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1.
Zhonghua Er Ke Za Zhi ; 58(3): 194-200, 2020 Mar 02.
Artigo em Chinês | MEDLINE | ID: mdl-32135590

RESUMO

Objective: To survey the children under 7 years of age in nine cities of China for a better understanding of the current situation of childhood stunting. Methods: According to a stratified cluster sampling design, a cross-sectional survey on children under 7 years of age was carried out in 9 cities (Beijing, Harbin and Xi'an in northern China; Shanghai, Nanjing and Wuhan in central China; and Guangzhou, Fuzhou and Kunming in southern China) from June to November in 2016. A total of 110 499 children were recruited. Height of children was evaluated using the growth standards for Chinese children (2009 edition) .Children with height less than the 3rd percentile of the growth standards were considered as stunting, and children with height between the 3rd and 10th percentiles of the growth standards were considered as relatively short stature. Chi-square test was used for comparison between data of boys and girls, urban and suburban, as well as among different ages and regions. Results: Totally 113 084 children under 7 years of age should be investigated and actually 110 499 children were investigated, with a rate of 97.7%. The prevalence of stunting was 1.9% (2 141/110 499) among all the children. The prevalence of stunting in urban children (1.6%, 904/55 524) was lower than that in suburban children (2.3%, 1 237/54 975, χ(2)=56.246, P<0.01). The gender difference in stunting prevalence was not statistically significant (1.9% (1 121/57 921) in boys and 1.9% (1 020/52 578) in girls, χ(2)=0.003, P=0.965). The prevalence of stunting decreased with age for children younger than 3 years, from 1.8% (312/17 080) in 0-<1 year of age group to 1.2% (168/13 740) in 2-<3 years of age group, but increased to 2.2% (240/11 073) at 6-<7 years group. Comparison among different regions showed that the stunting prevalence in southern region was higher than those in the central and northern regions (0.9% (193/20 374) in northern urban, 0.8% (154/18 486) in central urban, and 3.3% (557/16 664) in southern urban children), showing a statistical significance (χ(2)=437.736, P<0.01); 1.1% (241/21 924) in northern suburban, 1.4% (227/16 775) in central suburban and 4.7% (769/16 276) in southern suburban children, showing a statistical significance (χ(2)=646.533, P<0.01). In urban areas, the difference between the central and northern regions showed no statistical significance (χ(2)=1.429, P=0.232) and the stunting prevalence of central Chinese children was slightly higher than that of northern Chinese children in suburban areas (χ(2)=5.130, P=0.024). Among the nine cities, the stunting prevalence of Guangzhou (6.1%, 613/10 019) was higher than those of other cities (χ(2)=1 559.64, P<0.01). Among the stunting children, 78.4% (1 679/2 141) were classified as borderline or mild and only 7.2% (154/2 141) were classified as severe. The prevalence of relatively short stature was 5.2% (5 721/110 499). Conclusions: The prevalence of stunting among children under 7 years of age in nine cities of China is low and most of the stunting children were classified as mild; the prevalence of stunting in suburban children is higher than that in urban children; the gender difference show no statistical significance; and the prevalence of stunting in southern Chinese children is higher than those in central and northern Chinese children.


Assuntos
Estatura , Desenvolvimento Infantil , Transtornos do Crescimento/epidemiologia , Pequim , Estatura/fisiologia , Peso Corporal , Criança , Pré-Escolar , China/epidemiologia , Cidades/estatística & dados numéricos , Estudos Transversais , Feminino , Transtornos do Crescimento/diagnóstico , Humanos , Masculino , Prevalência , Inquéritos e Questionários
2.
PLoS Negl Trop Dis ; 14(1): e0007975, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31929525

RESUMO

BACKGROUND: A major limitation to understanding the etiopathogenesis of environmental enteric dysfunction (EED) is the lack of a comprehensive, reproducible histologic framework for characterizing the small bowel lesions. We hypothesized that the development of such a system will identify unique histology features for EED, and that some features might correlate with clinical severity. METHODS: Duodenal endoscopic biopsies from two cohorts where EED is prevalent (Pakistan, Zambia) and North American children with and without gluten sensitive enteropathy (GSE) were processed for routine hematoxylin & eosin (H&E) staining, and scanned to produce whole slide images (WSIs) which we shared among study pathologists via a secure web browser-based platform. A semi-quantitative scoring index composed of 11 parameters encompassing tissue injury and response patterns commonly observed in routine clinical practice was constructed by three gastrointestinal pathologists, with input from EED experts. The pathologists then read the WSIs using the EED histology index, and inter-observer reliability was assessed. The histology index was further used to identify within- and between-child variations as well as features common across and unique to each cohort, and those that correlated with host phenotype. RESULTS: Eight of the 11 histologic scoring parameters showed useful degrees of variation. The overall concordance across all parameters was 96% weighted agreement, kappa 0.70, and Gwet's AC 0.93. Zambian and Pakistani tissues shared some histologic features with GSE, but most features were distinct, particularly abundance of intraepithelial lymphocytes in the Pakistani cohort, and marked villous destruction and loss of secretory cell lineages in the Zambian cohort. CONCLUSIONS: We propose the first EED histology index for interpreting duodenal biopsies. This index should be useful in future clinical and translational studies of this widespread, poorly understood, and highly consequential disorder, which might be caused by multiple contributing processes, in different regions of the world.


Assuntos
Desenvolvimento Infantil , Meio Ambiente , Transtornos do Crescimento/etiologia , Enteropatias/diagnóstico , Enteropatias/epidemiologia , Biópsia , Criança , Pré-Escolar , Duodeno/patologia , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Enteropatias/complicações , Masculino , América do Norte/epidemiologia , Paquistão/epidemiologia , Zâmbia/epidemiologia
3.
BMC Neurol ; 19(1): 317, 2019 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-31823743

RESUMO

BACKGROUND: Cerebral palsy (CP) is considered as the main cause of severe physical impairment and malnutrition in children. This cross-sectional study intended to survey the nutritional status of children cerebral palsy in Riyadh, Saudi Arabia. METHODS: We examined 74 children (age: 1-10 yrs) with CP, who attended Sultan Bin Abdulaziz Humanitarian City (SBAHC), Riyadh Saudi Arabia. Data on age, general demographics, nutritional status, and dietary intake were collected. A child was considered underweight, wasted, stunted or thin if the standard deviation scores for his/her weight for age, weight for height, height for age and body mass index for age were ≤ -2.0 standard deviation (SD) using WHO growth standards. Multivariable logistic regression identified the factors associated with nutritional indicators. RESULTS: More than half (56.4%) of the children with cerebral palsy were malnourished as they had z-score below <-2 SD in at least one of the four indicators. Thinness (50%) was the most common form of malnutrition, followed by underweight, stunting, and wasting. Arm anthropometrics gave similar results on the percent number of malnourished children. Factors that were independently associated with malnutrition with an adjusted OR (aOR) were as follow: age ≤ 5 yrs. (aOR: 4.29); presence of cognitive impairment (aOR: 4.13); presence of anemia (aOR: 3.41) and inadequate energy intake (aOR: 4.86) (p, for all trends <0.05). CONCLUSION: Children with cerebral palsy of the current study have impaired growth and nutritional status as assessed by all four common nutritional status indicators. Further large-scale community-based studies for in-depth evaluation of nutritional status and growth patterns in children with CP are needed.


Assuntos
Paralisia Cerebral/complicações , Transtornos da Nutrição Infantil/epidemiologia , Transtornos da Nutrição do Lactente/epidemiologia , Estado Nutricional , Índice de Massa Corporal , Peso Corporal , Criança , Pré-Escolar , Estudos Transversais , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Masculino , Arábia Saudita/epidemiologia , Inquéritos e Questionários , Magreza/epidemiologia
4.
Int J Equity Health ; 18(1): 203, 2019 12 27.
Artigo em Inglês | MEDLINE | ID: mdl-31881899

RESUMO

BACKGROUND: Despite a fast-growing economy and the largest anti-malnutrition programme, India has the world's worst level of child malnutrition. Despite India's 50% increase in GDP since 1991, more than one third of the world's malnourished children live in India. Among these, half of the children under age 3 years are underweight and a third of wealthiest children are over-nutrient. One of the major causes for malnutrition in India is economic inequality. Therefore, using the data from the fourth round of National Family Health Survey (2015-16), present study aims to examine the socio-economic inequality in childhood malnutrition across 640 districts of India. METHOD: Concentration curve and generalized concentration index were used to examine the socioeconomic inequalities in malnutrition. However, regression-based decomposition methodology was used to decomposes the causes of inequality in childhood malnutrition. RESULT: Result shows that about 38% children in India were stunted and 35% were underweight during 2015-16. Prevalence of stunting and underweight children varies considerably across Indian districts (13 to 65% and 7 to 67% respectively). Districts having the higher share of undernourished children is coming from the particular regions like central, east and west part of the country. On an average about 35% of household in a district having the access of safe drinking water and 42% of household in a district exposed to open defecation. The study found the inverse relationship between district's economic development with childhood stunting and underweight. The concentration of stunted as well as underweight children were found in least developed districts of India. Decomposition approach found that practice of open defecation is positively influenced the inequality in stunting and underweight. Further, inequality in undernutrition is accelerated by the height and education of the mother, and availability of safe drinking water in a district. CONCLUSIONS: The districts that lied out in a spectrum of developmental diversity are required some specific set of information's that covering socio-economic, demographic and health-related quality of life of people in those backward districts. More generally, policies to avail improved water and sanitation facility to public and female literacy should be continued. It is also important to see that the benefits of both infrastructure and more general economic development are spread more evenly across districts.


Assuntos
Transtornos da Nutrição Infantil/epidemiologia , Disparidades nos Níveis de Saúde , Adolescente , Adulto , Pré-Escolar , Feminino , Transtornos do Crescimento/epidemiologia , Inquéritos Epidemiológicos , Humanos , Índia/epidemiologia , Lactente , Masculino , Pessoa de Meia-Idade , Mães/estatística & dados numéricos , Fatores de Risco , Fatores Socioeconômicos , Magreza/epidemiologia , Adulto Jovem
5.
BMC Public Health ; 19(1): 1503, 2019 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-31711452

RESUMO

BACKGROUND: Optimal breastfeeding and complementary feeding practices are critical to prevent child undernutrition. Despite the occurrence of child undernutrition and widespread suboptimal feeding practices in Malawi, the association of breastfeeding and complementary feeding practices and undernutrition among Malawian children remains unclear. The purpose of the study was to determine the current breastfeeding and complementary feeding practices, to identify maternal determinants of each practice, and to analyze the associations between breastfeeding and complementary feeding practices with stunting, underweight, and wasting. METHODS: The most recent Malawi Demographic Health Survey (2015-2016) was used and data for 2294 children aged 0-23 months were included. A conceptual framework of five maternal domains: sociodemographic, health status, health behaviors, women's empowerment, and media exposure was used. Each domain contained exposure variables and the WHO Infant and Young Child Feeding indicators were used as outcome variables. All analyses were adjusted for clustering, and variables that reached a p-value of < 0.05 were considered significant in the final model. RESULTS: Among children, 30.8% were stunted, 9.9% were underweight, and 3.7% were wasted. Many (78%) were breastfed within the first hour of birth, 89% were breastfed until their first birthday, yet 40% were not exclusively breastfed to 6 months. Only 32% met minimum dietary diversity, 23% met minimum meal frequency, 12% met minimum acceptable diet and 12% consumed iron-rich foods. Children whose mothers lived in urban areas were less likely to be breastfed within 1 hour of birth but more likely to meet minimum dietary diversity. Children whose mothers listened to radio were more likely to meet minimum meal frequency. Children (13-23 months) who met minimum meal frequency and minimum acceptable diet were less likely to be underweight. CONCLUSIONS: Optimal breastfeeding and complementary feeding practices in Malawi remain suboptimal and child undernutrition remains problematic. Maternal characteristics from the five domains were significantly associated with optimal breastfeeding and complementary feeding indicators. Knowledge of these maternal determinants can assist in improving nutrition policies and interventions that aim to impact breastfeeding and complementary feeding practices and child growth in Malawi.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Comportamento Alimentar , Transtornos do Crescimento/prevenção & controle , Fenômenos Fisiológicos da Nutrição do Lactente , Magreza/prevenção & controle , Adulto , Transtornos da Nutrição Infantil/prevenção & controle , Pré-Escolar , Feminino , Transtornos do Crescimento/epidemiologia , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Malaui , Masculino , Refeições , Mães , Política Nutricional , Magreza/epidemiologia
6.
Environ Int ; 133(Pt B): 105243, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31675560

RESUMO

BACKGROUND: Pesticide exposure during pregnancy is thought to adversely affect fetal growth, which in turn may impact child growth, but results have been inconsistent across studies and few have explored these effects in developing countries. OBJECTIVES: To quantify urinary concentrations of pesticide biomarkers in early pregnancy (<16 weeks' gestation), and to estimate the association of these concentrations with preterm birth, low birth weight, small for gestational age, and stunting at ~1 and 2 years of age. METHODS: Eight pesticide biomarkers were quantified in urine collected from 289 pregnant women (aged 18-40 years) participating in a birth cohort study in Bangladesh. Anthropometry measurements were conducted on the index child at birth and approximately 1 and 2 years of age. A directed acyclic graph was used to identify minimal sufficient adjustment sets. Log-binomial regression was used to estimate the relative risk (RR) with 95% confidence intervals (CI). RESULTS: 3,5,6-trichloro-2-pyridinol (TCPY), a metabolite of chlorpyrifos and chlorpyrifos methyl, and 4-nitrophenol, a metabolite of parathion and methyl parathion, were detected in nearly all women with geometric mean (95% CI) values of 3.17 (2.82-3.56) and 18.66 (17.03-20.46) µg/g creatinine, respectively. 3-phenoxybenzoic acid (3-PBA), a non-specific metabolite of several pyrethroids, and 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPY), a diazinon metabolite, were detected in 19.8% and 16.1% of women, respectively. The remaining four pesticide biomarkers were detected in <10% of women. Women in the highest quartile of 4-nitrophenol were more than 3 times more likely to deliver preterm than women in the lowest quartile: unadjusted RR (95% CI), 3.57 (1.65, 7.73). Women in the highest quartile of 4-nitrophenol were also at increased risk of having a child born small for gestational age: RR (95% CI) adjusted for household income, maternal education, and maternal total energy and meat intake, 3.81 (1.10, 13.21). Women with detectable concentrations of IMPY were at increased risk of having a child born with low birth weight compared to women with non-detectable concentrations: adjusted RR (95% CI), 2.13 (1.12, 4.08). We observed no association between any of the pesticide biomarkers and stunting at 1 or 2 years of age. DISCUSSION: Exposure to the insecticides parathion and diazinon during early pregnancy may increase the risk of adverse birth outcomes.


Assuntos
Transtornos do Crescimento/epidemiologia , Exposição Materna/estatística & dados numéricos , Praguicidas/efeitos adversos , Resultado da Gravidez/epidemiologia , Adulto , Bangladesh , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Gravidez , Nascimento Prematuro/epidemiologia , População Rural/estatística & dados numéricos , Adulto Jovem
7.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(10): 1038-1042, 2019 Oct 06.
Artigo em Chinês | MEDLINE | ID: mdl-31607052

RESUMO

Objective: To analyze the urban-rural disparity of childhood stunting and its association with subnational economic growth among Chinese Han students aged 7-18 years. Methods: We used the data from 2014 Chinese National Survey on Students' Constitution and Health. 213 940 Chinese Han students aged 7-18 years with complete height records were included in this study. Stunting was defined according to the Screening Criteria of Malnutrition for School-age Children and Adolescents(2014 version, in Chinese). We divided students into two groups (economically developed and underdeveloped areas) according to the provincial GDP per capita. Spearman correlation coefficient was used to explore the association between the difference of urban-rural stunting prevalence and the provincial GDP per capita. Logistic regression models were established to assess the risk of stunting in rural children compared with urban children. Results: Among 213 940 students, 107 033 (50.0%) were from urban areas. The average height of 7-18 years old and 18 years old [(152.9±15.7) and (166.1±8.7) cm] of urban students were both higher than those of rural students [(150.7±16.0) and (165.1±8.6) cm] (P<0.001). The stunting prevalence of Chinese urban students (0.4%) was statistically significant lower than that of rural students (1.1%) (P<0.001), which was consistent in all age groups (P<0.05). The urban-rural disparity was found in 60% (18/30) of Chinese provinces. The difference of urban-rural stunting prevalence was negatively associated with provincial GDP per capita (r=-0.62, P<0.001). In economically underdeveloped areas, the risk of stunting for rural students aged 7-9 years was 4.69 (95%CI: 2.93-7.52) times that for urban children, while for students aged 10-18 years, the odds ratio was 2.44 (95%CI: 2.02-2.96). In economically developed areas, the risk of stunting for rural students aged 7-9 years was 5.43 (95%CI: 3.67-8.03) times that for urban children, while for students aged 10-18 years, the odds ratio was 2.15 (95%CI: 1.85-2.49). Conclusions: The urban-rural disparity of childhood stunting existed in most places in China. The difference of growth retardation between urban and rural areas was related to regional economic development.


Assuntos
Desenvolvimento Econômico , Transtornos do Crescimento/epidemiologia , Disparidades em Assistência à Saúde , População Rural , Adolescente , Criança , China/epidemiologia , Humanos , Prevalência , Estudantes
8.
Int J Equity Health ; 18(1): 156, 2019 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-31615530

RESUMO

BACKGROUND: With the adoption of the Sustainable Development Goals (SDGs), there is a renewed commitment of tackling the varied challenges of undernutrition, particularly stunting (SDG 2.2). Health equity is also a priority in the SDG agenda and there is an urgent need for disaggregated analyses to identify disadvantaged subgroups. We compared time trends in socioeconomic inequalities obtained through stratification by wealth quintiles and deciles for stunting prevalence. METHODS: We used 37 representative Demographic and Health Surveys and Multiple Indicator Cluster surveys from nine Latin American and Caribbean (LAC) countries conducted between 1996 and 2016. Stunting in children under-5 years was assessed according to the 2006 WHO Child Growth Standards and stratified by wealth quintiles and deciles. Within-country socioeconomic inequalities were measured through concentration index (CIX) and slope index of inequality (SII). We used variance-weighted least squares regression to estimate annual changes. RESULTS: Eight out of nine countries showed a statistical evidence of reduction in stunting prevalence over time. Differences between extreme deciles were larger than between quintiles in most of countries and at every point in time. However, when using summary measures of inequality, there were no differences in the estimates of SII with the use of deciles and quintiles. In absolute terms, there was a reduction in socioeconomic inequalities in Peru, Honduras, Dominican Republic, Belize, Suriname and Colombia. In relative terms, there was an increase in socioeconomic inequalities in Peru, Bolivia, Haiti, Honduras and Guatemala. CONCLUSIONS: LAC countries have made substantial progress in terms of reducing stunting,. Nevertheless, renewed actions are needed to improve equity. Particularly in those countries were absolute and relative inequalities did not change over time such Bolivia and Guatemala. Finer breakdowns in wealth distribution are expected to elucidate more differences between subgroups; however, this approach is relevant to cast light on those subgroups that are still lagging behind within populations and inform equity-oriented health programs and practices.


Assuntos
Transtornos do Crescimento/epidemiologia , Equidade em Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Fatores Socioeconômicos , Criança , Pré-Escolar , Feminino , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , América Latina/epidemiologia , Prevalência , América do Sul
9.
Artigo em Inglês | MEDLINE | ID: mdl-31600942

RESUMO

Stunting is a global burden affecting nearly 160 million children younger than five years of age. Whilst the linkages between nutrition and stunting are well recognized, there is a need to explore environmental factors such as water and sanitation, which may influence feeding practices and result in potential infection pathways. This paper explores the linkages between stunting and water, sanitation and hygiene (WASH) factors in Ethiopia, which is a relatively understudied context. The research draws upon baseline data for children under the age of five from 3200 households across four regions in Ethiopia as part of a wider study and integrated program led by the United Nations Children's Fund (UNICEF). Using World Health Organization (WHO) z-scoring, the average stunting rate in the sample is 47.5%. This paper also takes into account demographic and social behavioural factors such as the age, gender of children, and gender of the primary caregiver, in addition to handwashing behaviour and drinking water facilities. The evidence recommends efforts to improve handwashing behaviour for mothers and children with a focus on access to clean water. Higher stunting rates with an increase in the age of children highlight the need for continued interventions, as efforts to improve nutrition and WASH behaviours are most effective early on in promoting long-term health outcomes for children.


Assuntos
Transtornos do Crescimento/epidemiologia , Desinfecção das Mãos , Higiene , Saneamento , Abastecimento de Água , Criança , Pré-Escolar , Etiópia/epidemiologia , Características da Família , Comportamento Alimentar , Feminino , Humanos , Masculino , Mães , Estado Nutricional , População Rural , Água
10.
Pediatrics ; 144(4)2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31501233

RESUMO

BACKGROUND AND OBJECTIVES: Food insecurity and pediatric obesity affect young children. We examine how food insecurity relates to obesity, underweight, stunting, health, and development among children <4 years of age. METHODS: Caregivers of young children participated in a cross-sectional survey at medical centers in 5 US cities. Inclusion criteria were age of <48 months. Exclusion criteria were severely ill or injured and private health insurance. The Household Food Security Survey Module defined 3 exposure groups: food secure, household food insecure and child food secure, and household food insecure and child food insecure. Dependent measures were obesity (weight-age >90th percentile), underweight (weight-age <5th percentile), stunting (height/length-age <5th percentile), and caregiver-reported child health and developmental risk. Multivariable logistic regression analyses, adjusted for demographic confounders, maternal BMI, and food assistance program participation examined relations between exposure groups and dependent variables, with age-stratification: 0 to 12, 13 to 24, 25 to 36, and 37 to 48 months of age. RESULTS: Within this multiethnic sample (N = 28 184 children, 50% non-Hispanic African American, 34% Hispanic, 14% non-Hispanic white), 27% were household food insecure. With 1 exception at 25 to 36 months, neither household nor child food insecurity were associated with obesity, underweight, or stunting, but both were associated with increased odds of fair or poor health and developmental risk at multiple ages. CONCLUSIONS: Among children <4 years of age, food insecurity is associated with fair or poor health and developmental risk, not with anthropometry. Findings support American Academy of Pediatrics recommendations for food insecurity screening and referrals to help families cope with economic hardships and associated stressors.


Assuntos
Desenvolvimento Infantil , Abastecimento de Alimentos/estatística & dados numéricos , Transtornos do Crescimento/epidemiologia , Nível de Saúde , Obesidade Pediátrica/epidemiologia , Magreza/epidemiologia , Afro-Americanos/estatística & dados numéricos , Fatores Etários , Arkansas/epidemiologia , Baltimore/epidemiologia , Boston/epidemiologia , Cuidadores/estatística & dados numéricos , Pré-Escolar , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Minnesota/epidemiologia , Inquéritos Nutricionais , Philadelphia/epidemiologia , Pobreza , Análise de Regressão
11.
Public Health ; 177: 95-101, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31561051

RESUMO

OBJECTIVE: Despite several international commitments and national policies to eliminate the practice of girl child marriage, it remains pervasive in India. In this study, we aimed to examine the association between child marriage and nutritional status and anaemia in children aged below 5 years. STUDY DESIGN AND METHODS: We have used the data from the latest round of the Indian National Family Health Survey (NFHS), conducted in 2015-2016. For this study, the sample was limited to 80,539 living children aged below 5 years born to 60,003 ever-married women aged 15-24 years. We have considered children's stunting, wasting, underweight and anaemia as outcomes variables and child marriage (married below 18 years) as the exposure of variables of interest. Pearson's Chi-squared test and binary logistic regressions were applied to assess the associations. RESULTS: About 58% of sample women were married before 18 years of age. The prevalence of children's stunting, wasting and underweight were 37%, 23% and 36%, respectively. More than half of the sample children (62%) were anaemic. Regression analysis revealed that child marriage (<18 years) was significantly associated with increased likelihood of stunting (adjusted odds ratio [AOR] = 1.06, 95% confidence interval [CI] = 1.02-1.10) and underweight (AOR = 1.04, 95% CI = 1.00-1.08) even after controlling for relevant confounding variables. Child marriage had no significant association with children being wasted and anaemic in crude analyses. However, it is found that child marriage significantly increases the risk of childhood anaemia in adjusted analyses (AOR = 1.08, 95% CI = 1.03-1.13). CONCLUSIONS: The findings of our study suggest that there is a need for effective policies and programmes to end the practice of child marriage and targeted intervention should be made to improve nutritional outcomes of children born to women married in childhood.


Assuntos
Anemia/epidemiologia , Casamento/estatística & dados numéricos , Estado Nutricional , Adolescente , Pré-Escolar , Pesquisa Empírica , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Medição de Risco , Magreza/epidemiologia , Síndrome de Emaciação/epidemiologia , Adulto Jovem
12.
JNMA J Nepal Med Assoc ; 57(216): 98-103, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31477941

RESUMO

INTRODUCTION: Adequate nutrition is essential for proper growth and development of the child. We conducted a cross-sectional descriptive study to find the prevalence of nutritional status of 6-59 month old Tharu children in Duruwa VDC of Dang District. This study also deliberates the socio-economic and demographic character, maternal and child character and child feeding status of the Tharu community children. METHODS: This study is a descriptive cross sectional study and was done between February and March, 2017 in Tharu community of Duruwa, Dang. Total 189 children of age group 6 - 59 months were selected by using systematic random sampling technique; anthropometric measurements were performed to find the nutritional status of children. Pre-coded questionnaire was used to collect information from caretaker. WHO Anthro version 3.2.2 and SPSS version 20 were used to analyze data. RESULTS: Prevalence of wasting, stunting, and underweight were 25 (13.2%), 51 (27%), and 40 (21.2%) respectively. The prevalence of stunting was seen more in females than in males while underweight was higher among males, whereas wasting was very similar in both sexes. CONCLUSIONS: The findings showed that there is still high prevalence of malnutrition in Tharu children of Duruwa so monitoring of nutrition status in Tharu children should be taken seriously and needs to be addressed.


Assuntos
Transtornos da Nutrição Infantil/epidemiologia , Transtornos do Crescimento/epidemiologia , Estado Nutricional , Magreza/epidemiologia , Antropometria , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Nepal , Prevalência , Fatores Socioeconômicos , Inquéritos e Questionários , Síndrome de Emaciação/epidemiologia
13.
Nutrients ; 11(9)2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31500109

RESUMO

BACKGROUND: Lack of evidence on the burden and risk factors for malnutrition among children with cerebral palsy (CP) in Vietnam limits evidence-based interventions. We aimed to define the nutritional status of children with CP in Vietnam. MATERIALS AND METHODS: The study utilized data from active prospective hospital-based surveillance modelled on the Pediatric Active Enhanced Disease Surveillance system. Children (0-18 years) with CP attending the National Children's Hospital Hanoi, Vietnam between June-November 2017 were included. Data on demographic, clinical and rehabilitation status were collected following detailed neurodevelopmental assessment. Anthropometric measurements were taken. Nutritional status was determined using the World Health Organization guideline. RESULTS: Of 765 children (the mean (SD) age was 2.6 (2.5) years; 35.8% were female), 28.9% (n = 213) were underweight and 29.0% (n = 214) stunted. The odds of underweight were significantly higher among children aged >5 years and/or having a monthly family income of <50 USD. Underweight and/or stunting was high among children with quadriplegia (81%, n = 60 and 84.5%, n = 87) and/or Gross Motor Functional Classification System (GMFCS) level IV-V (62.5%, n = 45 and 67.0%, n = 67). Nearly one-third of intellectually impaired and more than half of hearing-impaired children were underweight and/or stunted. CONCLUSIONS: Poor economic status and increased motor severity increased vulnerability to malnutrition. Our findings will inform nutritional rehabilitation programs among these vulnerable children.


Assuntos
Paralisia Cerebral/epidemiologia , Transtornos da Nutrição Infantil/epidemiologia , Fenômenos Fisiológicos da Nutrição Infantil , Crianças com Deficiência , Transtornos da Nutrição do Lactente/epidemiologia , Desnutrição/epidemiologia , Estado Nutricional , Adolescente , Desenvolvimento do Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Fatores Etários , Paralisia Cerebral/fisiopatologia , Paralisia Cerebral/psicologia , Paralisia Cerebral/reabilitação , Criança , Desenvolvimento Infantil , Transtornos da Nutrição Infantil/fisiopatologia , Transtornos da Nutrição Infantil/reabilitação , Pré-Escolar , Feminino , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/fisiopatologia , Humanos , Lactente , Transtornos da Nutrição do Lactente/fisiopatologia , Transtornos da Nutrição do Lactente/reabilitação , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Masculino , Desnutrição/fisiopatologia , Desnutrição/reabilitação , Atividade Motora , Inquéritos Nutricionais , Estudos Prospectivos , Magreza/epidemiologia , Magreza/fisiopatologia , Vietnã/epidemiologia
14.
Artigo em Inglês | MEDLINE | ID: mdl-31509998

RESUMO

The objective of this study was to determine the prevalence and socio-demographic predictors of malnutrition in two urbanized economically active provinces (Gauteng N = 733, Western Cape N = 593) in South Africa. A multistage stratified cluster random sampling design was applied. Fieldworkers visited homes, measured children aged 1-<10-years old (N = 1326) and administered a questionnaire (mother/primary caregiver). In under-five year old children (N = 674) 21.6% were stunted [height-for-age z-score < -2 SD], 5.6 % underweight [weight-for-age z-score < -2 SD], 10.3% overweight (body mass index-for-age z-score) (BAZ)> +2 SD ≤ +3 SD] and 7.0% obese (BAZ > +3 SD). In 5-<10-year olds (N = 626) 6.7% were stunted, 6.8% underweight, 13.4% overweight and 6.8% obese. Stunting and overweight in the same child was present in 5.7% under-five year olds and 1.7% in 5-<10-year olds. Multiple logistic regression analyses identified having a mother with a post-grade 12 qualification (OR = 0.34) and having an obese mother (OR 0.46) as protectors and being in the under-five age group (OR = 3.73) as a risk factor for stunting. Being in the under-five age group was also a risk factor for a BAZ > 1 (OR 2.39), while being in the third wealth quintile was protective (OR = 0.62). Results indicate that stunting and overweight/obesity are still present at concerning levels, especially in the under-five age group.


Assuntos
Transtornos do Crescimento/epidemiologia , Desnutrição/epidemiologia , Sobrepeso/epidemiologia , Magreza/epidemiologia , Criança , Pré-Escolar , Inquéritos sobre Dietas , Feminino , Humanos , Lactente , Masculino , Mães , Prevalência , Fatores de Risco , África do Sul/epidemiologia , Inquéritos e Questionários , Urbanização
15.
Nutrients ; 11(8)2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31394737

RESUMO

Short maternal stature is identified as a strong predictor of offspring undernutrition in low and middle-income countries. However, there is limited information to confirm an intergenerational link between maternal and under-five undernutrition in Bangladesh. Therefore, this study aimed to assess the association between short maternal stature and offspring stunting and wasting in Bangladesh. For analysis, this study pooled the data from four rounds of Bangladesh Demographic and Health Surveys (BDHS) 2004, 2007, 2011, and 2014 that included about 28,123 singleton children aged 0-59 months born to mothers aged 15-49 years. Data on sociodemographic factors, birth history, and anthropometry were analyzed using STATA 14.2 to perform a multivariable model using 'Modified Poisson Regression' with step-wise backward elimination procedures. In an adjusted model, every 1 cm increase in maternal height significantly reduced the risk of stunting (relative risks (RR) = 0.960; 95% confidence interval (CI): 0.957, 0.962) and wasting (RR = 0.986; 95% CI: 0.980, 0.992). The children of the short statured mothers (<145 cm) had about two times greater risk of stunting and three times the risk of severe stunting, 1.28 times the risk of wasting, and 1.43 times the risk of severe wasting (RR = 1.43; 95% CI: 1.11, 1.83) than the tall mothers (≥155 cm). These findings confirmed a robust intergenerational linkage between short maternal stature and offspring stunting and wasting in Bangladesh.


Assuntos
Estatura , Transtornos do Crescimento/epidemiologia , Mães , Síndrome de Emaciação/epidemiologia , Adolescente , Adulto , Bangladesh/epidemiologia , Estatura/genética , Estatura/fisiologia , Pré-Escolar , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Masculino , Desnutrição/epidemiologia , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
16.
Pan Afr Med J ; 33: 34, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384349

RESUMO

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


Assuntos
Anemia/epidemiologia , Transtornos da Nutrição Infantil/epidemiologia , Enteropatias Parasitárias/epidemiologia , Estado Nutricional , Adolescente , Anemia/parasitologia , Criança , Transtornos da Nutrição Infantil/parasitologia , Pré-Escolar , Estudos Transversais , Fezes/parasitologia , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/parasitologia , Humanos , Enteropatias Parasitárias/complicações , Enteropatias Parasitárias/parasitologia , Nigéria/epidemiologia , Prevalência , Magreza/epidemiologia , Magreza/parasitologia , Síndrome de Emaciação/epidemiologia , Síndrome de Emaciação/parasitologia
17.
BMC Res Notes ; 12(1): 504, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412922

RESUMO

OBJECTIVE: The objective of the study was to assess the prevalence of stunting and associated factors among under-five children of Wukro town, Tigray, Ethiopia, 2017-2018. RESULT: Totally 394 under-five children were participated in this study with a response rate of 98.5%. A total of 222 (56.3%) of respondents were females and 106 (26.95%) were in the age group of 12-23 month. One hundred ninety-eight (50.3%) of the participants were between 2 and 3 in birth order and 194 (49.2%) had 4 to 5 house hold size. The overall prevalence of stunting was 194 (49.2%). Being female and presence of washing facilities nearby latrine were significantly associated with stunting. Under-five female children were 35.4% lower odds of stunting compared to male children (p = .041, OR = .644, and 95% CI (.422, .983)).


Assuntos
Aparelho Sanitário/estatística & dados numéricos , Transtornos do Crescimento/epidemiologia , Higiene das Mãos/estatística & dados numéricos , Desnutrição/epidemiologia , Fatores Socioeconômicos , Aparelho Sanitário/normas , Criança , Estudos Transversais , Etiópia/epidemiologia , Feminino , Higiene das Mãos/normas , Humanos , Lactente , Masculino , Prevalência , Fatores de Risco , Fatores Sexuais , Inquéritos e Questionários
18.
Artigo em Inglês | MEDLINE | ID: mdl-31438531

RESUMO

BACKGROUND: Overweight and obesity are increasing at an alarming rate in South Africa, while childhood undernutrition remains persistently high. This study determined the magnitude and predictors of stunting and underweight among schoolchildren in the Dikgale and Health Demographic Surveillance System Site, a rural site in South Africa. METHODS: A cross sectional study using multistage sampling was conducted among 508 schoolchildren and their mothers. Anthropometric measurements were taken from children and their mothers, while sociodemographic information was obtained from mothers using a questionnaire. The World Health Organization Anthro Plus was used to generate height-for-age and weight-for-age z-scores to indicate stunting and underweight, respectively, among the children. Maternal overweight and obesity were assessed using body mass index. Bivariate and multivariate logistic regression analyses were used to evaluate the predictors of stunting and underweight among schoolchildren. RESULTS: Twenty-two percent (22%) of children were stunted and 27% were underweight, while 27.4% of the mothers were overweight and 42.3% were obese. The odds of being stunted were lower in younger children, whereas having a mother who was overweight/obese and had a short stature increased the odds of stunting. Access to water, having a refrigerator, and having a young mother were protective against being underweight. Having a mother who was overweight/obese increased the odds of being underweight. CONCLUSIONS: The study showed a high prevalence of stunting and underweight among children, and overweight and obesity among mothers, indicating a household double burden of malnutrition. The age of the child and maternal overweight/obesity and short stature were predictors of stunting and underweight, while having a younger mother and access to water and a refrigerator were protective against being underweight. The need for an evidence-based and feasible nutrition program for schoolchildren, especially those in rural schools, cannot be over-emphasized.


Assuntos
Transtornos do Crescimento/epidemiologia , Desnutrição/epidemiologia , Adolescente , Adulto , Índice de Massa Corporal , Peso Corporal , Criança , Estudos Transversais , Características da Família , Feminino , Humanos , Masculino , Mães , Estado Nutricional , Prevalência , Fatores de Risco , Saúde da População Rural , População Rural/estatística & dados numéricos , Instituições Acadêmicas , África do Sul/epidemiologia , Inquéritos e Questionários
19.
BMC Res Notes ; 12(1): 391, 2019 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-31296269

RESUMO

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


Assuntos
Transtornos da Nutrição Infantil/diagnóstico , Transtornos do Crescimento/diagnóstico , Estado Nutricional , Magreza/diagnóstico , Transtornos da Nutrição Infantil/epidemiologia , Pré-Escolar , Etiópia/epidemiologia , Feminino , Transtornos do Crescimento/epidemiologia , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Masculino , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Magreza/epidemiologia
20.
Nutrients ; 11(7)2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31284369

RESUMO

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


Assuntos
Transtornos da Nutrição Infantil/epidemiologia , Fenômenos Fisiológicos da Nutrição Infantil , Transtornos do Crescimento/epidemiologia , Desnutrição/epidemiologia , Estado Nutricional , Fatores Etários , Camboja/epidemiologia , Desenvolvimento Infantil , Transtornos da Nutrição Infantil/diagnóstico , Transtornos da Nutrição Infantil/fisiopatologia , Pré-Escolar , Feminino , Transtornos do Crescimento/diagnóstico , Transtornos do Crescimento/fisiopatologia , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Estudos Longitudinais , Masculino , Desnutrição/diagnóstico , Desnutrição/fisiopatologia , Prevalência , Medição de Risco , Fatores de Risco , Fatores de Tempo
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