer-administered questionnaires. Differences in measurements at baseline and follow-up studies were compared. PARTICIPANTS: A total of 207 households, comprising 127 women and 109 children were included. RESULTS: The current prevalence of children with wasting and overweight was higher in the follow-up study than at baseline UHNS-2019 (18·3 % v. 13·7 %; P = 0·26 and 8·3 % v. 3·7 %; P = 0·12, respectively). There was a decrease in prevalence of child stunting (14·7 % v. 11·9 %; P = 0·37). A change was not observed in overall obesity in women, which was about 30·7 %. Repeated lockdown was associated with a significant reduction in food security from 57 % in UHNS-2019 to 30 % in the current study (P < 0·001). CONCLUSIONS: There was an increase in wasting and overweight among children while women had a persistent high prevalence of obesity. This population needs suitable interventions to improve nutrition status of children and women to minimise susceptibility to COVID-19.

Vitamin D deficiency among children aged 10-18 years in Sri Lanka

Background: Vitamin D deficiency (VDD) and insufficiency (VDI) are public health problems in many countries, and limited data is available on the prevalence of VDD/VDI in Sri Lanka. Objectives: To determine the prevalence and associated factors of VDD in children aged 10- 18 years. Methods: This was a cross-sectional study among school children aged 10-18 years at national level. A representative sample of 2525 children were recruited from July to November 2017. Serum 25(OH)D concentration and the patterns of vitamin D rich foods consumption were assessed. VDD and VDI cut offs were set at serum 25(OH)D concentrations of <12 ng/mL and 12-20 ng/mL, respectively as defined by global consensus in 2016. Results: The mean serum 25(OH)D level was 19.3±7.4 ng/mL. The prevalence of VDD and VDI were 13.2% (95%CI: 11.9%-14.5%) and 45.6% (95%CI: 43.7%-47.5%), respectively. The prevalence of VDD was highest in the central province (32.2%) and highest prevalence of VDI was in the Inabaragamuwa province (58.9%). VDD and VDI were lowest in North Central province (0.7% and 34.7%, respectively). Significantly higher serum 25(OH)D levels were observed with male gender (p=0.000), BMI for age <-2SD (p=0.000), daily milk consumption (p=0.000) and residing in dry zone (p=0.0 Conclusions: Though Sri Lanka is a tropical country, VDD is prevalent among school children aged 10-18 years. It is important to develop a VDD preventive strategy, especially for high risk groups.