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1.
BMJ Open ; 13(12): e075600, 2023 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-38149415

RESUMO

BACKGROUND: Owing to the unavoidable consequences of nutritional transition, the double burden of malnutrition (DBM) is an emerging public health problem. An increasing number of studies have found that Ethiopians face a DBM. However, country-level evidence has not yet been summarised using a scoping review study design. OBJECTIVE: The main objective of this review was to map the national evidence on DBM in Ethiopia for the implications of research gap identifications. ELIGIBILITY CRITERIA: The population, concept and context approach was used. All age groups, box sexes, all dates of publication and articles in English language focused on DBM conducted in Ethiopia were included. SOURCES OF EVIDENCE: Primary research articles, systematic reviews, meta-analyses and scoping reviews searched from electronic databases such as PubMed, ScienceDirect, Cochrane Library, Wiley Online Library, Google Scholar and Google were the sources of evidence. CHARTING METHODS: The Joanna Briggs Institute Reviewer's manual was used as a review methodology. The authors, publication year, region, study design, sample size, population group, measured outcomes and main findings were charted in a table. RESULTS: A total of 35 articles met the inclusion criteria among 124 426 participants. The average summarised prevalence of DBM was 33.6%, with the average proportions of undernutrition and overnutrition at 21.5% and 12.1%, respectively. The major factors that influenced the DBM were categorised as child, maternal, adolescent, household and adult-related factors. CONCLUSION: In Ethiopia, the overall prevalence of DBM is high, which makes one-third of the population affected by DBM. The foremost determinant factors that influenced the DBM were characterised as child, maternal, adolescent, household and adult-related factors. Therefore, a double-duty interventions should be used to address DBM, considering multilevel factors at the individual, community and societal levels. PROTOCOL REGISTRATION: This review was registered on the figshare website on 28 February 2021, with DOI number https://doi.org/10.6084/m9.figshare.14131874. The review protocol was published with a DOI number http://dx.doi.org/10.1136/bmjopen-2021-050805.


Assuntos
Lacunas de Evidências , Desnutrição , Humanos , Etiópia/epidemiologia , Características da Família , Desnutrição/epidemiologia
2.
Washington, D.C.; OPS; 2023-11-16.
Não convencional em Espanhol | PAHO-IRIS | ID: phr-58553

RESUMO

En este marco de acción se presenta a grandes rasgos la manera de formular (o fortalecer) y aplicar una política pública de compras y servicios de alimentos saludables, así como de evaluar su cumplimiento y eficacia. Este documento ha sido concebido para ser utilizado por las instancias normativas gubernamentales o los gerentes de programas que se ocupan de las compras o los servicios de alimentos en el sector público, ya sea a nivel nacional o subnacional, incluso a nivel regional, provincial y municipal. Los gobiernos pueden adaptar este marco de acción para determinar un alcance viable de la política que se adapte a sus necesidades y al contexto local. El documento contiene ejemplos de países que han formulado y ejecutado políticas públicas para las compras y los servicios de alimentos saludables. En él se propone un conjunto de pasos clave de política, divididos en cuatro secciones que se fundamentan en el ciclo de formulación de políticas: Sección 1: Preparación de la política, en la que se describen los pasos clave que deben seguirse con antelación a la formulación o la revisión de una política pública de compras y servicios de alimentos saludables. Sección 2: Formulación de la política, en la que se describen los pasos clave del proceso de elaboración de la política, particularmente el proceso de definición del propósito, el alcance, los criterios de nutrición y otros criterios que se incluirán en la política. Sección 3: Aplicación de la política, en la que se examinan los pasos clave para facilitar y garantizar la plena incorporación de la política, y se destaca que es fundamental contar con una estrategia de aplicación claramente definida para el éxito de la política. Sección 4: Seguimiento, cumplimiento y evaluación, en la que se brinda orientación sobre el proceso de seguimiento y cumplimiento de la política, así como de evaluación para determinar si se la está aplicando de manera eficaz.


Assuntos
Política Nutricional , Manejo da Obesidade , Desenvolvimento Sustentável , Desnutrição
3.
Public Health Nutr ; 26(11): 2226-2242, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37800336

RESUMO

OBJECTIVE: To conduct a comprehensive systematic review and meta-analysis of the available literature on the anthropometric nutritional status of South African infants and children, 0-18 years old and to report on trends of changes in nutritional status over the period 1997-2022. DESIGN: Systematic review and meta-analysis. SETTING: Review of the available literature on the anthropometric nutritional status of South African infants and children, 0-18 years old, over the period 1997-2022. PARTICIPANTS: South African infants and children, 0-18 years old. RESULTS: Only quantitative data from ninety-five publications that described the nutritional status in terms of anthropometry were included. Most recent studies applied the WHO 2006 and 2007 definitions for malnutrition among children 0-5 years old and 5-19 years old, respectively. Meta-analysis of all prevalence data shows the highest stunting prevalence of 25·1 % among infants and preschool children, compared to 11·3 % among primary school-age children and 9·6 % among adolescents. Furthermore, the overweight and obesity prevalence was similar among children younger than 6 years and adolescents (19 %), compared to 12·5 % among primary school-age children. In national surveys, adolescent overweight prevalence increased from 16·9 % in 2002 to 23·1 % in 2011. Meta-regression analysis shows a decrease in stunting among children 6-18 years old and an increase in combined overweight and obesity in the 10-19 years age group. CONCLUSION: The double burden of malnutrition remains evident in South Africa with stunting and overweight/obesity the most prevalent forms of malnutrition among children.


Assuntos
Desnutrição , Obesidade Pediátrica , Lactente , Pré-Escolar , Adolescente , Humanos , Recém-Nascido , Criança , Estado Nutricional , Sobrepeso/epidemiologia , África do Sul/epidemiologia , Desnutrição/epidemiologia , Antropometria , Transtornos do Crescimento/epidemiologia , Prevalência
4.
J Nutr Sci ; 12: e102, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37771505

RESUMO

Undernutrition in elders remains under-detected, under-treated, and under-resourced and leads to further weight loss, increased infections, and delay in recovery from illness as well as increased hospital admissions and length of stay. The reports of the findings were fragmented and inconsistent in Ethiopia. Therefore, the main objective of this meta-analysis was to estimate the pooled prevalence of undernutrition and its association with dietary diversity among older persons in Ethiopia. Online databases (Medline, PubMed, Scopus, and Science Direct), Google, Google Scholar, and other grey literature were used to search articles until the date of publication. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. The random effect model was used to estimate the pooled prevalence; whereas subgroup analysis and meta-regression were performed to identify the probable source of heterogeneity using Stata version 14.0 software. Out of 522 studies accessed, 14 met our criteria and were included in the study. A total of 7218 older people (aged above 60 years old) were included in the study. The pooled proportion of undernutrition among older persons in Ethiopia was 20⋅6 % (95 % CI 17⋅3, 23⋅8). Elders who consumed low dietary diversity scores were strongly associated with undernutrition among older persons. Therefore, promoting appropriate intervention strategies for elders to improve dietary diversity practices and nutritional status is crucial.


Assuntos
Dieta , Desnutrição , Humanos , Idoso , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade , Etiópia/epidemiologia , Desnutrição/epidemiologia , Estado Nutricional , Prevalência
5.
Glob Health Action ; 16(1): 2240158, 2023 12 31.
Artigo em Inglês | MEDLINE | ID: mdl-37497693

RESUMO

BACKGROUND: Undernutrition remains a major public health issue in low- and middle-income countries. Objective Our aim for this study was to identify the factors contributing to undernutrition in children under five years old in North Africa. METHODS: We searched five electronic bibliographic databases (Ovid MEDLINE, Web of Science, Embase (Ovid), ProQuest, and CINAHL) for eligible observational studies published after 2006. STATA version 17 software was used to calculate the odds ratios between associated factors and indicators of undernutrition, with 95% confidence intervals. For each factor, the overall odds were pooled using a forest plot. Due to the significant heterogeneity among the studies (I2 > 50%), a random-effects model was used, and sensitivity analysis was conducted to examine the effect of outliers. RESULTS: Out of 1093 initially identified studies, 14 met the selection criteria. Our meta-analysis revealed that uneducated mothers were the most common factor associated with undernutrition in North African children. Children aged 0-23 months were significantly associated with stunting (odds ratios (OR) = 1.27; 95% CI: 1.18; 1.37) and wasting (OR = 1.68; 95% CI: 1.42; 1.99). Children living in rural areas were also at higher odds of being stunted (OR = 1.74; 95% CI: 1.64; 1.84) and underweight (OR = 1.59; 95% CI: 1.35; 1.88). These analyses also indicated that a lower wealth index, mothers' nutritional health, uneducated fathers, and low birth weight were other factors significantly associated with stunting. CONCLUSION: Addressing undernutrition in Northern Africa requires a multidisciplinary approach prioritising mothers and young children, especially families in underprivileged areas.


Assuntos
Desnutrição , Síndrome de Emaciação , Feminino , Humanos , Criança , Lactente , Pré-Escolar , Desnutrição/epidemiologia , Mães , Magreza , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Prevalência , África do Norte/epidemiologia
6.
PLoS One ; 18(4): e0280784, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37022989

RESUMO

BACKGROUND: Ethiopia has undergone rapid economic growth over the last two decades that could influence the diets and nutrition of young people. This work systematically reviewed primary studies on adolescent nutrition from Ethiopia, to inform future interventions to guide policies and programs for this age group. METHOD: A systematic search of electronic databases for published studies on the prevalence of and interventions for adolescent malnutrition in Ethiopia in the English language since the year 2000 was performed using a three-step search strategy. The results were checked for quality using the Joanna Bridge Institute (JBI) checklist, and synthesized and presented as a narrative description. RESULTS: Seventy six articles and two national surveys were reviewed. These documented nutritional status in terms of anthropometry, micronutrient status, dietary diversity, food-insecurity, and eating habits. In the meta-analysis the pooled prevalence of stunting, thinness and overweight/obesity was 22.4% (95% CI: 18.9, 25.9), 17.7% (95% CI: 14.6, 20.8) and 10.6% (7.9, 13.3), respectively. The prevalence of undernutrition ranged from 4% to 54% for stunting and from 5% to 29% for thinness. Overweight/obesity ranged from 1% to 17%. Prevalence of stunting and thinness were higher in boys and rural adolescents, whereas overweight/obesity was higher in girls and urban adolescents. The prevalence of anemia ranged from 9% to 33%. Approximately 40%-52% of adolescents have iodine deficiency and associated risk of goiter. Frequent micronutrient deficiencies are vitamin D (42%), zinc (38%), folate (15%), and vitamin A (6.3%). CONCLUSIONS: The adolescent population in Ethiopia is facing multiple micronutrient deficiencies and a double-burden of malnutrition, although undernutrition is predominant. The magnitude of nutritional problems varies by gender and setting. Context-relevant interventions are required to effectively improve the nutrition and health of adolescents in Ethiopia.


Assuntos
Desnutrição , Estado Nutricional , Masculino , Feminino , Humanos , Adolescente , Sobrepeso/epidemiologia , Magreza/epidemiologia , Etiópia/epidemiologia , Obesidade/epidemiologia , Desnutrição/epidemiologia , Micronutrientes , Transtornos do Crescimento/epidemiologia , Prevalência
7.
PLoS One ; 18(4): e0283685, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37023076

RESUMO

Undernutrition (stunting, wasting and underweight) among children remains a public health concern in North Africa, especially following recent conflicts in the region. Therefore, this paper systematically reviews and meta-analyses the prevalence of undernutrition among children under five in North Africa to determine whether efforts to reduce undernutrition are on track to achieving the Sustainable Development Goals (SDGs) by 2030. Eligible studies published between 1st January 2006 and 10th April 2022 were searched for, using five electronic bibliographic databases (Ovid MEDLINE, Web of Science, Embase (Ovid), ProQuest and CINAHL). The JBI critical appraisal tool was used, and a meta-analysis was conducted using the 'metaprop' command in STATA, to estimate the prevalence of each undernutrition indicator in the seven North African countries (Egypt, Sudan, Libya, Algeria, Tunisia, Morocco, and Western Sahara). Due to the significant heterogeneity among studies (I2 >50%), a random effect model and sensitivity analysis were conducted to examine the effect of outliers. Out of 1592 initially identified, 27 met the selection criteria. The prevalence of stunting, wasting and being underweight were 23.5%, 7.9% and 12.9%, respectively. Significant variations between the countries with the highest rates of stunting and wasting were reported in Sudan (36%, 14.1%), Egypt (23.7%, 7.5%), Libya (23.1%, 5.9%), and Morocco (19.9%, 5.1%). Sudan also had the highest prevalence of underweight (24.6%), followed by Egypt (7%), Morocco (6.1%), and Libya (4.3%) with more than one in ten children in Algeria and Tunisia having stunted growth. In conclusion, undernutrition is widespread in the North African region, particularly in Sudan, Egypt, Libya, and Morocco, making it challenging to meet the SDGs by 2030. Nutrition monitoring and evaluation in these countries is highly recommended.


Assuntos
Desnutrição , Magreza , Criança , Humanos , Magreza/epidemiologia , Prevalência , Marrocos , Tunísia , Desnutrição/epidemiologia , Transtornos do Crescimento/epidemiologia
8.
PLoS One ; 18(4): e0282240, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37043492

RESUMO

BACKGROUND: As adolescence is a transition period from childhood to adulthood malnutrition occurring at this age resonates through generations. Although there were many individual studies in Ethiopia about different form of malnutrition among adolescent, their results are inconclusive indicating the need for generating a pooled estimate of adolescent nutritional status and associated factors. This review and meta-analyses aimed at estimating the pooled prevalence of different forms of malnutrition and associated factors among adolescents in Ethiopia. METHOD AND MATERIALS: We searched data bases from Pub Med, Cochrane Library, Health Inter Network Access to Research Initiative (HINARI), Science Direct and search engines; Google and Google Scholar and other sources; Reference of References and expert contact which were used to select the studies. Joanna Briggs Institute (JBI) quality appraisal tool was applied to identify eligible studies. STATA/SE V.14 was used to analyze the data. Effect size with 95% Confidence Interval (CI) and heterogeneity were estimated. Heterogeneity of studies was quantified with I2 statistic >50% used as an indicator of heterogeneity. Potential publication bias was assessed using Funnel plots and Egger's regression test. Trim and fill analysis was also performed. The presences of a statistical association between independent and dependent variables were declared at P <0.05. The PROSPERO registration number for the review is CRD42020159734. RESULTS: The pooled prevalence of overweight/obesity, stunting and thinness were 10.63% (95% CI: 8.86, 12.40), 20.06% (95% CI: 15.61, 24.51) and 21.68% (95% CI: 9.56, 33.81), respectively. Being female (OR: 2.02, CI: 1.22-3.34), low dietary diversity score (OR: 2.26 CI: 1.28-3.99) and high physical activity (OR: 0.36, 95%CI: 0.14-0.88) were significantly associated with adolescent overweight/obesity. Urban residence (OR: 0.82, 95%CI: 0.68-0.99), protected drinking water source (OR: 0.50, CI: 0.27-0.90) and having family size<5 people (OR: 0.54, CI: 0.44-0.66) were independent predictors of adolescent stunting. Early adolescent age (10-14 years) (OR: 2.38, CI: 1.70-3.34), protected water source for drinking (OR: 0.36, CI: 0.21-0.61), low wealth index (OR: 1.80, CI: 1.01-3.19) and family size <5 people (OR: 0.50, CI: 0.28-0.89) were significantly (P < 0.05) associated with adolescent thinness. CONCLUSION: The prevalence of overweight/obesity, stunting and thinness are high in Ethiopian adolescents indicating the upcoming challenge of double burden of malnutrition. The results imply the presence of double burden of malnutrition among adolescents which heralds the need for programmatic and policy response in terms of addressing modifiable risk factors including: dietary practices, physical activity, water source and economic status of these adolescents.


Assuntos
Desnutrição , Obesidade Pediátrica , Humanos , Adolescente , Feminino , Criança , Adulto Jovem , Masculino , Etiópia/epidemiologia , Sobrepeso/epidemiologia , Magreza/epidemiologia , Desnutrição/epidemiologia , Prevalência , Transtornos do Crescimento/epidemiologia
9.
Syst Rev ; 12(1): 46, 2023 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-36922839

RESUMO

BACKGROUND: Undernutrition is defined as not consuming enough nutrients and energy to meet one's needs for maintaining good health. It is exacerbated by armed conflict. Individuals cannot stick to jobs because of a lack of safety during conflicts, which has an impact on families' ability to purchase food. However, there is a paucity of evidence on pooled evidence on the impact of armed conflict on childhood undernutrition among children aged 6 to 59 months in Africa. Therefore, this review aimed to examine the effects of armed conflict on the magnitude of undernutrition, particularly stunting, underweight, and wasting among children in Africa. METHODS: A comprehensive literature search was conducted using electronic databases (PubMed, Hinari, and Google Scholar database) to locate potential studies. Heterogeneity between studies was checked using Cochrane Q test statistics and I2 test statistics. Small-study effects were checked using Egger's statistical test at a 5% significance level. A random-effects model was employed to estimate the pooled prevalence and associated factors of undernutrition among children aged 6-59 months in Africa. RESULTS: Of a total of 585 articles retrieved from the databases, 12 studies met our inclusion criteria. The pooled prevalence of wasting, stunting, and being underweight among conflict-affected African countries was 20.25% (95%CI = 15.08-25.43), 34.18% (95% CI = 26.34-42.02), and 24.00% (95%CI = 16.35-31.65), respectively. The most consistent factors associated with childhood stunting, wasting, and being underweight in Africa were low mother's education, prolonged duration of armed conflict, and rural place of residence. CONCLUSION: The severity of malnutrition crises will be assisted by a better understanding of the variables associated with child malnutrition, which will improve the effectiveness of development and humanitarian responses. We urge that health planners, policymakers, and the general public prioritize children with acute malnutrition in Africa's conflict-affected areas. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022367487.


Assuntos
Desnutrição , Síndrome de Emaciação , Criança , Humanos , Magreza/epidemiologia , Magreza/etiologia , Síndrome de Emaciação/epidemiologia , Síndrome de Emaciação/complicações , Desnutrição/epidemiologia , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/complicações , África/epidemiologia , Conflitos Armados , Prevalência
10.
PLoS One ; 18(3): e0283502, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36961844

RESUMO

BACKGROUND: Undernutrition (Body Mass Index < 18.5 kg/m2) is a common problem and a major cause of hospital admission for patients living with HIV. Though sub-Saharan Africa is the most commonly affected region with HIV and malnutrition, a meta-analysis study that estimates the prevalence and correlates of undernutrition among adults living with HIV has not yet been conducted. The objective of this study was to determine the pooled prevalence of undernutrition and associated factors among adults living with HIV/AIDS in sub-Saharan Africa. METHODS: Studies published in English were searched systematically from databases such as PubMed, Google Scholar, and gray literature, as well as manually from references in published articles. Observational studies published from 2009 to November 2021 were included. The data extraction checklist was prepared using Microsoft Excel and includes author names, study area, publication year, sample size, prevalence/odds ratio, and confidence intervals. The results were presented and summarized in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standard. Heterogeneity was investigated using the Q test, I2, τ2, τ and predictive interval. STATA version 17 was used to analyze the data. A meta-analysis using a random-effects model was used to determine the overall prevalence and adjusted odds ratio. The study has been registered in PROSPERO with a protocol number of CRD42021268603. RESULTS: In this study, a total of 44 studies and 22,316 participants were included. The pooled prevalence of undernutrition among adult people living with HIV (PLWHIV) was 23.72% (95% CI: 20.69-26.85). The factors associated with undernutrition were participants' age (AOR = 0.5, 95% CI: 0.29-0.88), gender (AOR = 2.08, 95% CI: 0.22-20.00), World Health Organization (WHO) clinical stage (AOR = 3.25, 95% CI: 2.57-3.93), Cluster of Differentiation 4 (CD4 count) (AOR = 1.94, 95% CI: 1.53-2.28), and duration of ART (AOR = 2.32, 95% CI: 1.6-3.02). CONCLUSION: The pooled prevalence of undernutrition among adult PLWHIV in sub-Saharan Africa remained high. WHO clinical stage, CD4 count, duration of ART treatment, age, and sex were found to be the factors associated with undernutrition. Reinforcing nutrition counseling, care, and support for adults living with HIV is recommended. Priority nutritional screening and interventions should be provided for patients with advanced WHO clinical stages, low CD4 counts, the male gender, younger age groups, and ART beginners.


Assuntos
Infecções por HIV , Desnutrição , Humanos , Adulto , Masculino , Avaliação Nutricional , Prevalência , Estado Nutricional , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Desnutrição/epidemiologia , Desnutrição/complicações , África Subsaariana/epidemiologia
11.
Brasília; Fiocruz Brasília; 10 mar. 2023. 21 p.
Não convencional em Português | LILACS, Coleciona SUS, PIE | ID: biblio-1435173

RESUMO

Contexto O Ministério da Saúde, por meio da Portaria GM/MS nº 28, de 20 de janeiro de 2023, declarou a Emergência em Saúde Pública de Importância Nacional (ESPIN) em decorrência de desassistência à população Yanomami. Desde então, entre 19 crianças indígenas de seis meses e cinco anos de idade com desnutrição grave que foram atendidas pela Casa de Apoio à Saúde Indígena (Casai) de Boa Vista/RR, 15 (78%) ganharam peso e estão evoluindo de quadros graves para moderados de desnutrição, a partir dos protocolos e diretrizes do Ministério da Saúde. No Brasil, a recomendação do Ministério da Saúde para o tratamento da desnutrição grave inclui esquemas para alimentação utilizando preparado alimentar inicial ­ F-75 (75 kcal e 0,9g de proteína/100ml) e o preparado alimentar para crescimento rápido - F-100 (100 kcal e 2,9g de proteína/100ml). O guia de prática clínica (GPC) da Organização Mundial da Saúde (OMS) refere que a maioria das crianças de seis meses ou mais com desnutrição aguda grave, sem complicações médicas, pode ser tratada com segurança por meio de alimentos terapêuticos prontos para uso (Ready-to-use-therapeutic-food - RUTF), sem necessidade de internação em unidade de saúde. Pergunta Qual é a segurança e eficácia de RUTF, no curto e longo prazo, para o tratamento de crianças menores de cinco anos com desnutrição grave? Métodos Após realização de protocolo de pesquisa, cinco bases da literatura eletrônica foram acessadas em março de 2023 para identificar estudos que pudessem oferecer resposta à pergunta de investigação. Utilizando atalhos de revisão rápida, foram realizados os processos de seleção de estudos, extração de dados e avaliação da qualidade metodológica das RS incluídas com a ferramenta AMSTAR 2. Resultados Duas revisões sistemáticas (RS) foram incluídas, sendo avaliadas como de confiança baixa e moderada. Uma RS realizou metanálises, indicando que não houve diferença entre os grupos RUTF e F-100 para ganho de peso e mortalidade. A maioria dos estudos primários, 3 de 5 ensaios clínicos randomizados (ECR) citados nas RS mostram que não houve diferença entre os grupos RUTF e F-100 quanto à altura, circunferência do braço e desnutrição aguda. Dois estudos primários incluídos nas RS indicam que o tratamento com RUFT apresenta os seguintes resultados positivos: maior probabilidade de atingir o escore Z de peso para altura; menor probabilidade de recaída e de recidiva; melhora no ganho de peso e redução do tempo de recuperação. Ressalta-se que um destes ECR apresenta conflito de interesses. Nenhuma RS analisou desfechos acerca da segurança do uso de RUTF. Dois GPC da Organização Mundial da Saúde foram selecionados mediante busca manual. Um GPC recomenda que o RUTF pode ser utilizado para crianças com desnutrição aguda grave que apresentam diarreia aguda ou persistente da mesma forma que crianças sem diarreia, quer sejam tratadas como pacientes internados ou ambulatoriais. O outro GPC recomenda que para tratamento ambulatorial de crianças com desnutrição aguda grave seja utilizado o RUTF padrão (com pelo menos 50% de proteína proveniente de laticínios). Considerações finais Esta revisão rápida aponta que há poucos estudos sobre o tema. As evidências são insuficientes para afirmar quais intervenções (RUTF ou F-100) são mais eficazes. As recomendações dos GPC também são baseadas em evidências escassas. Portanto, não há evidências que sustentem o uso do RUTF em detrimento da F-100, pois não há comprovação de maior eficácia e nenhum estudo abordou a segurança a longo prazo do uso de RUTF.


Context: The Ministry of Health, through Ordinance GM/MS No. 28, of January 20, 2023, declared a Public Health Emergency of National Importance (ESPIN) due to lack of assistance to the Yanomami population. Since then, among 19 indigenous children aged between six months and five years old with severe malnutrition who were assisted by the Casa de Apoio à Saúde Indígena (Casai) in Boa Vista/RR, 15 (78%) have gained weight and are evolving from serious conditions. for moderate malnutrition, based on the protocols and guidelines of the Ministry of Health. In Brazil, the recommendation of the Ministry of Health for the treatment of severe malnutrition includes feeding schemes using initial food preparation - F-75 (75 kcal and 0.9g of protein/100ml) and food preparation for rapid growth - F-100 (100 kcal and 2.9g of protein/100ml). The clinical practice guide (CPG) of the World Health Organization (WHO) states that most children aged six months or more with severe acute malnutrition, without medical complications, can be safely treated with ready-to-use therapeutic foods ( Ready-to-use-therapeutic-food - RUTF), without the need for hospitalization in a health unit. Question: What is the safety and efficacy of RUTF, in the short and long term, for the treatment of children under five with severe malnutrition? Methods: After carrying out a research protocol, five electronic literature databases were accessed in March 2023 to identify studies that could answer the research question. Using rapid review shortcuts, the processes of study selection, data extraction and methodological quality assessment of the SR included with the AMSTAR 2 tool were carried out. Results: Two systematic reviews (SR) were included, being assessed as having low and moderate confidence. An SR performed meta-analyses, indicating that there was no difference between the RUTF and F-100 groups for weight gain and mortality. Most of the primary studies, 3 out of 5 randomized clinical trials (RCTs) cited in the SR show that there was no difference between the RUTF and F-100 groups in terms of height, arm circumference and acute malnutrition. Two primary studies included in the SR indicate that treatment with RUFT has the following positive outcomes: increased likelihood of achieving weight-for-height Z-score; lower probability of relapse and recurrence; improvement in weight gain and reduced recovery time. It should be noted that one of these RCTs has a conflict of interest. No SR analyzed outcomes regarding the safety of using RUTF. Two World Health Organization CPGs were selected by manual search. A CPG recommends that RUTF can be used for children with severe acute malnutrition who have acute or persistent diarrhea in the same way as children without diarrhea, whether they are treated as inpatients or outpatients. The other CPG recommends that standard RUTF be used for outpatient treatment of children with severe acute malnutrition (with at least 50% protein from dairy products). Final considerations: This quick review points out that there are few studies on the subject. There is insufficient evidence to state which interventions (RUTF or F-100) are most effective. The CPGs recommendations are also based on sparse evidence. Therefore, there is no evidence to support the use of RUTF over F-100, as there is no evidence of greater efficacy and no study has addressed the long-term safety of using RUTF.


Assuntos
Desnutrição Aguda Grave , Transtornos da Nutrição Infantil , Alimentos Formulados , Revisão
12.
Acta Paediatr ; 112(5): 1074-1081, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36843242

RESUMO

AIM: We evaluated the impact of inpatient and outpatient treatment provided by an infant nutrition foundation in Las Heras, Mendoza, Argentina and identified the factors that influenced nutritional recovery. METHODS: This 2010-2018 retrospective study was based on 300 children up to 5 years of age with primary malnutrition, who were treated by an inpatient recovery centre, then an outpatient prevention centre. We analysed the children's height, weight, psychomotor development and living conditions when they were admitted, discharged and had received 1 year of outpatient treatment. There were full data on 241 children and just admission and discharge data for 59. RESULTS: The children's mean age on admission and weight were 14.8 ± 12.4 months and 6.9 ± 2.3 kg and they stayed in hospital for a mean of 59.5 ± 49.7 days. We observed a significant increase in the weight-for-age, height-for-age and weight-for-height z-scores when all three time points were compared (p < 0.001). Psychomotor development improved considerably in all patients after treatment. The factors that negatively influenced nutritional recovery were higher age at admission, suboptimal breastfeeding practices, low birth weight, longer hospital stays, younger maternal age and overcrowded housing. CONCLUSION: Combining inpatient recovery and outpatient preventive treatment was effective for undernourished children in Argentina.


Assuntos
Transtornos da Nutrição Infantil , Desnutrição , Criança , Feminino , Humanos , Lactente , Argentina , Pacientes Internados , Desnutrição/prevenção & controle , Estado Nutricional , Pacientes Ambulatoriais , Estudos Retrospectivos , Serviços de Saúde Comunitária
13.
BMC Pregnancy Childbirth ; 23(1): 116, 2023 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-36797675

RESUMO

BACKGROUND: There are foods considered as taboo across different communities in the world and in Ethiopia in particular. Although food taboos exist across all ages or physiologic states, they are predominant among pregnant women and children. Identifying such foods among pregnant women is crucial in providing focused interventions and prevents their negative consequences. Therefore, the aim of this review was to review the available evidence on food taboos and their perceived reasons among pregnant women in Ethiopia to provide comprehensive and precise evidence for decision making. METHODS: Electronic search of the literature was made from Pub-Med, Google Scholar, Google Scopus, and Medline databases using search terms set based on the PICO/PS (Population, Intervention/exposure, Comparison, and Outcome) and PS (Population and Situation) search table. The search was made from December 05, 2020 - December, 29, 2021, and updated on January, 2022. All quantitative and qualitative studies published in English were included in the review. The systematic review protocol was registered at INPLASY (Registration number: INPLASY202310078). The outcome of interest was food taboo for pregnant women and its perceived reasons. The results of the review was narrated. RESULTS: After identifying eighty two articles, thirteen were found eligible for the review. Vegetables, fruits, and fatty foods like meat, and dairy products were considered as taboo for pregnant women in different parts of Ethiopia. The reasons stated for the food taboo vary from fear of having a big baby, obstructed labour, and abortion to evil eye and physical and aesthetic deformities in the newborn. CONCLUSIONS: Though not uniform across the country, there are foods considered as taboo for pregnant women in Ethiopia due to several perceived reasons, misconceptions, and societal influences. This could increase the risk of malnutrition and could have short and long term consequences on both the mother and her growing foetus. Therefore, context specific nutritional counseling with emphasis during ante-natal care and post-natal service is important.


Assuntos
Desnutrição , Gestantes , Criança , Recém-Nascido , Gravidez , Feminino , Humanos , Gestantes/psicologia , Tabu , Etiópia , Verduras
14.
Syst Rev ; 12(1): 13, 2023 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-36698215

RESUMO

BACKGROUND: Vitamin B deficiencies are involved with several outcomes in fertility and pregnancy. In Brazil, the national prevalence rates of these micronutrient deficiencies in women of reproductive age were not known. This study aims to systematically identify, select, evaluate, analyze, and report the prevalence rates of vitamin B complex deficiencies in women of reproductive age in Brazil and identify variables that may modify the outcome rates. METHODS: A systematic review will be conducted guided by the following question: "What is the prevalence of vitamin B deficiencies in women of reproductive age in Brazil?". The studies will be identified and selected from a literature search using electronic databases, consultation with researchers/specialists, and reference lists of eligible studies and reviews on the topic. Major eligibility criteria include observational cross-sectional and cohort studies carried out in Brazil and performed in women 10-49 years old, or pregnant and lactating mothers, and investigated the deficiency of vitamin B complex by laboratory test. Two reviewers independently will perform the screening and selection of the studies, data extraction, and risk of bias assessment. For the data report, a narrative approach will be used to present the characteristics of the included studies and individual findings. A random meta-analysis model will be implemented to summarize the individual prevalence rates in a global value if the studies are sufficiently homogeneous. DISCUSSION: This study aims to identify the national and regional prevalence rates of vitamin B complex deficiencies in women of reproductive age; allow the policymakers discuss, plan, and implement public policies to screen; and prevent and/or treat these malnutrition conditions. This also aims to know the rates of nutritional deficiencies over the years, serving as an indirect indicator of the socioeconomic and dietary patterns of the population. Specifically for folate, this study allows to compare the prevalence rates of deficiency of this vitamin before and after the mandatory fortification of wheat and corn flours implemented since 2004 in Brazil, in this specific population. The evidence gathered may highlight the need for population-based studies to investigate the deficiency of these vitamins. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020188474.


Assuntos
Desnutrição , Complexo Vitamínico B , Deficiência de Vitaminas do Complexo B , Gravidez , Humanos , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Lactação , Prevalência , Brasil/epidemiologia , Estudos Transversais , Ácido Fólico , Metanálise como Assunto , Revisões Sistemáticas como Assunto
15.
BMJ Open ; 13(1): e062845, 2023 01 24.
Artigo em Inglês | MEDLINE | ID: mdl-36693689

RESUMO

OBJECTIVE: Undernutrition contributes to decreased physical and cognitive functional status, higher healthcare consumption, premature institutionalisation and increased mortality. So, the objective of this study was to determine the pooled prevalence and factors associated with undernutrition among older adults in Ethiopia. DESIGN: Systematic review and meta-analysis was used. Articles that presented original data on undernutrition using body mass index (BMI) were included. We made an inclusive literature search from PubMed, Medline and Google Scholar. The I2 test was used to examine the heterogeneity of the studies considered in this meta-analysis. Stata software V.14 and METANDI command were used. SETTING: Studies conducted in Ethiopia were included. PARTICIPANTS: Eight independent studies were eligible and enrolled for final analysis. OUTCOME: Prevalence and determinants of undernutrition. A selection of publications, data extraction and reported results for the review was designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: A total of eight unique studies were enrolled for final analysis. The pooled prevalence of undernutrition was 20.53% (95% CI 17.39% to 23.67%). The study revealed that males had lesser odds of being undernutrition with AOR 0.17 (95% CI 0.15 to 0.20). Older adults in the age range of 65-74 years were less likely to be undernourished as compared with those whose age was above 85 years with Adjusted Odds Ratio (AOR) 022 (95% CI 0.22 to 0.25). Older adults who were depressed had higher odds of undernutrition as compared with their counterparts with AOR 1.27 (95% CI 1.19 to 1.37). However, older adults from households with poor wealth indexes were two times more likely to be undernourished as compared with those who were from rich households. CONCLUSION: The burden of undernutrition in Ethiopia is significant. The limitation of the current study was that all included studies were observational, mainly cross-sectional.


Assuntos
Desnutrição , Masculino , Humanos , Idoso , Etiópia/epidemiologia , Estudos Transversais , Desnutrição/epidemiologia , Índice de Massa Corporal , Prevalência
16.
Int J Technol Assess Health Care ; 39(1): e9, 2023 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-36710506

RESUMO

BACKGROUND: This study aimed to provide a structured description of the commonalities and differences in healthcare structures across Africa to establish a reliable basis for the health technology assessment (HTA) of nutrition and nutrition interventions. A ranking of current nutrition conditions in the general population of the participating countries was included to gain a better understanding of the factors influencing hospital malnutrition (HMN), which will inform future multi-country research. METHOD: A questionnaire on the structure of the health systems was distributed among ten African countries. Subsections were included that inquired about the drivers or barriers to using principles of HTA to assess nutritional care. Analysis and ranking of malnutrition data were based on data from the Global Hunger Index report and two poverty indicators used by the World Bank. RESULTS: The health system structure of each country was identified and described, whereas questions about HTA could not always be analyzed due to a lack of adequate in-depth knowledge and skills in most countries. Early experience from some countries demonstrates a conceivable route ahead for African countries in strengthening the capacity for and implementing HTA in accordance with distinct national healthcare contexts and social determinants of health. CONCLUSION: Problems related to nutritional care represent one of the major priorities in the surveyed countries. A future HMN multi-country study will provide valuable insight into the potential of low-cost primary prevention orientations.


Assuntos
Desnutrição , Avaliação da Tecnologia Biomédica , Humanos , Desnutrição/prevenção & controle , África , Atenção à Saúde
17.
Nutr Health ; 29(1): 61-69, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35369816

RESUMO

Background: Malnutrition prevents children from reaching their full physical and mental potential. Health and physical consequences of prolonged states of malnourishment among children are: delay in their physical growth and motor development; lower intellectual quotient (IQ), greater behavioural problems and deficient social skills; susceptibility to contracting diseases. According to the 2015 Millennium development goal (MDG) report, sub-Saharan Africa (SSA) accounts for one third of all undernourished children globally, highlighting that malnutrition still remains a major health concern for children under 5 years in the sub-region, thus buttressing the need for urgent intervention. Aim: The aim of this study is to explore the risk factors of child malnutrition in sub-Saharan Africa through a scoping review. Methods: The scoping review was conducted using the following specific subject databases: EBSCOhost, google scholar, Pub med, demographic research and research gate. Attention was paid to keywords during navigation to ensure consistency of searches in each database. Two limiters were applied in all five databases. These included the use of the English language and articles published on child malnutrition in sub Saharan Africa. Results: The researchers identified eight themes for inclusion in the findings. The themes fell into four major categories being maternal related, family related, child related as well as context related factors. These themes reflect factors associated with child malnutrition. Conclusion: This scoping review revealed that there are quite a number of risk factors that lead to child malnutrition. Therefore, there is an urgency for strategic interventions aimed at improving child nutrition through female education if the 2030 end malnutrition SDG 2.2 are to be achieved.


Assuntos
Transtornos da Nutrição Infantil , Desnutrição , Criança , Humanos , Feminino , Pré-Escolar , Transtornos da Nutrição Infantil/epidemiologia , Desnutrição/epidemiologia , Desnutrição/prevenção & controle , Fatores de Risco , África Subsaariana/epidemiologia , Família
18.
Ginebra; WHO; 2023. 182 p. tab.
Não convencional em Inglês | BIGG - guias GRADE | ID: biblio-1532352

RESUMO

Over 45.4 million infants and children under 5 years of age experience wasting each year. The risk of wasting and nutritional oedema in infants and children, particularly in high-risk contexts where health and socioeconomic indicators are at their poorest, is heightened by ongoing crises including climate change, the COVID-19 pandemic, and conflict. There have therefore been major challenges along the road to achieving global targets for wasting and nutritional oedema including Sustainable Development Goal 2 to reach "Zero Hunger" by 2030. In 2019, the United Nations (UN) Secretary-General released the Global Action Plan for Child Wasting in order to establish a common focus for governments, UN agencies and civil society organizations and guide individual and collective action to accelerate progress towards targets for wasting. One of the key commitments of World Health Organization (WHO) to this action plan was to update the normative guidance on the prevention and management of wasting and/or nutritional oedema, also known as acute malnutrition


Assuntos
Humanos , Pré-Escolar , Suplementos Nutricionais , Nutrição da Criança , Desnutrição Aguda Grave/prevenção & controle
19.
Copenhagen; World Health Organization. Regional Office for Europe; 2023. (WHO/EURO:2023-8931-48703-72392).
em Inglês | WHO IRIS | ID: who-375033

RESUMO

This fact sheet on disease-related malnutrition is intended for national and regional policymakers for health care. It provides a concise overview of the actions recommended by ESPEN in guidelines and position papers to strengthen nutritional care for the prevention and management of disease-related malnutrition in primary care and for hospital outpatients and inpatients. It includes a recommendation that health-care professionals be trained in nutritional care.


Assuntos
Desnutrição , Terapia Nutricional , Política de Saúde , Doenças não Transmissíveis
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