Trends in obesity among 4-year-old children in New Zealand-pre- and post-COVID comparison.

AIMS: We described long-term trends in obesity using preschool data from New Zealand and compared rates pre- and post-COVID by key demographic variables. METHODS: Growth data from the B4 School Check (B4SC) information system for the period 1 July 2012 to 30 June 2022 were used to calculate obesity rates. The date 25 March 2020 was the threshold used to compare the rates between pre- and post-COVID periods. Obesity rate ratios for these two periods were calculated for each demographic sub-group. RESULTS: The overall obesity rate increased by 1.8% after COVID-19. Males had higher obesity rates and a greater absolute increase (2%) in the post-COVID period. The greatest absolute increase in obesity was among Pacific peoples (4.3%), followed by Maori (2.2%). Children in most deprived areas and those in the Auckland Region had greater absolute increases of 3% and 2.5% respectively, post-COVID. CONCLUSION: The COVID-19 lockdown has had an immediate impact on obesity rates among 4-year-old children, especially for the Pacific population, those living in high deprivation areas and regions with longer periods of lockdown (Auckland). There are implications for public health policy and practice to support children in adopting a healthy lifestyle, especially during pandemics.

COVID-19 impact on overweight and obesity rates in Aotearoa | New Zealand 4-year-old children.

BACKGROUND: COVID-19 has had profound societal impacts. This study estimated overweight, obesity, and extreme obesity rates in 4-year-old children over pre- and post-COVID-19 periods, and investigated differential changes between sex, ethnic and deprivation groups. METHODS: A national screening programme of 4-year-old children undertaking B4 School Checks (B4SCs) between 1 January 2010 and 7 March 2023 was analysed. B4SCs include anthropometric measurements enabling sex-specific body mass index-for-age Z-scores (BMI z-scores) to be derived. Children with ≥85th, ≥95th, and ≥99.7th percentile BMI z-scores were classified as overweight, obese, and extremely obese. RESULTS: The eligible sample included 656,038 children (48.8% girls). Overall, 210,492 (32.1%) children were overweight, 95,196 (14.5%) obese, and 19,926 (3.0%) extremely obese. While decreasing in the pre-COVID-19 period, annual prevalence estimates for overweight, obese, and extremely obese significantly (all p < 0.001) increased in the year after COVID-restrictions were implemented. However, after three years, overweight and obese prevalence estimates were no different to pre-COVID levels overall or stratified by sex for ethnicity and deprivation groups. Extreme obesity prevalence estimates also decreased but remained higher than pre-COVID levels. CONCLUSION: The sharp and steep increases in prevalence estimates all dampened relatively quickly. The question remains whether these rates will continue to decrease in time. IMPACT: Compared to pre-COVID-19 estimates, the prevalence of overweight, obesity and extreme obesity significantly and substantially increased for 4-year-old children in the immediate post-COVID-19 period. These post-COVID-19 prevalence estimates dampened relatively quickly, returning to pre-COVID-19 rates for overweight and obesity after 3 years. Inequities between ethnic and social deprivation groups in overweight and obesity prevalence estimates remained similar between pre- and post-COVID-19 periods.

The pattern of association between early childhood caries and body mass index in pre-school children within Aotearoa | New Zealand: a national cross-sectional study.

OBJECTIVES: The relationship between childhood anthropometric measurements and dental caries has an inconsistent evidence-base. This study investigated dental caries experience and body mass index (BMI) measurements of children aged 4 years in a national cohort, after accounting for key confounding variables. METHODS: A near whole-population cross-sectional study of children who had a health and developmental assessment, as part of the nationwide B4 School Check screening program, conducted in Aotearoa | New Zealand (ANZ) between 1 July 2010 and 30 June 2021 was studied. The extracted database included 582 820 children, of whom 572 523 (98.2%) had valid BMI and oral health records. Dental caries experience was derived from the 'lift the lip' oral health screening, and measured height and weight were used to calculate sex-specific BMI-for-age z-scores (BMIz). Analyses were adjusted for age, sex, ethnicity and area-level deprivation. Modified Poisson regression models using 2-degree fractional polynomial curves for BMIz were employed. RESULTS: In the extracted sample, the median age was 4.3 years (interquartile range: 4.1-4.5 years), 283 565 (48.7%) were female, 135 734 (23.4%) and 74 237 (12.8%) were identified as Maori and Pacific, respectively, and 140 931 (24.4%) lived in the most deprived areas of ANZ. Overall, 81 926 (14.2%) had dental caries identified. In unadjusted analyses, a significant J-shaped association was observed between dental caries experience and BMIz. However, in the adjusted analysis, a significant flattened S-shaped association was found; those with lower BMIz had lower predicted probabilities of dental caries experience. Large differences in predicted probabilities were observed between different sex, ethnicity and area-level deprivation groups. CONCLUSIONS: This study found significant non-linear associations between dental caries experience and BMI in 4-year-old children. However, the inclusion of confounders importantly changed the shape of this non-linear association. Sex, ethnicity and area-level deprivation inequalities had a greater impact on dental caries experience than BMI.

Impact of a targeted typhoid vaccination campaign following cyclone Tomas, Republic of Fiji, 2010.

After a category 4 cyclone that caused extensive population displacement and damage to water and sanitation infrastructure in Fiji in March 2010, a typhoid vaccination campaign was conducted as part of the post-disaster response. During June-December 2010, 64,015 doses of typhoid Vi polysaccharide vaccine were administered to persons ≥ 2 years of age, primarily in cyclone-affected areas that were typhoid endemic. Annual typhoid fever incidence decreased during the post-campaign year (2011) relative to preceding years (2008-2009) in three subdivisions where a large proportion of the population was vaccinated (incidence rate ratios and 95% confidence intervals: 0.23, 0.13-0.41; 0.24, 0.14-0.41; 0.58, 0.40-0.86), and increased or remained unchanged in 12 subdivisions where little to no vaccination occurred. Vaccination played a role in reducing typhoid fever incidence in high-incidence areas after a disaster and should be considered in endemic settings, along with comprehensive control measures, as recommended by the World Health Organization.

Congenital rubella syndrome in fiji, 1995-2010.

Setting. A nationwide study in Fiji. Objective. To describe the incidence of congenital rubella syndrome (CRS) and its relationship to the incidence of notified cases of rubella in Fiji from 1995 to 2010. Design. Descriptive, retrospective review of all recorded congenital abnormalities associated with live births in Fiji over 16 years. Results. There were 294 infants who met the criteria for CRS. Of these, 95% were classified as "suspected" cases, 5% were "clinically confirmed," and none were "laboratory confirmed cases". There was a significant linear increase over the study period in the incidence of CRS (odds ratio 1.045 per year, 95% CI 1.019 to 1.071, P ≤ 0.001). There was no significant association between the incidence of CRS and the reported incidence of rubella (P = 0.3). Conclusion. There is a rising trend in reports of suspected CRS cases in Fiji. This highlights the need to strengthen surveillance for CRS through improvements in clinical and laboratory diagnosis to confirm or exclude suspected cases. It is also important to ensure high coverage of rubella vaccination in Fiji.