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1.
BMJ ; 367: l6540, 2019 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-31826875

RESUMEN

OBJECTIVE: To evaluate the impact of the US government's Feed the Future initiative on nutrition outcomes in children younger than 5 years in sub-Saharan Africa. DESIGN: Difference-in-differences quasi-experimental approach. SETTING: Households in 33 low and lower middle income countries in sub-Saharan Africa. POPULATION: 883 309 children aged less than 5 years with weight, height, and age recorded in 118 surveys conducted in 33 countries between 2000 and 2017: 388 052 children were from Feed the Future countries and 495 257 were from non-Feed the Future countries. MAIN OUTCOME MEASURES: A difference-in-differences approach was used to compare outcomes among children in intervention countries after implementation of the initiative with children before its introduction and children in non-intervention countries, controlling for relevant covariates, time invariant national differences, and time trends. The primary outcome was stunting (height for age >2 standard deviations below a reference median), a key indicator of undernutrition in children. Secondary outcomes were wasting (low weight for height) and underweight (low weight for age). RESULTS: Across all years and countries, 38.3% of children in the study sample were stunted, 8.9% showed wasting, and 21.3% were underweight. In the first six years of Feed the Future's implementation, children in 12 countries with the initiative exhibited a 3.9 percentage point (95% confidence interval 2.4 to 5.5) greater decline in stunting, a 1.1 percentage point (0.1 to 2.1) greater decline in wasting, and a 2.8 percentage point (1.6 to 4.0) greater decline in underweight levels compared with children in 21 countries without the initiative and compared with trends in undernutrition before Feed the Future was launched. These decreases translate to around two million fewer stunted and underweight children aged less than 5 years and around a half million fewer children with wasting. For context, about 22 million children were stunted, 11 million children were underweight, and four million children were wasted in the Feed the Future countries at baseline. CONCLUSIONS: Feed the Future's activities were closely linked to notable improvements in stunting and underweight levels and moderate improvements in wasting in children younger than 5 years. These findings highlight the effectiveness of this large, country tailored initiative focused on agriculture and food security and have important implications for the future of this and other nutrition interventions worldwide.


Asunto(s)
Conducta Alimentaria , Encuestas Epidemiológicas , Estado Nutricional , Delgadez/epidemiología , África del Sur del Sahara/epidemiología , Peso Corporal , Trastornos de la Nutrición del Niño/epidemiología , Preescolar , Países en Desarrollo , Femenino , Humanos , Incidencia , Lactante , Masculino , Delgadez/terapia
2.
Global Health ; 15(1): 62, 2019 11 06.
Artículo en Inglés | MEDLINE | ID: mdl-31694661

RESUMEN

BACKGROUND: The aim of this study was to examine the determinants of nutritional status among children under age 5 (0-59 months) in Ethiopia. Child malnutrition is an underlying cause of almost half (45%) of child deaths, particularly in low socioeconomic communities of developing countries. In Ethiopia, the prevalence of stunting decreased from 47% in 2005 to 39% in 2016, but the prevalence of wasting changed little over the same time period (from 11 to 10%). Despite improvements in reducing the prevalence of malnutrition, the current rate of progress is not fast enough to reach the World Health Organization global target for reducing malnutrition 40% by 2025. METHODS: This study used data from the 2016 Ethiopia Demographic and Heath Survey (EDHS). The analysis used stunting and wasting as dependent variables, while the independent variables were characteristics of children, mothers, and households. Logistic regression was used to analyze the determinants of nutritional status among children. Bivariate analysis was also used to analyze the association between the dependent and independent variables. RESULTS: Study results show that child's age, sex, and perceived birth weight, mother's educational status, body mass index (BMI), and maternal stature, region, wealth quintile, type of toilet facility, and type of cooking fuel had significant associations with stunting. Child's age, sex, and perceived birth weight, mother's BMI, and residence and region showed significant associations with wasting. The study found that child, maternal, and household characteristics were significantly associated with stunting and wasting among children under age 5. CONCLUSION: These findings imply that a multi-sectorial and multidimensional approach is important to address malnutrition in Ethiopia. The education sector should promote reduction of cultural and gender barriers that contribute to childhood malnutrition. The health sector should encourage positive behaviors toward childcare and infant feeding practices. More should be done to help households adopt improved types of toilet facilities and modern types of cooking fuels.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Estado Nutricional , Preescolar , Demografía , Etiopía/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Factores de Riesgo , Factores Socioeconómicos
3.
Asunción; s.n; Nov 2019. (1-67) p.
Tesis en Español | LILACS, BDNPAR | ID: biblio-1021733

RESUMEN

La infancia es considerada como una etapa trascendental en el proceso evolutivo del hombre, caracterizada por dos fenómenos: crecimiento y desarrollo, por tanto es fundamental una adecuada nutrición. Con relación a este aspecto, el programa de complementación nutricional denominado PANI (Programa Ampliado Nutricional Integral), se implementa, para garantizar la atención oportuna de niños desnutridos y en riesgo de desnutrición y evitar otros factores de riesgo que puedan poner en peligro a esta población vulnerable. Objetivo: Analizar el impacto de la implementación del programa PANI en niños menores de 5 años desnutridos y con riesgo de desnutrición en la Unidad de Salud Familiar ItáKa´aguy, durante el periodo 2015 a 2017. Metodología: Se realizó un estudio descriptivo, retrospectivo, transversal, en donde se evaluó a 74 niños menores de 5 años desnutridos y con riesgos de desnutrición, que fueron atendidos en la Unidad de Salud Familiar ItáKa´aguy, (Fernando de la Mora, XIa Región Sanitaria - Central). Se implementó con ellos el Programa de Asistencia Nutricional y luego de 2 años se compararon los resultados de la evaluación inicial, con las actuales. Resultados: Se resalta que, previo a la intervención sólo 4 niños tuvieron un peso adecuado; 19 niños se encontraban en estado de desnutrición; 6 niños se encontraban en el nivel de peso no adecuado y 40 niños se encontraban en "Riesgo de desnutrición". Mientras que posterior a la implementación del programa, 62 niños obtuvieron el peso adecuado a su edad; 3 niños se mantuvieron con signos clínicos de desnutrición y 4 niños manifestaron riesgo de desnutrición. Conclusión: se encontró que el PANI ha contribuido a mejorar de la desnutrición en los niños y niñas, como en el peso acorde con la edad, pero no así en aspectos como talla y el edema, por lo que se concluye que el impacto ha sido medio. Palabras Clave: Nutrición de los Grupos de Riesgo, Programas y Políticas de Nutrición y Alimentación,


The childhood is considered as a transcendental stage in the evolutionary process of man, characterized by two phenomena: growth and development, therefore proper nutrition is essential. In relation to this aspect, the nutritional complementation program called PANI (Comprehensive Nutritional Extended Program), is implemented to ensure timely care of malnourished children at risk of malnutrition and avoid other risk factors that may endanger this population vulnerable. Objective: To analyze the impact of the implementation of the PANI program in children under 5 years of age undernourished and at risk of malnutrition in the ItáKa'aguy Family Health Unit, during the period 2015 to 2017. Methodology: A descriptive, retrospective study was conducted, cross-sectional, in which 74 under-5 undernourished children with risk of malnutrition were evaluated, who were attended in the ItáKa'aguy Family Health Unit (Fernando de la Mora, XIa Sanitary - Central Region). The Nutritional Assistance Program was implemented with them and after 2 years the results of the initial evaluation were compared with the current ones. Results: It is highlighted that, prior to the intervention, only 4 children had an adequate weight, 19 children were in malnutrition, 6 children were at the unsuitable weight level and 40 children were at risk of malnutrition; while after the implementation of the program, 62 children obtained the appropriate weight at their age, 3 children remained with clinical signs of malnutrition and 4 children showed risk of malnutrition. Conclusion: it was found that PANI has contributed to improve malnutrition in boys and girls, as in weight according to age, but not in aspects such as height and edema, so it is concluded that the impact has been medium.


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Programas de Nutrición , Trastornos de la Nutrición del Niño/epidemiología , Trastornos de la Nutrición del Lactante/epidemiología , Políticas Públicas de Salud , Paraguay/epidemiología , Trastornos de Alimentación y de la Ingestión de Alimentos , Estudios Transversales , Estudios Retrospectivos , Factores de Riesgo , Nutrición del Niño , Nutrición del Lactante , Clasificación Internacional de la Atención Primaria
4.
Afr Health Sci ; 19(2): 1897-1909, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31656473

RESUMEN

Background: One of the public health problems in developing countries is child malnutrition. An important factor for children's well-being is good nutrition. Therefore, the malnutrition status of children under the age of five is an important outcome measure for children's health. This study uses the proportional odds model to identify risk factors associated with child malnutrition in Ethiopia using the 2016 Ethiopian Demographic and Health Survey data. Methods: This study uses the 2016 Ethiopian Demographic and Health Survey results. Based on weight-for-height anthropometric index (Z-score) child nutrition status is categorized into four levels namely- underweight, normal, overweight and obese. Since this leads to an ordinal variable for nutrition status, an ordinal logistic regression (OLR)proportional odds model (POM) is an obvious choice for analysis. Results: The findings and comparison of results using the cumulative logit model with and without complex survey design are presented. The study results revealed that to produce the appropriate estimates and standard errors for data that were obtained from complex survey design, model fitting based on taking the survey sampling design into account is better. It has also been found that for children under the age of five, weight of a child at birth, mother's age, mother's Body Mass Index (BMI), marital status of mother and region (Affar, Dire Dawa, Gambela, Harari and Somali) were influential variables significantly associated with underfive children's nutritional status in Ethiopia. Conclusion: This child's age of a child, sex, weight of child at birth, mother's BMI and region of residence were significant determinants of malnutrition of children under five years in Ethiopia. The effect of these determinants can be used to develop strategies for reducing child malnutrition in Ethiopia. Moreover, these findings show that OLR proportional odds model is appropriate assessing thedeterminants of malnutrition for ordinal nutritional status of underfive children in Ethiopia.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Desnutrición/epidemiología , Estado Nutricional , Antropometría , Índice de Masa Corporal , Peso Corporal , Niño , Trastornos de la Nutrición del Niño/diagnóstico , Preescolar , Etiopía/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Desnutrición/etiología , Obesidad/epidemiología , Prevalencia , Características de la Residencia , Factores Socioeconómicos , Delgadez/epidemiología
5.
BMC Health Serv Res ; 19(1): 756, 2019 Oct 26.
Artículo en Inglés | MEDLINE | ID: mdl-31655588

RESUMEN

BACKGROUND: Village Health and Nutrition Days (VHNDs) are a cornerstone of the Government of India's strategy to provide first-contact primary health care to rural areas. Recent government programmes such as the Janani Suraksha Yojana (JSY) and Mission Indradhanush (MI) have catalysed important changes impacting VHNDs. To learn how VHNDs are currently being delivered, we assessed the fidelity of services provided as compared to government norms in a priority district of Uttar Pradesh. METHODS: We fielded a cross-sectional study of VHNDs to provide a snapshot of health services functioning. Process evaluation data were collected via administrative sources, non-participant observation using a standardised form, and structured questionnaires. Questionnaires were designed using a framework to assess implementation fidelity. Key respondents were VHND participants, front-line workers involved in VHND delivery, and VHND non-participants (pregnant women due for antenatal care or children due for vaccination as per administrative records). Results were summarised as counts, frequencies, and proportions. RESULTS: In the 30 villages randomly selected for inclusion, 36 VHNDs were scheduled but four (11.1%) were cancelled and one VHND was not surveyed. Vaccination and antenatal care were offered at 96.8% (30/31) and child weighing at 83.9% (26/31) of VHNDs. Other normed services were infrequently provided or completely absent. Health education and promotion were particularly weak; institutional delivery was the only topic discussed in a majority of VHNDs. The true proportion of any serious problem impeding vaccine delivery was 47.2% (17/36), comprising 4 VHND cancellations and 13 VHNDs experiencing vaccine shortages. Of the 13 incidents of vaccine shortage, 11 related to an unexpected global shortage of injectable polio vaccine (IPV). Over the 31 VHNDs, 37.8% (171 of the 452 scheduled beneficiaries) did not participate. Analysis of missed opportunities for vaccination highlighted inaccuracies in beneficiary identification and tracking and demand side-factors. CONCLUSIONS: The transformative potential of VHNDs to improve population health is only partially being met. A core subset of high-priority services for antenatal care, institutional delivery, and vaccination associated with high-priority government programmes (JSY, MI) is now being provided quite successfully. Other basic health promotion and prevention services are largely not provided, constituting a critical missed opportunity.


Asunto(s)
Trastornos de la Nutrición del Niño/prevención & control , Servicios de Salud Materno-Infantil/organización & administración , Servicios de Salud Rural/organización & administración , Salud Rural/estadística & datos numéricos , Adulto , Niño , Trastornos de la Nutrición del Niño/epidemiología , Estudios Transversales , Femenino , Investigación sobre Servicios de Salud , Humanos , India/epidemiología , Masculino , Embarazo , Atención Prenatal/organización & administración , Encuestas y Cuestionarios , Vacunación
6.
Int J Equity Health ; 18(1): 143, 2019 09 17.
Artículo en Inglés | MEDLINE | ID: mdl-31530283

RESUMEN

BACKGROUND: Millions of poor households in India undertake short duration rural to urban migration along with their children to find work in the informal economy in the city. While literature has documented the precarity of such temporary jobs, typically characterized by low wages, insecure jobs, harsh recruitment regimes and economic vulnerability, little is known about its implications for children who migrate with their parents to the city. In this study, we draw attention to children of migrant construction workers and focus on their overall nutritional well-being, which remains under-studied. Our objectives were to categorize the current nutritional status of children under the age of five and determine the underlying causes of poor nutritional outcomes. METHODS: The field work for this study was undertaken between May 2017 and January 2018 at five construction sites in the city of Ahmedabad. We undertook anthropometric measurements of children under the age of five [N = 131; (male: 46%, female 53%); (mean age: 31.7 months)] and categorized their nutritional status. Using the UNICEF framework on undernutrition, we examined the underlying causes of poor nutritional outcomes among this group of children with the help of qualitative methods such as interviews, focused group discussions and participant observation at the field sites. RESULTS: Undernutrition was highly prevalent among the children (N = 131): stunted (40.5%); wasted (22.1%); and underweight (50.4%). We found common factors across parents interviewed such as similar misperceptions of malnutrition, long hours of work and lack of childcare provision at the worksite which resulted in disrupted quality of care. While socio-cultural beliefs and lack of information influenced breastfeeding, other factors such as inability to take breaks or lack of space further impaired infant feeding practices more broadly. Lack of dietary diversity at home, poor hygiene and sanitation, and economic inability to seek healthcare further affected child nutritional status. CONCLUSIONS: Our study addresses a critical gap in migration literature in India by building a comprehensive narrative of migrant children's experiences at construction sites. We find that parents' informal work setting exposes children to a nutritionally challenging environment. Policies and programs seeking to address undernutrition, a critical challenge in India, must pay attention to the specific needs of migrant children.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Industria de la Construcción , Migrantes/estadística & datos numéricos , Adolescente , Adulto , Preescolar , Femenino , Humanos , India/epidemiología , Lactante , Recién Nacido , Masculino , Prevalencia , Factores de Riesgo , Adulto Joven
7.
BMC Public Health ; 19(1): 1204, 2019 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-31477069

RESUMEN

BACKGROUND: Intestinal worm infection adversely impacted child health and was one of the China's largest health burdens. However, yet little was known about associations between intestinal worm infection and malnutrition in school-aged children in rural China. This study aimed to fill into the gap. METHODS: Data were from a survey of children aged 9-11 years old in Guizhou Province, China conducted in June 2013. Considering anemia and low intelligent quotient (IQ) as mediating factors, binomial logistic regression was used to estimate the associations of intestinal worm infection with thinness, underweight, and stunting. Moreover, the associations between socio-demographic factors and malnutrition were also explored. RESULTS: Among 2179 children, part of children was infected by intestinal worm (41.85%). Stunting (28%), low memory IQ (87.52%), and low process IQ (62.59%) were highly prevalent in the sample. Socio-demographic factors were associated with thinness, underweight, stunting, low memory IQ, low process IQ, anaemia, and intestinal worm infection. Intestinal worm infection was associated with low IQ, anemia, and stunting. In addition, anemia and low IQ could not confound the other expected associations. CONCLUSION: This study demonstrated the association between intestinal worm infections and stunting appeared to be largely mediated via low IQ. The study highlighted the importance of deworming and improving nutrition in the surveyed areas.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Helmintiasis/epidemiología , Parasitosis Intestinales/epidemiología , Población Rural/estadística & datos numéricos , Niño , China/epidemiología , Femenino , Humanos , Masculino , Factores de Riesgo , Encuestas y Cuestionarios
8.
Int J Equity Health ; 18(1): 137, 2019 09 02.
Artículo en Inglés | MEDLINE | ID: mdl-31477149

RESUMEN

BACKGROUND: In Ethiopia it is documented that 16% of all grade repetitions in primary school and 33.9% childhood deaths are associated with undernutrition. School aged children are often omitted from public health research. Thus, the present study was carried out to find out the prevalence and determinants of pre-adolescent (5-14 years) acute and chronic undernutrition in Lay Armachiho District. METHODS: In this community based cross-sectional study, anthropometrics, individual and household characteristics data were collected from December, 2016 to January, 2017. A total of 848 school aged children (5-14 years) were included in the study. Z-scores for height-for-age (HAZ) and body-mass-index-for-age (BAZ) were calculated to illustrate stunting (chronic undernutrition) and thinness (acute undernutrition), respectively with Anthro Plus software version 1.0.4 using the WHO 2007 growth reference standard. Finally, backward stepwise multivariable logistic regression analysis was carried out to identify factors associated with stunting and thinness, individually. RESULTS: The overall prevalence of stunting and thinness was 35.5 and 9.9%, respectively. The multivariable analysis showed that child age 10-14 years [AOR = 1.58, 95% CI: 1.17, 2.12] and lack of availability of a latrine at home [AOR = 1.60; 95% CI: 1.17, 2.20)] were associated with increased likelihood of stunting. Nevertheless, child's hand washing practice before eating [AOR = 0.67; 95% CI: 0.49, 0.91] was protective against stunting. Children who consumed diversified foods [AOR = 0.64; 95% CI 0.39, 0.97] were protected from thinness. CONCLUSION: In Lay Armachiho district, one-third and one in every ten of school aged children were stunted and thin, respectively. Children age 10-14 years, lack of availability of a latrine at home and hand washing practices before eating were associated with stunting, while only dietary diversity was associated with thinness. Ensuring consistent hand washing practices before eating and ensuring availability of latrine should be improved in the region, which can assist in effectively tackling undernutrition. Finally, dietary diversification should be enhanced to rectify burden of acute undernutrition.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Enfermedad Aguda , Adolescente , Niño , Preescolar , Enfermedad Crónica , Etiopía/epidemiología , Femenino , Humanos , Masculino , Prevalencia , Factores de Riesgo
9.
BMC Public Health ; 19(1): 1200, 2019 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-31470824

RESUMEN

BACKGROUND: Rates of childhood undernutrition are persistently high in Cambodia. Existing ready-to-use supplementary and therapeutic foods (RUSFs and RUTFs) have had limited acceptance and effectiveness. Therefore, our project developed and trialled a locally-produced, multiple micronutrient fortified lipid-based nutrient supplement (LNS) with therapeutic and supplementary versions. This ready-to-use food (RUF) is innovative in that, unlike many RUFs, it contains fish instead of milk. Development began in 2013 and the RUF was finalised in 2015. From 2015 until the present, both the RUTF and the RUSF versions were trialled for acceptability and effectiveness. METHODS: This paper draws on project implementation records and semi-structured interviews to describe the partnership between the Cambodian Ministries of Health and Agriculture, Forestry and Fisheries, UNICEF, the French National Research Institute for Sustainable Development (IRD), universities, and Vissot factory. It discusses the project implementation and lessons learned from the development and trialling process, and insights into positioning nutrition on the health agenda in low and middle-income countries. RESULTS: The lessons learned relate to the importance of project planning, management, and documentation in order to seize opportunities in the research, policy, advocacy, and programming environment while ensuring adequate day-to-day project administration and resourcing. CONCLUSIONS: We conclude that projects such as ours, that collaborate to develop and test novel, locally-produced RUTFs and RUSFs, offer an exciting opportunity to respond to both local programmatic and broader research needs.


Asunto(s)
Trastornos de la Nutrición del Niño/prevención & control , Suplementos Dietéticos , Comida Rápida , Cambodia/epidemiología , Niño , Trastornos de la Nutrición del Niño/epidemiología , Humanos
10.
Pan Afr Med J ; 33: 34, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31384349

RESUMEN

Introduction: A cross-sectional study was conducted between the months of April to October 2015, to determine the effects of intestinal parasitic infections (IPIs) on nutritional status of school age children in Owerri and Orlu geographical zones, in Imo State, Nigeria. Methods: Faecal samples were examined using Kato Katz method and formol-ether concentration techniques, while blood samples were examined using cyamethahaemoglobin method. Anthropometric indices were used as indicators of nutritional status, children whose Height-for-Age, Weight-for-Age and Weight-for-Height were <-2 standard deviation (SD) were classified as stunted, wasted, and underweight respectively. Results: Total prevalence rate of 16.6% was recorded in the study areas with Ascaris lumbricoides (4.0%), Trichuris trichiura (0.6%), Hookworm (1.0%) Taenia sp (0.3%), Entaomeba histolytica (5.3%), Entamoeba coli (2.7%) and Giardia lambia (2.7) Majority (73.4%) of the children had light intensity. Anthropometric study results showed that 79(31.3%) of the children were malnourished. The prevalence of stunting, under-weight and wasting were higher in uninfected (86.1%, 90.0% and 10%) respectively than in infected children (13.9%, 10.0% and 0.0%) respectively, although not significant at p = 0.857, 0.587 and 0.368 respectively. Prevalence of anaemia was 17.4%, anaemia was insignificantly (p = 0.09) higher in infected (21.1%) than in uninfected (16.5%) children. Children that had co-infection recorded higher prevalence (2.2%) of severe anaemia. There was an association (p = 0.002) between anaemia and intensity of helminth infection. Malnutrition was insignificantly (p = 0.319) higher in children with heavy (100.0%) and moderate (75.0%) intensity of helminth infection than children that had light intensity (41.7%) of helminth infection. Conclusion: When compared with previous study, there were decline in the prevalence of intestinal parasitic infections and anaemia among school age children. Low intensity parasitemia with intestinal parasites had no significant effect on the malnutrition and haemoglobin profile of the children in the study areas. Therefore, improved sanitation and more deworming efforts should be intensified to ensure further decline in prevalence of intestinal parasitic infections.


Asunto(s)
Anemia/epidemiología , Trastornos de la Nutrición del Niño/epidemiología , Parasitosis Intestinales/epidemiología , Estado Nutricional , Adolescente , Anemia/parasitología , Niño , Trastornos de la Nutrición del Niño/parasitología , Preescolar , Estudios Transversales , Heces/parasitología , Trastornos del Crecimiento/epidemiología , Trastornos del Crecimiento/parasitología , Humanos , Parasitosis Intestinales/complicaciones , Parasitosis Intestinales/parasitología , Nigeria/epidemiología , Prevalencia , Delgadez/epidemiología , Delgadez/parasitología , Síndrome Debilitante/epidemiología , Síndrome Debilitante/parasitología
11.
PLoS Med ; 16(8): e1002906, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31454357

RESUMEN

The Guest Editors for the PLOS Medicine Special Issue on Maternal and Child Health & Nutrition discuss the published research in the context of global priorities for women's and children's health.


Asunto(s)
Fenómenos Fisiológicos Nutricionales Infantiles , Fenómenos Fisiologicos Nutricionales Maternos , Niño , Trastornos de la Nutrición del Niño/epidemiología , Trastornos de la Nutrición del Niño/prevención & control , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Embarazo
12.
BMC Res Notes ; 12(1): 391, 2019 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-31296269

RESUMEN

OBJECTIVE: The aim of this study was to assess the risk factors for malnutrition among children aged 0-59 months in Ethiopia. The analyzed data were obtained from the 2016 EDHS and 9495 under-5 years' children were considered in this analysis. The data was extracted, edited and analyzed by using SPSS Version 23.0. Both bivariate and multivariable binary logistic regression model was used to identify the determinants of children malnutrition. RESULTS: The prevalence of stunting, wasting, and underweight were 38.3%, 10.1%, and 23.3%, respectively. About 19.47% of children were both stunted and underweighted, and only 3.87% of children had all the three conditions. Among the factors that considered in this study, age of a child, residence region, mothers' education level, mothers' BMI, household wealth index, sex of a child, family size, water and toilet facility were significantly associated with malnutrition in Ethiopia. The authors concluded that malnutrition among under-five children was one of the public health problems in Ethiopia. Therefore, the influence of these factors should be considered to develop strategies for reducing malnutrition in Ethiopia.


Asunto(s)
Trastornos de la Nutrición del Niño/diagnóstico , Trastornos del Crecimiento/diagnóstico , Estado Nutricional , Delgadez/diagnóstico , Trastornos de la Nutrición del Niño/epidemiología , Preescolar , Etiopía/epidemiología , Femenino , Trastornos del Crecimiento/epidemiología , Encuestas Epidemiológicas , Humanos , Lactante , Recién Nacido , Masculino , Prevalencia , Factores de Riesgo , Factores Socioeconómicos , Delgadez/epidemiología
13.
BMC Public Health ; 19(1): 962, 2019 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-31319828

RESUMEN

BACKGROUND: India faces a high burden of child undernutrition. We evaluated the effects of two community strategies to reduce undernutrition among children under 3 years in rural Jharkhand and Odisha, eastern India: (1) monthly Participatory Learning and Action (PLA) meetings with women's groups followed by home visits; (2) crèches for children aged 6 months to 3 years combined with monthly PLA meetings and home visits. METHODS: We tested these strategies in a non-randomised, controlled study with baseline and endline cross-sectional surveys. We purposively selected five blocks of Jharkhand and Odisha, and divided each block into three areas. Area 1 served as control. In Area 2, trained local female workers facilitated PLA meetings and offered counselling to mothers of children under three at home. In Area 3, workers facilitated PLA meetings, did home visits, and crèches with food and growth monitoring were opened for children aged 6 months to 3 years. We did a census across all study areas and randomly sampled 4668 children under three and their mothers for interview and anthropometry at baseline and endline. The evaluation's primary outcome was wasting among children under three in areas 2 and 3 compared with area 1, adjusted for baseline differences between areas. Other outcomes included underweight, stunting, preventive and care-seeking practices for children. RESULTS: We interviewed 83% (3868/4668) of mothers of children under three sampled at baseline, and 76% (3563/4668) at endline. In area 2 (PLA and home visits), wasting among children under three was reduced by 34% (adjusted Odds Ratio [aOR]: 0.66, 95%: 0.51-0.88) and underweight by 25% (aOR: 0.75, 95% CI: 0.59-0.95), with no change in stunting (aOR: 1.23, 95% CI: 0.96-1.57). In area 3, (PLA, home visits, crèches), wasting was reduced by 27% (aOR: 0.73, 95% CI: 0.55-0.97), underweight by 40% (aOR: 0.60, 95% CI: 0.47-0.75), and stunting by 27% (aOR: 0.73, 95% CI: 0.57-0.93). CONCLUSIONS: Crèches, PLA meetings and home visits reduced undernutrition among children under three in rural eastern India. These interventions could be scaled up through government plans to strengthen home visits and community mobilisation with Accredited Social Health Activists, and through efforts to promote crèches. TRIAL REGISTRATION: The evaluation was registered retrospectively with Current Controlled Trials as ISCRTN89911047 on 30/01/2019.


Asunto(s)
Trastornos de la Nutrición del Niño/terapia , Consejo/métodos , Desnutrición/terapia , Educación del Paciente como Asunto/métodos , Mujeres/psicología , Adulto , Trastornos de la Nutrición del Niño/epidemiología , Trastornos de la Nutrición del Niño/psicología , Preescolar , Estudios Transversales , Femenino , Visita Domiciliaria , Humanos , India/epidemiología , Lactante , Masculino , Desnutrición/epidemiología , Desnutrición/psicología , Madres/psicología , Ensayos Clínicos Controlados no Aleatorios como Asunto , Aceptación de la Atención de Salud , Población Rural
14.
Nutrients ; 11(7)2019 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-31284369

RESUMEN

Even though limited evidence is available, the relationship between morbidity and under-nutrition among children under-five is likely to be a strong two-way association. This study aims to explore this vicious cycle by employing longitudinal data of four periods within a 24 month follow-up, whereby morbidity was captured between two subsequent anthropometric measures. Malnutrition was classified according to z-scores of anthropometric measures and morbidity by number of sick days experienced inbetween. Mixed-effects models were used to assess this relation, where dependency of morbidity and nutritional status were interchanged; models were adjusted for province, age, gender, wealth index score, maternal education level, diet, and Water, Sanitation, and Hygiene indicators. Stunting and wasting prevalences were 29.9% and 8.9%, respectively, where 21.3% of the children hadmultiple anthropometric failures. Children identified as wasted were 35% more likely to experience prolonged illness periods (OR: 1.35, 95% CI: 1.02-1.56). Those experiencing high proportion of sick days were found to be 64% more likely to become stunted (OR: 1.64, 95% CI: 1.18-2.29). This study suggests that the link between wasting and stunting could be partly explained by acute illness, where wasting increases the likelihood of prolonged epiosed of illness, which increases the risk of stunting.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Fenómenos Fisiológicos Nutricionales Infantiles , Trastornos del Crecimiento/epidemiología , Desnutrición/epidemiología , Estado Nutricional , Factores de Edad , Cambodia/epidemiología , Desarrollo Infantil , Trastornos de la Nutrición del Niño/diagnóstico , Trastornos de la Nutrición del Niño/fisiopatología , Preescolar , Femenino , Trastornos del Crecimiento/diagnóstico , Trastornos del Crecimiento/fisiopatología , Humanos , Lactante , Fenómenos Fisiológicos Nutricionales del Lactante , Estudios Longitudinales , Masculino , Desnutrición/diagnóstico , Desnutrición/fisiopatología , Prevalencia , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo
15.
Nutrients ; 11(7)2019 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-31261779

RESUMEN

Little is known about the prevalence of anaemia and associated factors in school children in Vietnam. In this cross-sectional study, we aimed to determine the prevalence of anaemia and its subtypes, and the associations of types of anaemia with demographic, socio-economic and anthropometric factors among 6-9-year-old primary school children in rural areas of Hai Phong City, Vietnam. Haemoglobin (Hb) and mean corpuscular volume (MCV) were measured, and demographic, socio-economic and anthropometric data were collected in 893 children from eight primary schools. The prevalence of anaemia (Hb < 115 g/L) was 12.9% (95% CI: 8.1%, 19.9%), microcytic anaemia (Hb < 115 g/L and MCV < 80 fL) was 7.9% (95% CI: 5.3%, 11.6%) and normocytic anaemia (Hb < 115 g/L and MCV 80-90 fL) was 5.3% (95% CI: 2.9%, 9.5%). No child presented with macrocytic anaemia (Hb < 115 g/L and MCV > 90 fL). Children who were underweight, wasted, or in anthropometric failure (either underweight, stunted or wasted) were more likely to be anaemic (all p ≤ 0.004), and specifically, to have normocytic anaemia (all p ≤ 0.006), than those who were not underweight, wasted or in anthropometric failure. Stunted children were more likely to be anaemic (p = 0.018) than those who were not stunted. Overweight/obese children were less likely to be anaemic (p = 0.026) or have normocytic anaemia (p = 0.038) compared with children who were not overweight/obese. No anthropometric status indicator was associated with the risk of microcytic anaemia. No demographic or socio-economic factor was associated with any type of anaemia. Anaemia remains a public health issue in rural areas in Hai Phong City, Vietnam, and future approaches for its prevention and control should target undernourished primary school children.


Asunto(s)
Anemia/epidemiología , Trastornos de la Nutrición del Niño/epidemiología , Fenómenos Fisiológicos Nutricionales Infantiles , Desnutrición/epidemiología , Estado Nutricional , Salud Rural , Factores Socioeconómicos , Estudiantes , Factores de Edad , Anemia/sangre , Anemia/diagnóstico , Anemia Macrocítica/sangre , Anemia Macrocítica/diagnóstico , Anemia Macrocítica/epidemiología , Biomarcadores/sangre , Niño , Desarrollo Infantil , Trastornos de la Nutrición del Niño/diagnóstico , Trastornos de la Nutrición del Niño/fisiopatología , Estudios Transversales , Femenino , Hemoglobinas/análisis , Humanos , Masculino , Desnutrición/diagnóstico , Desnutrición/fisiopatología , Prevalencia , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo , Vietnam/epidemiología
16.
J Public Health Policy ; 40(3): 342-350, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31171847

RESUMEN

A double burden of malnutrition (DBM) is the coexistence of under-nutrition and over-nutrition in a single household that has been reported from many developing countries. We performed a secondary analysis on India Human Development Survey (IHDS-II) data assessing 'stunted child and overweight/obese mother (SCOWT) pairs' in Kerala households. We included 344 pairs of children below 5 years of age and their mothers, with anthropometric measurements. We also performed the Pearson's Chi-square test to study the association of SCOWT pairs with socio-economic variables. The prevalence of SCOWT pairs was 10.7% for Kerala. The bivariate analysis showed no significant association for SCOWT pairs, irrespective of their socio-economic status. It is clear that the DBM is prevalent in Kerala and cannot be addressed exclusively by policies focusing on over-nutrition.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Trastornos del Crecimiento/epidemiología , Madres/estadística & datos numéricos , Obesidad/epidemiología , Distribución de Chi-Cuadrado , Preescolar , Costo de Enfermedad , Femenino , Humanos , India/epidemiología , Sobrepeso/epidemiología , Prevalencia , Factores Socioeconómicos
17.
Glob Health Action ; 12(1): 1556572, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31154991

RESUMEN

Background: Child undernutrition is a prevalent health problem and poses various short and long-term consequences. Objective: This study seeks to investigate the burden of child undernutrition and its drivers in Kilte Awlaelo-Health and Demographic Surveillance Site, Tigray, northern Ethiopia. Methods: In 2015, cross-sectional data were collected from 1,525 children aged 6-23 months. Maternal and child nutritional status was assessed using the mid upper arm circumference. Child's dietary diversity score was calculated using 24-hours dietary recall method. Log-binomial regression and partial proportional odds model were fitted to examine the drivers of poor child nutrition and child dietary diversity (CDD), respectively. Results: The burden of undernutrition and inadequate CDD was 13.7% (95% CI: 12.1-15.5%) and 81.3% (95%CI: 79.2-83.1%), respectively. Maternal undernutrition (adjusted prevalence ratio, adjPR = 1.47; 95%CI: 1.14-1.89), low CDD (adjPR = 1.90; 95%CI: 1.22-2.97), and morbidity (adjPR = 1.83; 95%CI: 1.15-2.92) were the nutrition-specific drivers of child undernutrition. The nutrition-sensitive drivers were poverty (compared to the poorest, adjPR poor = 0.65 [95%CI:0.45-0.93], adjPR medium = 0.64 [95%CI: 0.44-0.93], adjPR wealthy = 0.46 [95%CI: 0.30-0.70], and adjPR wealthiest = 0.53 [95%CI: 0.34-0.82]), larger family size (adjPR = 1.10; 95%CI: 1.02-1.18), household head's employment insecurity (adjPR = 2.10; 95%CI: 1.43-3.09), and residing in highlands (adjPR = 1.93; 95%CI: 1.36-2.75). The data show that higher CDD was positively associated with wealth (OR wealthy = 3.06 [95%CI: 1.88-4.99], OR wealthiest = 2.57 [95%CI: 1.53-4.31]), but it was inversely associated with lack of diverse food crops production in highlands (OR = 0.23; 95%CI: 0.10-0.57]). Conclusions: Our findings suggest that the burden of poor child nutrition is very high in the study area. Multi-sectoral collaboration and cross-disciplinary interventions between agriculture, nutrition and health sectors are recommended to address child undernutrition in resource poor and food insecure rural communities of similar settings.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Abastecimiento de Alimentos/estadística & datos numéricos , Desnutrición/epidemiología , Estado Nutricional , Salud Pública/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Preescolar , Estudios Transversales , Etiopía/epidemiología , Composición Familiar , Femenino , Humanos , Lactante , Masculino , Vigilancia de la Población , Prevalencia
18.
Nutrients ; 11(6)2019 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-31200550

RESUMEN

This study sought to elucidate the multi-level factors that influence behaviors underlying high childhood stunting and widespread micronutrient deficiencies in Kiribati. This two-phase formative research study had an emergent and iterative design using the socio-ecological model as the guiding theoretical framework. Phase 1 was exploratory while phase 2 was confirmatory. In phase 1, in-depth interviews, free lists, seasonal food availability calendar workshops, and household observations were conducted. In phase 2, focus group discussions, pile sorts, participatory workshops, and repeat observations of the same households were completed. Textual data were analyzed using NVivo software; ethnographic data were analyzed with Anthropac software for cultural domain analysis. We found a combination of interrelated structural, community, interpersonal, and individual-level factors contributing to the early child nutrition situation in Kiribati. Despite widespread knowledge of nutritious young child foods among community members, households make dietary decisions based not only on food availability and access, but also longstanding traditions and social norms. Diarrheal disease is the most salient young child illness, attributable to unsanitary environments and sub-optimal water, sanitation, and hygiene behaviors. This research underscores the importance of a multi-pronged approach to most effectively address the interrelated policy, community, interpersonal, and individual-level determinants of infant and young child nutrition in Kiribati.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Trastornos de la Nutrición del Niño/etiología , Fenómenos Fisiológicos Nutricionales Infantiles , Dieta/efectos adversos , Fenómenos Ecológicos y Ambientales , Antropología Cultural , Preescolar , Dieta/etnología , Composición Familiar , Femenino , Trastornos del Crecimiento/epidemiología , Trastornos del Crecimiento/etiología , Humanos , Lactante , Masculino , Micronesia/epidemiología , Micronutrientes/deficiencia , Encuestas Nutricionales , Estado Nutricional , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos
19.
BMC Public Health ; 19(1): 764, 2019 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-31200695

RESUMEN

BACKGROUND: Child undernutrition is a global health concern. Many studies have focused on the association of childhood undernutrition indicators with their predictors. A few studies have looked at relationship between the undernutrition indicators. This study aimed at investigating the possible association structures of childhood undernutrition indicators. METHODS: A log-linear model of cell counts of a three way table of stunting, wasting, and underweight was fitted based on the 2016 Ethiopia demographic health survey data. The variables of interest were generated based on the 2006 WHO Child Growth Standards as: stunted, wasted and underweight if z-scores of height-for-age, weight-for-height and weight-for age are below-2, respectively; otherwise not stunted, wasted and underweight. RESULTS: This study showed that 36.34, 12.09 and 24.87% were stunted, wasted and underweight out of sampled children respectively and the prevalence of total undernutrition in children was about 45.96%.The fitted log-linear model showed that underweight was associated with both stunting (P-value< 0.001), and wasting (P-value< 0.001). There was no association between stunting and wasting (P-value = 0.999). Furthermore, the model showed that there is no a three way interaction among stunting, wasting, and underweight (P-value = 1.000). CONCLUSION: The authors conclude that there is lack of three way association of stunting, wasting, and underweight. This confirms that the three anthropometric indicators of children have multi-dimensional nature. Thus, the concerned body should consider the three undernutrition indicators simultaneously to estimate the actual burden of childhood undernourishment as they are not redundant of each other.


Asunto(s)
Antropometría , Trastornos de la Nutrición del Niño/epidemiología , Indicadores de Salud , Preescolar , Etiopía/epidemiología , Femenino , Trastornos del Crecimiento/epidemiología , Encuestas Epidemiológicas , Humanos , Lactante , Masculino , Prevalencia , Delgadez/epidemiología , Síndrome Debilitante/epidemiología
20.
BMC Public Health ; 19(1): 773, 2019 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-31208397

RESUMEN

BACKGROUND: For over 20 years, Madagascar has been challenged by continued high prevalence of stunting, underweight and wasting among children under 5 years of age. Yet, nutritional status of post-under-five age group has never been assessed in the country, despite its importance in relation not only to physical health but also to cognitive capacity and educational achievements of children. This study aims to estimate prevalence of malnutrition among schoolchildren aged 5-14 years in Madagascar. It further attempts to identify the possible risk factors for their malnutrition. This is the first study that estimates prevalence of malnutrition among school-aged children in Madagascar. METHODS: A cross-sectional household survey was conducted in Antananarivo-Avaradrano district, Analamanga region, Madagascar. The study targeted 393 first and second graders 5-14 years of age enrolled at 10 primary schools, where school-feeding was implemented. Data were collected from anthropometric measurements, their subsequent household structured interviews and observations. Bivariate (Chi-square test or Mann-Whitney's U test) and multivariable (logistic regression) analyses were performed, to identify the possible risk factors associated with malnutrition. RESULTS: The overall prevalence rates of stunting, underweight and thinness were 34.9%, 36.9% and 11.2%, respectively. Nineteen children (4.8%) suffered from all the three forms of undernutrition. Older schoolchildren had a significantly greater likelihood of being stunted, underweight and thin. The greater number of members a household had, the higher likelihood of being stunted and thin its schoolchild had. Children having lower Household Dietary Diversity Score were more likely to be underweight. Yet, 'Had lunch at school yesterday' was associated neither with being stunted nor with being underweight and thin. This implies room for improvement of the current school feeding program. CONCLUSIONS: Prevalence rates of stunting and underweight among 393 children examined were as high as the national averages among children under 5 years of age. Adequate food availability and dietary diversity over a sufficient period (incl. 5-14 years of age) are necessary for increasing likelihood of catch-up in height-for-age and weight-for-age, which are expectable during adolescence. To supplement inadequate household dietary diversity practices, school-feeding program may need to use more animal-protein ingredients.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Población Rural/estadística & datos numéricos , Adolescente , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Madagascar/epidemiología , Masculino , Prevalencia , Factores de Riesgo
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