Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.608
Filtrar
1.
Int J Clin Pract ; 2022: 2212624, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35685513

RESUMO

Introduction: Anemia is indeed a significant risk factor for children's health as it affects growth retardation and has severe short and prolonged effects that follow in morbidity and death. Notwithstanding such ways to tackle anemia, the prevalence remains high in India and poses a severe public health concern. Objectives: The primary focus of this study was to find the prevalence and to determine the factors associated with the anemia of children under five years of age in India. Problem Statement. The increasing prevalence of childhood anemia and the life-threatening consequences for millions of children in India are a major concern. Knowing the relevant associated factors with childhood anemia is essential to reduce the frequency and severity level. Study design. For analysis purposes, this study utilized a cross-sectional study design. Methodology. Using the Indian Demographic and Health Survey 2015-16 data, we used chi-squared and gamma tests to find the association. Then, we utilized multinomial logistic regression and ordinal logistic regression to find the better model and the influencing factors of anemia in India. Results: In our study, we have found that children with highly educated mothers were 36.7% less likely (OR = 0.633, P ≤ 0.001, 95% CI: 0.608, 0.658) to be higher anemic than the children with not educated mother. Children with moderate and severe anemic mothers were 163.3% (OR = 2.633, P ≤ 0.001, 95% CI: 2.565, 7.704) more likely to be higher anemic than the children with not anemic mother. Not stunting children were 21.9% (OR = 0.781, P ≤ 0.001, 95% CI: 0 .764, 0.797) less likely to be higher anemic than the stunting children. Children aged 36-59 months were 73.9% (OR = 0.361, P ≤ 0.001, 95% CI: 0.353, 0.369) less likely to be higher anemic than the children aged 6-24 months. Again, the ACI value revealed that ordinal logistic regression was a better-fitted model for these data. Conclusion: and contribution. The variables such as stunting, underweight, wasting, child age, size of the child, and source of drinking water were the most critical indicators for child anemia in India. In summary, our study result indicated the major socioeconomic and demographic factors associated with childhood anemia in India, which can help the policymaker to take quick decision to reduce the severity level.


Assuntos
Anemia , Anemia/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Transtornos do Crescimento/complicações , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Modelos Logísticos , Prevalência , Fatores de Risco , Fatores Socioeconômicos
2.
Clin Perinatol ; 49(2): 475-484, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35659098

RESUMO

The burden of infant malnutrition is greatest in low- and middle-income countries (LMICs). Infant malnutrition is defined based on distinct subcategories, among them stunting (low-height-for-age) and wasting (low-weight-for-height). Some experts are shifting more toward understanding the interplay between these overlapping phenotypes and other confounding factors such as maternal nutrition and environmental hygiene. Current guidelines emphasize appropriate breastfeeding and nutrition within the 1000 days from conception to a child's second birthday to optimize early development. Future research directed toward better biomarkers of malnutrition before acute clinical symptoms develop will help direct targeted efforts toward at-risk populations.


Assuntos
Transtornos da Nutrição do Lactente , Desnutrição , Países em Desenvolvimento , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Transtornos da Nutrição do Lactente/epidemiologia , Desnutrição/diagnóstico , Estado Nutricional
3.
PLoS One ; 17(6): e0269380, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35679288

RESUMO

BACKGROUND: Wasting continued to threaten the lives of 52 million (7.7%) under-five children globally. Sub-Saharan Africa accounts for one-third of all wasted children globally, and Ethiopia is among the countries with the highest magnitude of Wasting in the region. Despite, the little decrement in the prevalence of other forms of malnutrition (stunting and underweight), the burden of wasting remains the same in the country. Gedeo zone is among those with a high prevalence of under-five wasting. OBJECTIVE: To identify determinants of wasting among children aged 6-59 months in Wonago Woreda, 2018. METHODS: A facility-based unmatched case-control study was conducted from May 11 to July 21/2018. A total of 356 (119 cases and 237 controls) mothers/caregivers of under-five children who visited the Wonago woreda public health facilities were included in the study using systematic random sampling. Data were collected using a structured questionnaire and anthropometric measurement. Descriptive analysis was used to describe data. Binary logistic regression was used to identify determinants of wasting among children aged 6-59 months. Variables with p-value < 0.25 in bi-variate analysis entered to multivariate analysis. Those variables with a p-value less than 0.05 during the multivariate regression were considered significant. RESULTS: Determinants which found to have an association with wasting in this study were; maternal illiteracy [AOR = 2.48, 95% CI (1.11, 5.53)] family size <3 [AOR = 0.16, 95% CI (0.05, 0.50)] wealth index [AOR = 2.41, 95% CI (1.07, 5.46)] exclusive breastfeeding in the first 6 months [AOR = 2.71, 95% CI (1.15, 6.40)] dietary diversity [AOR = 5.52, 95% CI (2.06, 14.76)] and children been sick in the last 2 weeks [AOR = 4.36, 95% CI (2.21, 8.61)]. CONCLUSION AND RECOMMENDATIONS: Determinants identified were maternal education, family size, wealth index, and exclusive breastfeeding, dietary diversity, and morbidity history of a child in the last 2 weeks. To reduce childhood wasting, due emphasis should be given to empowering women and improving the knowledge and practice of parents on appropriate infant and young child-caring practices.


Assuntos
Transtornos do Crescimento , Desnutrição , Caquexia , Estudos de Casos e Controles , Criança , Estudos Transversais , Etiópia/epidemiologia , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Desnutrição/epidemiologia
4.
PLoS One ; 17(6): e0269279, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35679306

RESUMO

INTRODUCTION: Over the past three decades, undernutrition has become a major cause of morbidity and mortality among children under five years globally. Low birth weight has been identified as a risk factor for child morbidity and mortality, especially among children under five years in sub-Saharan Africa. There is, however, a paucity of empirical literature establishing the association between low birth weight and undernutrition in sub-Saharan Africa. We examined the association between birth weight and nutritional status of children under five in sub-Saharan Africa. METHODS: Our analyses were performed on a weighted sample of 110,497 children under five years from 32 countries in sub-Saharan Africa. Data were obtained from the Demographic and Health Surveys conducted from 2010 to 2019. We reported the prevalence of low birth weight and nutritional status (stunting, wasting, and underweight) for all the 32 countries using percentages. We used multilevel binary logistic regression to examine the association between birth weight and nutritional status (stunting, wasting, and underweight) of the children, controlling for covariates. The results of the regression analyses were presented using adjusted odds ratios (aOR) with 95% confidence intervals. Statistical significance was set at p<0.05. RESULTS: The prevalence of low birth weight was 5.4%, with the highest (13.1%) and lowest (0.9%) reportedin South Africa and Chad, respectively. The pooled prevalence of wasting, underweight, and stunting were 8.1%, 17.0%, and 31.3%, respectively. Niger had the highest prevalence of wasting (21.5%) and underweight (37.1%), whereas Burundi had the highest prevalence of stunting (51.7%). We found that children with low birth weight were more likely to be stunted [aOR = 1.68, 95% CI = 1.58-1.78], underweight [aOR = 1.82, 95% CI = 1.70-1.94], and wasted [aOR = 1.35, 95% CI = 1.20-1.38] after controlling for covariates. CONCLUSION: Our study has demonstrated that low birth weight is a key determinant of undernutrition among children under five in sub-Saharan Africa. Policymakers need to give special attention to improving the nutritional status of children under-five years in sub-Saharan Africa by implementing measures aimed at enhancing the weight of children. To accelerate progress towards the achievement of the Sustainable Development Goal 3.2 target of ending preventable deaths of newborns and under-five by 2030, it is imperative for countries in sub-Saharan Africa to intensify interventions aimed at improving maternal and child nutrition. Specific nutrition interventions such as dietary modification counselling should prioritized.


Assuntos
Desnutrição , Estado Nutricional , Peso ao Nascer , Caquexia/complicações , Criança , Pré-Escolar , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Recém-Nascido , Desnutrição/complicações , Desnutrição/epidemiologia , Prevalência , África do Sul , Magreza/epidemiologia , Magreza/etiologia
5.
BMC Pediatr ; 22(1): 333, 2022 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-35681131

RESUMO

BACKGROUND: Childhood stunting and anemia are on the increase in many resource-constrained settings, without a counter increase in proper feeding practices such as exclusive breastfeeding. The objective of this study was to explore the prevalence of stunting, anemia and exclusive breastfeeding across African countries. METHODS: Demographic and Health Survey (DHS) data from 39 African countries was analyzed. Data from under 5 children were analyzed. Forest plot was used to determine inequalities in the prevalence of the outcome variables. RESULTS: The prevalence of stunting was highest in Burundi (56%), Madagascar (50%) and Niger (44%). In addition, Burkina Faso (88%), Mali (82%), Cote d'Ivoire and Guinea (75% each) and Niger (73%) had the highest prevalence of anemia. Furthermore, Burundi (83%), Rwanda (81%) and Zambia (70%) had the highest exclusive breastfeeding. We found statistical significant difference in the prevalence of stunting, anemia and exclusive breastfeeding (p < 0.001). Higher prevalence of stunting and anemia were estimated among the male, rural residents, those having mothers with low education and from poor household wealth. CONCLUSION: Concerted efforts are required to improve childhood health, survival and proper feeding practice. Reduced stunting and anemia could be achieved through sustained socioeconomic improvement that is shared in equity and equality among the population. Interventions aimed at increasing food availability can also aid in the reduction of hunger, particularly in impoverished communities.


Assuntos
Anemia , Aleitamento Materno , Anemia/epidemiologia , Burkina Faso , Criança , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Masculino , Prevalência
6.
Artigo em Inglês | MEDLINE | ID: mdl-35682207

RESUMO

Composite child feeding indices (CCFIs) developed from various relevant measures of dietary intake by infants and young children have several potential applications in nutritional epidemiological studies for the development and deployment of precise public health nutrition interventions against child undernutrition. The predictive utility of some CCFIs (computed from varying formulation components) for child nutritional status (stunting, wasting, and underweight) were compared. The purpose of the study was to identify the most suitable among them for possible standardization, validation, and adoption by nutritional health researchers. Using cluster sampling, data from 581 mother-child pairs were collected. Multivariable regression analyses were applied to the data obtained through a community-based analytical cross-sectional survey design. Three of the CCFIs were found to be significantly associated with only wasting (WHZ) from the linear regression models after adjusting for potential confounders and/or correlates. None of the CCFIs (whether in the continuous nor categorical form) was consistently predictive of all three measures of child nutritional status, after controlling for potential confounders and/or correlates, irrespective of the choice of regression method. CCFI 5 was constructed using a dimension reduction technique-namely principal component analysis (PCA)-as the most optimal summary index in terms of predictiveness for child wasting status, validity, and reliability (Cronbach's α = 0.80) that captured relevant dimensions of optimal child food intake. The dimension reduction approach that was used in constructing CCFI 5 is recommended for standardization, validation, and possible adoption for wider applicability across heterogeneous population settings as an optimum CCFI usable for nutritional epidemiological studies among children under five years.


Assuntos
Transtornos da Nutrição Infantil , Desnutrição , Transtornos da Nutrição Infantil/epidemiologia , Pré-Escolar , Estudos Transversais , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Desnutrição/epidemiologia , Estado Nutricional , Prevalência , Reprodutibilidade dos Testes , Magreza/epidemiologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-35682268

RESUMO

Young children in low- and middle-income countries (LMICs) are vulnerable to adverse effects of household microenvironments. The UN Sustainable Development Goals (SDGs)-specifically SDG 3 through 7-urge for a comprehensive multi-sector approach to achieve the 2030 goals. This study addresses gaps in understanding the health effects of household microenvironments in resource-poor settings. It studies associations of household microenvironment variables with episodes of acute respiratory infection (ARI) and diarrhoea as well as with stunting among under-fives using logistic regression. Comprehensive data from a nationally representative, cross-sectional demographic and health survey (DHS) in Uganda were analysed. We constructed and applied the multidimensional energy poverty index (MEPI) and the three-dimensional women empowerment index in multi-variate regressions. The multidimensional energy poverty was associated with higher risk of ARI (OR = 1.32, 95% CI 1.10 to 1.58). Social independence of women was associated with lower risk of ARI (OR= 0.91, 95% CI 0.84 to 0.98), diarrhoea (OR = 0.93, 95% CI 0.88 to 0.99), and stunting (OR = 0.83, 95% CI 0.75 to 0.92). Women's attitude against domestic violence was also significantly associated with episodes of ARI (OR = 0.88, 95% CI 0.82 to 0.93) and diarrhoea (OR = 0.89, 95% CI 0.84 to 0.93) in children. Access to sanitation facilities was associated with lower risk of ARI (OR = 0.55, 95% CI 0.45 to 0.68), diarrhoea (OR = 0.83, 95% CI 0.71 to 0.96), and stunting (OR = 0.64, 95% CI 0.49 to 0.86). Investments targeting synergies in integrated energy and water, sanitation and hygiene, and women empowerment programmes are likely to contribute to the reduction of the burden from early childhood illnesses. Research and development actions in LMICs should address and include multi-sector synergies.


Assuntos
Pobreza , Infecções Respiratórias , Criança , Pré-Escolar , Estudos Transversais , Diarreia/epidemiologia , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Avaliação de Resultados em Cuidados de Saúde , Uganda/epidemiologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-35682329

RESUMO

The adolescence period is considered a life stage worthy of strategic health investments since it is a critical period of physical and neuro-maturational development. Adolescent girls face different health difficulties in that phase of life. Children born to adolescent mothers are at a higher risk of undernutrition. This paper aims to estimate the prevalence of stunting among adolescent mothers and their children in Bangladesh by time period and determine the associated factors of adolescent maternal stunting status. We also sought to establish the relationship between maternal and childhood stunting by comparing the geographical regions in Bangladesh. We derived data from the nationally representative Bangladesh Demographic and Health Survey, which was conducted between 2007 and 2017/18. The outcome variables of this study were ever-married adolescent girls' stunting status and their children's stunting status. Interaction analysis between administrative division and maternal stunting status was conducted with childhood stunting as the outcome variable to investigate the impact of maternal stunting status on their children's stunting compared to geographical location. Our results indicated that in comparison to other divisions, the frequency of stunting among children and adolescent mothers was higher in the Sylhet region. It also revealed that children whose mothers were stunted had a 2.36 times increased chance of being stunted. Our study suggests that education for women could help them attain self-sufficiency and, as a result, reduce the prevalence of poor childhood nutrition, especially stunting.


Assuntos
Desnutrição , Adolescente , Bangladesh/epidemiologia , Criança , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Desnutrição/epidemiologia , Mães , Estado Nutricional
9.
Proc Natl Acad Sci U S A ; 119(24): e2122389119, 2022 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-35666875

RESUMO

SignificanceThis randomized, controlled trial demonstrates that by relieving a constraint on household nutritional assets, here through reducing chicken mortality through vaccination, households make dietary choices for young children that increase consumption of protein- and micronutrient-rich foods and decrease relative consumption of high-carbohydrate, low-protein grains. The study provides causal evidence that this shift in diet results in improved height for age, a key measure of childhood stunting. Given the high prevalence of childhood growth failure in rural Africa, these results highlight the potential to increase the utility of a common household animal asset to reduce the burden of childhood stunting in these communities.


Assuntos
Galinhas , Dieta , Transtornos do Crescimento , Estado Nutricional , Vacinação , Animais , Desenvolvimento Infantil , Pré-Escolar , Tomada de Decisões , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/prevenção & controle , Humanos , Lactente , Quênia/epidemiologia , População Rural , Vacinação/veterinária
10.
PLoS One ; 17(6): e0269527, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35671275

RESUMO

BACKGROUND: Malnutrition is a public health problem, but outside the theoretical framework, little is known about the concrete intergenerational effects of malnutrition. OBJECTIVE: The objective of this study is to compare the nutritional status and health indicators of school children born to mothers who were treated for severe acute malnutrition (SAM). METHODOLOGY: The study took place in Miti-Murhesa health zone in the Democratic Republic of Congo. This is a cohort study assessing the nutritional and health status of school children born to mothers who had been treated for SAM, based on WHZ or edema, in Lwiro hospital between 1988-2002 compared to children born to mothers who were not exposed to SAM. Stunting and thinness were evaluated by Height for Age Z-score (HAZ) and Body Mass Index by Age criteria (BMIAZ) respectively. On admission, blood samples were taken to assess anemia, HIV serology, hemogram and others biological indicators. Stool's examinations were conducted by using Olympus optical microscope. Parametric and non-parametric tests were applied to compare the different variables in two groups. RESULTS: We identified 106 children aged 5-16 years (103 exposed and 58 unexposed) and we received 83.5% and 91.4% children respectively for anthropometric parameters. The mean of age was 7.9 ± 2.4 year in exposed group and 7.4 ± 2.1 year in unexposed group (p = 0.26). The prevalence of stunting was 68.3% in the exposed group and 67.3% in the unexposed group (p = 0.90). The prevalence of thinness was 12.8% in the exposed group and 9.6% in the unexposed group (p = 0.57). The biological profile (glycemia, urea, creatinine and hemogram) and the prevalence of intestinal parasites were similar in the two groups. CONCLUSION: In this sample, in a malnutrition-endemic area, there was no statistically significant difference in nutrition and health indicators between school children born to mothers exposed to SAM and their community controls.


Assuntos
Desnutrição , Desnutrição Aguda Grave , Criança , Estudos de Coortes , República Democrática do Congo/epidemiologia , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Desnutrição/epidemiologia , Mães , Estado Nutricional , Prevalência , Desnutrição Aguda Grave/epidemiologia , Desnutrição Aguda Grave/terapia , Magreza/epidemiologia
11.
PLoS One ; 17(6): e0265788, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35714070

RESUMO

BACKGROUND AND OBJECTIVES: Studies in low-and middle-income countries where nutrition transition is underway provides mixed evidence of double burden of maternal overnutrition and child undernutrition among mother-child pairs. Shifting dietary pattern and rapid increase in overweight/obesity among adults with persistent child undernutrition indicate that India is experiencing nutrition transition and double burden of malnutrition. Hence, the study explores the presence of and the factors associated with mother-child dyads of over- and undernutrition in India. METHODS AND MATERIALS: The study uses National Family Health Survey 2015-16 data. The analytic sample consists of 28,817 weighted mother-child pairs where an overweight/obese mother is paired with an undernourished child. The nutritional status of children is defined according to WHO 2006 child growth standards as underweight (i.e., low weight-for-age), stunting (i.e., low height-for-age) and wasting (i.e., low weight-for-height). Maternal overweight/obesity (i.e., BMI ≥ 25 kg/m2) is defined using adult BMI criterion. Descriptive, bivariate, and adjusted multivariable logistic regression analysis are conducted. RESULTS: Of the overweight/obese mothers, 21.3%, 26.5%, and 14% have underweight, stunted, and wasted children respectively. In adjusted models, maternal short stature (aOR: 2.94, 95% CI: 2.30-3.75), age of child (aOR: 3.29, 95% CI: 2.76-3.92), and poorest wealth status (aOR: 2.01, 95% CI: 1.59-2.54) are significant predictors of overweight/obese mothers and stunted child pairs. Similarly, poor wealth status (aOR: 1.68, 95% CI:1.32-2.14), maternal stature (aOR: 2.70, 95% CI: 2.08-3.52), and child aged 2-5 years (aOR: 1.77, 95% CI:1.51-2.08) are also significantly associated with higher occurrence of overweight/obese mother and-underweight child pairs. CONCLUSION: Findings of the study are consistent with the phase of nutrition transition and double burden of malnutrition. The paper concludes with suggestions to improve the socioeconomic condition, more strategic nutrition specific investments and policy interventions to eliminate all forms of malnutrition for achieving SDGs.


Assuntos
Transtornos da Nutrição Infantil , Desnutrição , Hipernutrição , Adulto , Transtornos da Nutrição Infantil/epidemiologia , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Desnutrição/epidemiologia , Mães , Obesidade/epidemiologia , Hipernutrição/epidemiologia , Sobrepeso/epidemiologia , Prevalência , Fatores Socioeconômicos , Magreza/epidemiologia
14.
Anesth Analg ; 135(1): 152-158, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35709446

RESUMO

BACKGROUND: Malnutrition is common in pediatric surgical patients, but there are little data from low-income countries that estimate the association of malnutrition with surgical outcomes. We aimed to determine the prevalence of malnutrition and its association with length of stay (LOS) among pediatric surgical patients in Kigali, Rwanda. METHODS: We conducted a prospective observational cohort study. We enrolled surgical patients between 1 month and 15 years of age. We measured the association of acute malnutrition (wasting) and chronic malnutrition (stunting) with postoperative LOS using log-gamma regression to account for the skewed LOS distribution. Adjustment was made for sex, age, elective versus emergency surgery, household income, and American Society of Anesthesiologists (ASA) classification. RESULTS: Of 593 children, 124 children (21.2%) had acute malnutrition (wasting) with 39 (6.6%) severely wasted. A total of 160 (26.9%) children had chronic malnutrition (stunting), with 81 (13.7%) severely stunted. Median (interquartile range [IQR]) LOS after surgery was 2 (1-5) days for children with mild/no wasting, 6 (2.5-12.5) days for children with moderate wasting, and 6 (2-15) days with severe wasting. Median (IQR) LOS after surgery was 2 (1-6) days for children with mild/no stunting, 3 (1-3) days for children with moderate stunting, and 5 (2.3-11.8) days with severe stunting malnutrition. After adjustment for confounders, the moderate wasting was associated with increased LOS, with ratio of means (RoM), 1.6; 95% confidence interval [CI], 1.3-2.0; P < .0001. Severe wasting was not associated with increased LOS (RoM, 1.3; 95% CI, 0.9-1.7; P = .12). Severe, but not moderate, stunting was associated with increased LOS (RoM, 1.9; 1.5-2.4; P < .0001). CONCLUSIONS: Malnutrition is prevalent in >20% of children presenting for surgery and associated with increased LOS after surgery, even after accounting for individual and family-level confounders. Although some aspects of malnutrition may relate to the surgical condition, severe malnutrition may represent a modifiable social risk factor that could be targeted to improve postoperative outcomes and resource use. Severely stunted children should be identified as at risk of having delayed recovery after surgery.


Assuntos
Desnutrição , Síndrome de Emaciação , Criança , Estudos de Coortes , Transtornos do Crescimento/complicações , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Tempo de Internação , Desnutrição/complicações , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Prevalência , Estudos Prospectivos , Ruanda/epidemiologia , Síndrome de Emaciação/complicações , Síndrome de Emaciação/epidemiologia
15.
Nutrients ; 14(11)2022 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-35684134

RESUMO

(1) Background: The purpose of this study was to identify the prevalence of obesity and stunting among Brazilian adolescents and its associations with social determinants of health (individual, family, and school), grounded on the necessity of investigating the determinants of nutritional problems within this population. (2) Methods: A population-based survey was administered to 16,556 adolescents assessed by the 2015 National School Health Survey. Multivariate models of obesity and stunting were estimated from Multilevel Poisson Regressions. (3) Results: The prevalence of obesity among Brazilian adolescents (10.0%; 95% CI: 9.4-10.6) was associated directly with indifference or dissatisfaction with body image, with eating breakfast four or fewer days a week, living with up to four people in the household, studying in private schools, and being from the South region, and was inversely associated with being female, 15 years old or older, with having the highest nutritional risk eating pattern, dining at fast-food restaurants, and eating while watching television or studying. The prevalence of stunting (2.3%; 95% CI: 2.0-2.8) was directly associated with the age of 15 years or older, and inversely associated with the lower number of residents living in the household, maternal education-decreasing gradient from literate to college level education, studying in urban schools, and being from the South and Central-West regions. (4) Conclusions: Obesity in adolescence presented behavioral determinants. Stunting and obesity have structural social determinants related, respectively, to worse and better socioeconomic position among Brazilian adolescents.


Assuntos
Estado Nutricional , Determinantes Sociais da Saúde , Adolescente , Brasil/epidemiologia , Estudos Transversais , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Masculino , Análise Multinível , Obesidade/epidemiologia , Prevalência , Fatores Socioeconômicos
16.
J Pediatr Endocrinol Metab ; 35(6): 709-726, 2022 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-35567286

RESUMO

BACKGROUND: Registries are considered valuable data sources for identification of pediatric conditions treated with growth hormone (GH), and their follow-up. Currently, there is no systematic literature review on the scope and characteristics of pediatric GH registries. Therefore, the purpose of this systematic review is to identify worldwide registries reported on pediatric GH treatment and to provide a summary of their main characteristics. CONTENT: Pediatric GH registries were identified through a systematic literature review. The search was performed on all related literature published up to January 30th, 2021. Basic information on pediatric GH registries, their type and scope, purpose, sources of data, target conditions, reported outcomes, and important variables were analyzed and presented. SUMMARY: Twenty two articles, reporting on 20 pediatric GH registries, were included in this review. Industrial funding was the most common funding source. The main target conditions included in the pediatric GH registries were: growth hormone deficiency, Turner syndrome, Prader Willi syndrome, small for gestational age, idiopathic short stature, and chronic renal insufficiency. The main objectives in establishing and running pediatric GH registries were assessing the safety and effectiveness of the treatment, describing the epidemiological aspects of target growth conditions and populations, serving public health surveillance, predicting and measuring treatment outcomes, exploring new and useful aspects of GH treatment, and improving the quality of patient care. OUTLOOK: This systematic review provides a global perspective on pediatric GH registries which can be used as a basis for the design and development of new GH registry systems at both national and international levels.


Assuntos
Nanismo Hipofisário , Hormônio do Crescimento Humano , Criança , Transtornos do Crescimento/tratamento farmacológico , Transtornos do Crescimento/epidemiologia , Hormônio do Crescimento , Hormônio do Crescimento Humano/uso terapêutico , Humanos , Sistema de Registros
17.
Clin Nutr ESPEN ; 49: 208-216, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35623815

RESUMO

BACKGROUND AND AIMS: West Nusa Tenggara Province has the fifth-highest prevalence of stunting cases in Indonesia. So far, limited research is available to understand the likelihood of stunting in this region. Transforming Growth Factor-Beta 1 (TGF-ß1), an immunoregulatory cytokine, may affect the stunting progression. Knowledge of messenger mRNA expression in the TGF-ß1 gene in stunted toddlers could help to determine therapeutic targets to catch up on their growth. OBJECTIVE: This study compared the expression of TGF- ß1 mRNA and TGF-ß1 concentrations in the stunted and the non-stunted toddlers. The nutritional status of all participants was also gathered and linked to the stunting issue. METHODS: A cross-sectional study was conducted on 48 toddlers aged 12-36 months. The stunting case was defined as a Z-Score of less than -2 of length/height for age according to WHO. The serum TGF-ß1 and TGF-ß1 gene mRNA were measured using ELISA and RT-PCR, respectively. The nutritional status data were collected through interviewer-administered structured questionnaire to the toddlers' parents and 48-h food recalls. Descriptive analyses were applied to determine the distribution of participants' macronutrient and micronutrient levels. RESULTS: Results show that there were significant differences in expressions of the TGF- ß1 gene mRNA of the stunted and the non-stunted toddlers. The expression of the TGF- ß1 mRNA gene in the non-stunted toddlers was also higher with 13.7 ± 0.859 fold change than those of the stunted toddlers with 9.01 ± 1.76 fold change with a p-value <0.001. The serum TGF-ß1 concentrations in the stunted toddler (6.20 ± 3.60 pg/ml) were significantly lower than the ones in the non-stunted toddlers (14.3 ± 1.05 pg/ml) with p-value <0.001. However, there was no clear relationship between the likelihood of stunting and the nutritional status from the obtained data. CONCLUSION: Overall findings demonstrate the significantly lower both the TGF-ß1 gene mRNA expression and serum TGF-ß1 for the stunted toddlers than the non-stunted toddlers, impacting bone formation and resorption. The outcomes of this study encourage the development of interventional therapy for stunted toddlers by increasing the serum TGF-ß1 concentrations.


Assuntos
Estado Nutricional , Fator de Crescimento Transformador beta1/genética , Pré-Escolar , Estudos Transversais , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/genética , Humanos , Fatores de Crescimento Transformadores
18.
BMC Pediatr ; 22(1): 316, 2022 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-35637542

RESUMO

BACKGROUND: Undernutrition accounts for nearly half of under-five child mortality in developing countries where household nutrition is largely dependent on agriculture. Despite the strong influence of agroecology on agriculture in those countries, limited information exists on whether undernutrition in children under five varies with agro-ecological location. METHODS: Using Karamoja sub-region of Uganda, one of the most food insecure parts of Eastern Africa as a case area, and applying a multi-stage sampling procedure, and a structured questionnaire, this study examined in a comparative manner, the prevalence and predictors of undernutrition in children under five among the agricultural, pastoral, and agro-pastoral ecological zones. Chi-square test and Kruskal-Wallis test were used to establish the disparity in prevalence of undernutrition and household contextual characteristics, respectively. Binary logistic regression was used to determine the predictors of undernutrition in children under five among the three agro-ecological zones. The level of statistical significance was set at p ≤ 0.05. RESULTS: The prevalence of underweight, stunting, and wasting ranged from 36 to 58% but varied with agroecology in terms of the peak age ranging from 6 to 37 months. Child characteristics, feeding practices, household economic factors, sanitation factors, and caregiver characteristics that predict undernutrition among children under five were identified (p ≤ 0.05). Caregiver handwashing after using latrine (p = 0.005) and diarrhoea in a fortnight (p < 0.001) increased the likelihood of stunting in pastoral agroecology only whereas cereal storage in both sacks and granary in agro-pastoral zone was associated with reduced likelihood of both underweight (p < 0.001 and p = 0.014) and stunting (p = 0.011 and p = 0.018), respectively. A male child was more likely to be underweight and stunted in pastoral (p = 0.002 and p = 0.011) and agro-pastoral (p = 0.017 and p = 0.002) agroecology, respectively. Household expenses reduced the likelihood of both underweight and wasting in pastoral (p = 0.013 and p = 0.005) and agricultural (p = 0.011 and p = 0.021) agroecology, respectively. Flour storage duration increased the stunting likelihood in pastoral (p = 0.032) and agro-pastoral (p = 0.006) agroecologies. CONCLUSION: This study has revealed that, in a food insecure developing country setting such as Karamoja sub-region of Uganda, undernutrition among children under five varies with agroecology. Thus, nutritional interventions in such locations should be agroecology specific.


Assuntos
Desnutrição , Magreza , Agricultura , Criança , Pré-Escolar , Estudos Transversais , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Masculino , Desnutrição/epidemiologia , Prevalência , Magreza/epidemiologia , Uganda/epidemiologia
19.
J Nutr Sci ; 11: e28, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35573460

RESUMO

Adequate nutrition is essential for early childhood to ensure healthy growth, proper organ formation, and function, a strong immune system, neurological and cognitive development. The main aim of the present study was to assess the effect of maternal employment on nutritional status among children aged 6-23 months in the town of Bale Robe, Ethiopia. A community-based comparative cross-sectional study was conducted on about 597 (293 unemployed and 304 employed) having children aged 6-23-month-old children sampled were employed with a multistage sampling technique. A face-to-face interview was conducted using a structured pretested questionnaire. Descriptive statistics, binary and multivariable logistic regression analyses were used for the statistical analysis. The magnitude of stunting (39.9 %), underweight (39⋅9 %) and wasting (22⋅2 %) was greater in 6-23-month-old children born to employed mothers than their counterparts in unemployed ones [stunted (31⋅3 %), underweight (24⋅0 %) and wasted (11⋅8 %)]. Being a girl [AOR 0⋅31; 95 % CI (0⋅17, 0⋅54)] in employed mothers and [AOR 0⋅29; 95 % CI (0⋅16, 0⋅51)] in unemployed people significantly protected stunting. This study demonstrated that the nutritional status of 6-23-month-old children is better among unemployed mothers than among employed mothers. Therefore, concerted efforts may decrease child undernutrition in a study area.


Assuntos
Estado Nutricional , Magreza , Criança , Pré-Escolar , Estudos Transversais , Emprego , Etiópia/epidemiologia , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Magreza/epidemiologia
20.
J Nutr Sci ; 11: e33, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35620765

RESUMO

Undernutrition in children is a challenging problem in developing countries, including Ethiopia. Stunting is the most prevalent form of undernutrition. The majority of studies on childhood stunting and its associated factors focused on children, maternal and socioeconomic components. However, a few studies reported poor WaSH status and antibiotic exposure as environmental risk factors for child stunting, and the case of socio-demographic factors also lacks consistency. Concerning this, there is a lack of information in Ethiopia. Therefore, the present study assessed the association of socio-demographic, WaSH, and antibiotic exposure with stunting among under-five children. A cross-sectional study was conducted involving 340 mother-child pairs. Anthropometric data were collected using standard and calibrated height and weight scales. For factorial data, an interviewer-guided standard questionnaire was used. Logistic regression analyses were used to identify factors determining childhood stunting. In the present study, the prevalence of stunting, underweight and wasting was 14⋅7 % (95 % CI 10⋅9, 18⋅5), 4⋅4 % (95 % CI 2⋅4, 6⋅8) and 2⋅1 % (95 % CI 0⋅6, 3⋅5), respectively. Low dietary diversity, being born from a mother with an education level of secondary school, and belonging to a female-headed household were positively associated (P < 0⋅05) with stunting. The prevalence of overall undernutrition was lower (21⋅2 %) in the study area. Stunting was significantly associated with dietary diversity, maternal educational level and sex of households head. The government policy should focus on enhancing the dietary diversity of households, and encouraging women's education.


Assuntos
Transtornos do Crescimento , Desnutrição , Criança , Estudos Transversais , Etiópia/epidemiologia , Características da Família , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Desnutrição/complicações , Desnutrição/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...