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1.
BMJ Open ; 12(11): e060692, 2022 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-36356996

RESUMEN

BACKGROUND AND OBJECTIVES: Over centuries, Ethiopia has experienced severe famines and periods of serious drought, and malnutrition remains a major public health problem. The aims of this study were to estimate seasonal variations in child stunting and wasting, and identify factors associated with both forms of child malnutrition in drought-prone areas. METHODS: This cohort study was conducted among a random sample of 909 children in rural southern Ethiopia. The same children were followed for 1 year (2017-2018) with quarterly repeated measurements of their outcomes: height-for-age and weight-for-height indices (Z-scores). Linear regression models were used to analyse the association between both outcomes and baseline factors (eg, household participation in a social safety net programme and water access) and some time-varying factors (eg, household food insecurity). RESULTS: Child wasting rates varied with seasonal household food insecurity (ᵪ2 trend = 15.9, p=0.001), but stunting rates did not. Household participation in a social safety net programme was associated with decreased stunting (p=0.001) and wasting (p=0.002). In addition to its association with decreased wasting (p=0.001), protected drinking water access enhanced the association between household participation in a social safety net programme and decreased stunting (p=0.009). Absence of a household latrine (p=0.011), lower maternal education level (p=0.001), larger family size (p=0.004) and lack of non-farming income (p=0.002) were associated with increased child stunting. CONCLUSIONS: Seasonal household food insecurity was associated with child undernutrition in rural Ethiopia. Strengthening community-based food security programmes, such as the Ethiopian social safety net programme, could help to reduce child undernutrition in drought-prone areas. Improving clean water access and sanitation could also decrease child undernutrition.Key terms: Z-scores; Social safety net program; Water access.


Asunto(s)
Trastornos de la Nutrición del Niño , Desnutrición , Niño , Humanos , Lactante , Etiopía/epidemiología , Abastecimiento de Alimentos , Estudios de Cohortes , Sequías , Trastornos del Crecimiento/epidemiología , Trastornos del Crecimiento/etiología , Caquexia , Prevalencia
2.
Front Public Health ; 10: 1019300, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36438240

RESUMEN

Background: Among the social inequalities that continue to still surpasses the basic rights of several citizens, political and environmental organizations decisively "drag" the "ghost" of hunger between different countries of the world, including Brazil. The COVID-19 pandemic has increased the difficulties encountered in fighting poverty, which has led Brazil to a worrying situation regarding its fragility in the fight against new pandemics. Objectives: The present study aims to estimate, compare, and report the prevalence of mortality due to child malnutrition among the macro-regions of Brazil and verify possible associations with the outcome of death by COVID-19. This would identify the most fragile macro-regions in the country with the greatest need for care and investments. Methods: The prevalence of mortality was determined using data from the federal government database (DataSus). Child malnutrition was evaluated for the period from 1996 to 2017 and COVID-19 was evaluated from February to December 2020. The (dis)similarity between deaths from malnutrition and COVID-19 was evaluated by proximity matrix. Results: The North and Northeast regions have above average number of deaths than expected for Brazil (p < 0.05). A prospective analysis reveals that the distribution of the North and Northeast macro-regions exceeds the upper limit of the CI in Brazil for up to the year 2024 (p < 0.05). The proximity matrix demonstrated the close relationship between deaths from COVID-19 and malnutrition for the Northern region followed by the Northeast region. Conclusions: There are discrepancies in frequencies between macro-regions. Prospective data indicate serious problems for the North and Northeast regions for the coming years. Therefore, strategies to contain the outcome of health hazards must be intensified in the macro-regions North and Northeast of the country.


Asunto(s)
COVID-19 , Trastornos de la Nutrición del Niño , Desnutrición , Niño , Humanos , Brasil/epidemiología , Pandemias , Trastornos de la Nutrición del Niño/epidemiología , COVID-19/epidemiología , Desnutrición/epidemiología
3.
BMC Public Health ; 22(1): 2013, 2022 11 03.
Artículo en Inglés | MEDLINE | ID: mdl-36324089

RESUMEN

BACKGROUND: Acute Respiratory Infections (ARIs) account for more than 6% of the worldwide disease burden in children under the age of five, with the majority occurring in Sub-Saharan Africa. Rural children are more vulnerable to and disproportionately affected by ARIs. As a result, we examined the rural-urban disparity in the prevalence of ARI symptoms and associated factors among children under the age of five in Sub-Saharan Africa. METHODS: We used the most recent Demographic and Health Survey (DHS) data from 36 countries in Sub-Saharan Africa. The study included 199,130 weighted samples in total. To identify variables associated with ARIs symptoms, a multilevel binary logistic regression model was fitted. The Adjusted Odds Ratio (AOR) with a 95% CI was used to determine the statistical significance and strength of the association. To explain the rural-urban disparity in ARI prevalence, a logit-based multivariate decomposition analysis was used. RESULTS: Being female, ever breastfeeding, belonging to a poorer, better wealth status, and having better maternal educational status were significantly associated with lower odds of ARIs among under-five children. Whereas, small size or large size at birth, not taking vitamin A supplementation, being severely underweight, having diarrhea, didn't have media exposure, never had the vaccination, being aged 36-47 months, and being aged 48-59 months were significantly associated with higher odds of ARIs among under-five children. The multivariate decomposition analysis revealed that the difference in characteristics (endowment) across residences explained 64.7% of the overall rural-urban difference in the prevalence of ARIs, while the difference in the effect of characteristics (change in coefficient) explained 35.3%. CONCLUSION: This study found that rural children were highly affected by ARIs in SSA. To reduce the excess ARIs in rural children, public health interventions aimed at impoverished households, home births, and unvaccinated and malnourished children are crucial.


Asunto(s)
Trastornos de la Nutrición del Niño , Infecciones del Sistema Respiratorio , Niño , Recién Nacido , Humanos , Femenino , Masculino , Población Rural , Composición Familiar , Infecciones del Sistema Respiratorio/epidemiología , Vivienda , Prevalencia
4.
Nutrients ; 14(20)2022 Oct 12.
Artículo en Inglés | MEDLINE | ID: mdl-36296926

RESUMEN

Breastmilk is the only recommended source of nutrition for infants below six months of age. However, a significant proportion of children are either on supplemental breastfeeding (SBF) or weaned due to the early introduction of solid/semi-solid/soft food and liquids (SSF) before six months of age. There is good evidence that exclusive breastfeeding (EBF) in infants below six months of age protects them from preventable illnesses, including malnutrition. The relationship between infant feeding practices and coexisting forms of malnutrition (CFMs) has not yet been explored. This study examined the association of different feeding indicators (continuation of breastfeeding, predominant feeding, and SSF) and feeding practices (EBF, SBF, and complete weaning) with CFM in infants aged below six months in Pakistan. National and regional datasets for Pakistan from the last ten years were retrieved from the Demographic Health Surveys (DHS) and UNICEF data repositories. In Pakistan, 34.5% of infants have some form of malnutrition. Among malnourished infants, 44.7% (~15.4% of the total sample) had a CFM. Continuation of breastfeeding was observed in more than 85% of infants, but less than a quarter were on EBF, and the rest were either SBF (65.4%) or weaned infants (13.7%). Compared to EBF, complete weaning increased the odds of coexistence of underweight with wasting, and underweight with both wasting and stunting by 1.96 (1.12-3.47) and 2.25 (1.16-4.36), respectively. Overall, breastfed children had lower odds of various forms of CFM (compared to non-breastfed), except for the coexistence of stunting with overweight/obesity. Continuation of any breastfeeding protected infants in Pakistan from various types of CFM during the first six months of life.


Asunto(s)
Trastornos de la Nutrición del Niño , Desnutrición , Lactante , Femenino , Niño , Humanos , Delgadez/epidemiología , Lactancia Materna , Desnutrición/epidemiología , Trastornos del Crecimiento
5.
Nutrients ; 14(20)2022 Oct 18.
Artículo en Inglés | MEDLINE | ID: mdl-36297054

RESUMEN

Child complementary feeding (CF) practices meet dietary recommendations more often among educated, high-income groups. Much of the evidence for this association addresses inadequate CF for addressing child undernutrition. However, in many countries, including Thailand, child malnutrition assessments must now address under- and over-nutrition. More comprehensive data is needed to understand this complex situation. This study uses data from the Thailand Multiple Indicators Survey 2019, to identify the determinants of CF practices among 6-23-month children (n = 4125) using the newly developed WHO indicators. Logistic regression analysis was used to measure associations between sociodemographic factors and CF practices. In a fully adjusted model, child age, primary caregivers' education, and household incomes were statistically associated with (in)appropriate CF practices. Older children aged 9-23 months, not only have better minimum dietary diversity (MDD), minimum acceptable diet (MAD), and egg and/or flesh food consumption (EFF), but also tend to consume more unhealthy foods. The proportion of inappropriate CF practices was higher among children living with caregivers other than their mothers. While maternal education and household income were positively associated with MDD and MAD, children of mothers from middle-class households consumed more sweetened beverages. Therefore, nutrition programs addressing different feeding problems should be developed specifically for different primary caregiver and demographic groups.


Asunto(s)
Trastornos de la Nutrición del Niño , Alimentos Infantiles , Lactante , Femenino , Niño , Humanos , Adolescente , Lactancia Materna , Tailandia/epidemiología , Conducta Alimentaria , Factores Socioeconómicos , Encuestas Epidemiológicas , Fenómenos Fisiológicos Nutricionales del Lactante , Madres/educación , Dieta
6.
BMC Public Health ; 22(1): 1943, 2022 10 19.
Artículo en Inglés | MEDLINE | ID: mdl-36261797

RESUMEN

BACKGROUND: Undernutrition is a significant public health challenge and one of the leading causes of child mortality in a wide range of developing countries, including Ethiopia. Poor access to water, sanitation, and hygiene (WASH) facilities commonly contributes to child growth failure. There is a paucity of information on the interrelationship between WASH and child undernutrition (stunting and wasting). This study aimed to assess the association between WASH and undernutrition among under-five-year-old children in Ethiopia. METHODS: A secondary data analysis was undertaken based on the Ethiopian Demographic and Health Surveys (EDHS) conducted from 2000 to 2016. A total of 33,763 recent live births extracted from the EDHS reports were included in the current analysis. Multilevel logistic regression models were used to investigate the association between WASH and child undernutrition. Relevant factors from EDHS data were identified after extensive literature review. RESULTS: The overall prevalences of stunting and wasting were 47.29% [95% CI: (46.75, 47.82%)] and 10.98% [95% CI: (10.65, 11.32%)], respectively. Children from households having unimproved toilet facilities [AOR: 1.20, 95% CI: (1.05,1.39)], practicing open defecation [AOR: 1.29, 95% CI: (1.11,1.51)], and living in households with dirt floors [AOR: 1.32, 95% CI: (1.12,1.57)] were associated with higher odds of being stunted. Children from households having unimproved drinking water sources were significantly less likely to be wasted [AOR: 0.85, 95% CI: (0.76,0.95)] and stunted [AOR: 0.91, 95% CI: (0.83, 0.99)]. We found no statistical differences between improved sanitation, safe disposal of a child's stool, or improved household flooring and child wasting. CONCLUSION: The present study confirms that the quality of access to sanitation and housing conditions affects child linear growth indicators. Besides, household sources of drinking water did not predict the occurrence of either wasting or stunting. Further longitudinal and interventional studies are needed to determine whether individual and joint access to WASH facilities was strongly associated with child stunting and wasting.


Asunto(s)
Trastornos de la Nutrición del Niño , Agua Potable , Desnutrición , Niño , Humanos , Lactante , Saneamiento , Etiopía/epidemiología , Higiene , Trastornos de la Nutrición del Niño/epidemiología , Trastornos de la Nutrición del Niño/complicaciones , Trastornos del Crecimiento/epidemiología , Trastornos del Crecimiento/etiología , Desnutrición/epidemiología , Desnutrición/complicaciones , Prevalencia
7.
Glob Health Sci Pract ; 10(5)2022 10 31.
Artículo en Inglés | MEDLINE | ID: mdl-36316138

RESUMEN

OBJECTIVES: We evaluated changes in priority indicators of child growth from 2006 to 2021 and examined the role of human development measures in these changes. METHODS: We estimated cumulative and annualized changes in state- and district-level child growth indicators using 3 rounds of National Family Health Surveys (2005-2006, 2015-2016, 2019-2021) in 36 states. Outcomes included stunting, underweight, wasting, and overweight. Human development was measured using a principal components analysis of 9 ecological indicators. We contrasted expected versus observed changes in district-level growth outcomes between 2016 and 2021 based on changes in development indicators using 2-way Blinder Oaxaca decomposition. RESULTS: From 2006 to 2021, the prevalence of stunting, underweight, and wasting decreased by 12.3, 10.3, and 0.7 percentage points, respectively, while the prevalence of overweight increased by 1.9 percentage points. The annualized rate of within-state change for stunting was lower from 2016 to 2021 compared with the 2006 to 2016 period, while the rate of change in overweight was higher. Simultaneously, all 9 human development indicators improved between 2006 and 2021. A unit increase between 2016 and 2021 in the human development score predicted a -5.1 percentage point (95% confidence interval=-5.8, -4.4) change in stunting, yet observed stunting declined by just -2.5 percentage points. CONCLUSIONS: From 2016 to 2021, population-level reduction in child stunting has slowed and the rise in child overweight has accelerated, relative to the 10 years preceding this period.


Asunto(s)
Trastornos de la Nutrición del Niño , Desnutrición , Niño , Humanos , Lactante , Delgadez/epidemiología , Sobrepeso/epidemiología , Trastornos de la Nutrición del Niño/epidemiología , Trastornos del Crecimiento/epidemiología , India/epidemiología , Prevalencia , Desnutrición/epidemiología
8.
Front Public Health ; 10: 981484, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36311561

RESUMEN

Background: Malnutrition of under-five children has adverse effects on child's health and development, such as growth failure and muscle wasting. The household wealth index has a direct contribution to child malnutrition despite little attention being given to its indirect effect through other factors. This study aimed to identify the potential mediators of the link between wealth index and malnutrition. Methods: In this study, a cross-sectional study design was implemented based on the data obtained from the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS), which consists of a total of 3,918 under-five children. Mediation analysis of structural equation (SEM) was implemented to determine and estimate the effects of potential mediators of the link between wealth index and under-five children malnutrition. Results: Among 3,918 under-five children involved in this study, 51.4% were male children and 20.2% were from urban areas. The place of delivery of the majority of mothers (56.1%) was at home, and the majority of children were from the poorest household (36.4%). The estimated effects of height-for-age of female children were higher (1.31:95% CI = 0.45, 0.200), indicating that female children had a lower likelihood of stunting than males. As compared to children in an urban area, children from rural areas were more likely to be stunted (-0.269; 95%CI = -0.388, -0.135). The estimated total indirect effects of wealth index on stunting and underweight was 0.69 (95% = 0.045, 0.094) and 0.036 (95% = 0.013, 0.054), respectively, and significant (p-value of <0.05). Conclusion: Environmental, maternal, biological, and behavioral factors were the potential mediators of the link between the wealth index and the anthropometric indices. Besides, the total effects of the household wealth index had a significant effect on stunting, underweight, and wasting in which children from a household with low economic status were more likely to be malnourished.


Asunto(s)
Trastornos de la Nutrición del Niño , Desnutrición , Niño , Humanos , Masculino , Femenino , Delgadez/epidemiología , Estudios Transversales , Etiopía/epidemiología , Trastornos de la Nutrición del Niño/epidemiología , Trastornos del Crecimiento/epidemiología , Desnutrición/epidemiología
9.
J Pak Med Assoc ; 72(8): 1535-1543, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-36280915

RESUMEN

Objective: To find out the prevalence and associated factors of undernutrition in a semi-rural setting. METHODS: The community-based cross-sectional study was conducted in Tehsil Battagram of Khyber Pakhtunkhwa province, Pakistan, in January and February 2020 after approval from the ethics review committee of Nanjing Medical University, Jiangsu, China, and comprised children aged 6-59 months who had no physical or mental disability. Data was collected using a structured questionnaire. Anthropometric data was analysed using the World Health Organisation Anthro software. Multivariate logistic regression analysis was used to find out the association between dependent variables, like wasting, underweight and stunting, and independent variables, like socioeconomic, child, maternal and environmental characteristics. Data was analysed using SPSS 21. RESULTS: Of the 504 children, 257(51%) were girls and 247(49%) were boys. The largest group was aged 36-47 months 127(25.2%), while the smallest group was aged 6-11 months 56(11.1%). Overall, 94(18.7%) children were wasted, 167(33.1%) were underweight and 248(49.2%) were stunted. Children whose family income was high had low odds for being wasted (odds ratio: 0.59, 95% confidence interval: 0.25-0.71), underweight (odds ratio: 0.30, 95% confidence interval: 0.08-0.72) and stunted (odds ratio: 0.54, 95% confidence interval: 0.30-0.80). Similarly, those children who were exclusively breastfed had low odds of being wasted were (odds ratio: 0.45, 95% confidence interval: 0.32-0.53), underweight (odds ratio: 0.56, 95% confidence interval: 0.42-0.78) and stunted (odds ratio: 0.62, 95% confidence interval: 0.51-0.97). Children who were not immunised had higher odds of wasting (odds ratio: 4.16, 95% confidence interval: 2.18-7.93), underweight (odds ratio: 4.45, 95% confidence interval: 2.77-7.14) and stunted (odds ratio: 4.36, 95% confidence interval: 2.32-8.71). Children of mothers who did not have antenatal care visits had higher odds of being wasted (odds ratio: 1.91, 95% confidence interval: 1.13-3.22), underweight (odds ratio: 1.32, 95% confidence interval: 1.22-2.13) and stunted (odds ratio: 1.48, 95% confidence interval: 1.32-2.62). Children who did not have a latrine facility had higher odds of being wasted (odds ratio: 1.63, 95% confidence interval: 1.29-1.58), underweight (odds ratio: 1.76, 95% confidence interval: 1.36-3.84) and stunted (odds ratio: 1.45, 95% confidence interval: 1.22-2.12). Conclusion: Undernutrition among children aged 6-59 months was widespread. Nutrition awareness, interventions and multi-sectoral approaches were found to be needed to cope with the problem in the study area.


Asunto(s)
Trastornos de la Nutrición del Niño , Desnutrición , Síndrome Debilitante , Niño , Masculino , Femenino , Humanos , Embarazo , Lactante , Delgadez/epidemiología , Síndrome Debilitante/epidemiología , Trastornos de la Nutrición del Niño/epidemiología , Prevalencia , Estudios Transversales , Pakistán/epidemiología , Desnutrición/epidemiología , Trastornos del Crecimiento/epidemiología
10.
Int J Clin Pract ; 2022: 8310260, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36081808

RESUMEN

Childhood is a critical period for susceptibility to malnutrition. The consumption of ultraprocessed foods (UPFs) has been increasing among children. The objective of this study was to evaluate the relationship between UPF intake and overweight/obesity and malnutrition in children. 788 children aged 6 years were included in a population-based cross-sectional study in Tehran. A 168-item semiquantitative food frequency questionnaire was used to evaluate dietary intake. UPFs were detected using the NOVA classification system. Logistic regression analyses were used, and results were reported as odds ratios (ORs) and 95% confidence interval (CI) of obesity and malnutrition across the tertiles of UPFs adjusted for energy intake, socioeconomic status, and physical activity. The mean weight, height, BMI, and total energy intake of participants were 20.85 ± 2.35 kg, 113.75 ± 2.00 cm, 16.12 + 1.84 kg/m2, and 1014.74 ± 259.16 (kcal/d), respectively. There were no significant associations between UPF intake and obesity (OR = 0.97; 95% CI 0.31 to 3.01; P-trend = 0.98), wasting (OR = 0.94; 95% CI 0.30 to 2.87; P-trend = 0.87), overweight/obesity (OR = 0.86; 95% CI 0.59 to 1.25; P-trend = 0.45), underweight/wasting (OR = 0.69; 95% CI 0.40 to 1.17; P-trend = 0.17), marginal-stunting (OR = 1.16; 95% CI 0.71 to 1.89; P-trend = 0.53), or marginal-stunting/overweight/obesity (OR = 1.25; 95% CI 0.62 to 2.54; P-trend = 0.47). There was no evidence of an association between intake of UPFs and risk of overweight, obesity, and malnutrition in children.


Asunto(s)
Trastornos de la Nutrición del Niño , Desnutrición , Índice de Masa Corporal , Niño , Estudios Transversales , Ingestión de Alimentos , Trastornos del Crecimiento , Humanos , Irán/epidemiología , Obesidad , Sobrepeso/epidemiología
11.
PLoS One ; 17(9): e0274996, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36149880

RESUMEN

INTRODUCTION: Post-hospital discharge mortality is high among undernourished children in many low and middle-income countries. Although a number of quantitative studies have highlighted a range of potential socio-cultural, economic and health system factors influencing paediatric post-discharge treatment-seeking and recovery, few studies have explored family and provider perspectives of the post-discharge period in-depth. METHODS: This work was part of a large, multi-country prospective cohort study, the Childhood Acute Illness and Nutrition (CHAIN) Network. We conducted a qualitative sub-study to understand the post-discharge treatment-seeking and recovery experiences of families of undernourished children aged 2-23 months admitted in a rural and urban icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh) hospital. Methods included repeat in-depth interviews (73 interviews in total) with 29 family members of 17 purposively selected children. These data were supplemented by interviews with 33 health workers, and by observations in hospitals and homes. RESULTS: Important drivers of treatment-seeking perceived to support recovery included advice provided to family members while in hospital, media campaigns on hygiene practice, availability of free treatment, and social and financial support from family members, relatives and neighbours. Key perceived challenges included low household incomes, mothers having to juggle multiple responsibilities in addition to caring for the sick child, lack of support (sometimes violence) from the child's father, and family members' preference for relatively accessible drug shops, physicians or healers over hospital admission. CONCLUSION: Development of interventions that address the challenges that families face is essential to support post-discharge adherence to medical advice and recovery. Potential interventions include strengthening information giving during hospitalization on what post-discharge care is needed and why, reducing direct and indirect costs associated with hospital visits, engaging fathers and other 'significant others' in post-discharge advice, and building mobile phone-based support for follow-up care.


Asunto(s)
Cuidados Posteriores , Trastornos de la Nutrición del Niño , Bangladesh , Niño , Femenino , Hospitales , Humanos , Madres , Alta del Paciente , Estudios Prospectivos , Investigación Cualitativa
12.
Int J Equity Health ; 21(1): 135, 2022 09 15.
Artículo en Inglés | MEDLINE | ID: mdl-36104780

RESUMEN

BACKGROUND: Child undernutrition is a severe health problem in the developing world, which affects children's development in the long term. This study analyses the extent and patterns of under-five child undernutrition using Demographic and Health Surveys (DHS) for 73 low- and middle-income countries (LMICs). METHODS: First, we mapped the prevalence of undernutrition in the developing world. Second, using the LISA (a local indicator of spatial association) technique, we analyzed the geographical patterns in undernutrition to highlight the localized hotspots (regions with high undernutrition prevalence surrounded by similar other regions), cold spots (regions with low undernutrition prevalence surrounded by similar other regions), and outliers (regions with high undernutrition surrounded by low undernutrition and vice versa). Third, we used Moran's I to find global patterns in child undernutrition. RESULTS: We find that South Asia has the highest under-five child undernutrition rates. The intra-country nutritional inequalities are highest in Burundi (stunting), Kenya (wasting), and Madagascar (underweight). The local indicator of spatial association (LISA) analysis suggests that South Asia, Middle East and North Africa (MENA) region, and Sub-Saharan Africa are undernutrition hotspots and Europe and Central Asia and Latin America, and the Caribbean are undernutrition cold spots (regions with low undernutrition surrounded by similar other regions). Getis Ord-Gi* estimates generally support LISA analysis. Moran's I and Geary's C gave similar results about the global patterns of undernutrition. Geographically weighted regressions suggest that several socioeconomic indicators significantly explain child undernutrition. CONCLUSIONS: We found a significant within and across country variation in stunting, wasting and underweight rates among the under-five children's population. The geospatial analysis also suggested that stunting, wasting, and underweight patterns exhibit clear regional patterns, underscoring the need for coordinated interventions at the regional level.


Asunto(s)
Trastornos de la Nutrición del Niño , Desnutrición , Niño , Trastornos de la Nutrición del Niño/epidemiología , Países en Desarrollo , Trastornos del Crecimiento/epidemiología , Humanos , Kenia , Desnutrición/epidemiología , Delgadez/epidemiología
13.
Washington, D.C.; OPS; 2022-09-12. (OPS/NMH/NV/22-0030).
en Español | PAHO-IRIS | ID: phr-56411

RESUMEN

La gran mayoría de los niños, niñas y adolescentes con cáncer viven en países de ingresos bajos y medianos, donde las tasas de desnutrición aún son un problema de salud pública. El estado nutricional deficiente de los pacientes pediátricos con cáncer aumenta los riesgos de infección y toxicidades relacionadas con el tratamiento. En esta publicación se aborda el panorama actual sobre la nutrición de estos pacientes y las oportunidades de mejora.


Asunto(s)
Nutrición del Lactante , Trastornos de la Nutrición del Niño , Oncología Médica , América Latina , Región del Caribe
14.
Nutr. clín. diet. hosp ; 42(3): 22-33, Ago 2022. tab
Artículo en Español | IBECS | ID: ibc-207348

RESUMEN

Introducción: Los primeros años de la vida son dinámicos en comparación con todo el proceso de crecimiento, el cual se caracteriza por su vulnerabilidad ante las condiciones sociales, económicas y ambientales, lo que hace necesario un estado nutricional adecuado. Objetivo: analizar los factores asociados a la desnutrición aguda en niños menores de cinco años en el Valle del Cauca entre 2016 y 2019. Metodología: se realizó un estudio descriptivo de corte transversal con análisis correlacional a la luz de los determinantes sociales en salud. La población estuvo conformada por 2.237 niños/as registrados en la base de datos básicos y complementarios de la ficha epidemiológica del evento 113 del Sistema de Vigilancia en Salud Pública. Se concluyó que los más afectados por desnutrición fueron los niños de sexo masculino con un 55,4% y en edades entre los seis y 12 meses (62%). Resultados: entre la información relativa al peso, el 78,6% tuvo un normopeso al nacer, el 88% estaban inscritos en el programa Crecimiento y Desarrollo y la mayoría tenían residencia en el área de la cabecera municipal. Las madres o cuidadores que alcanzaban un grado de escolaridad de secundaria eran un 56,73%. Conclusiones: En esa medida, en el Valle del Cauca la presencia de desnutrición aguda se relaciona con el tiempo de lactancia materna, la inscripción al programa de Crecimiento y Desarrollo, la edad del menor, la pertenencia étnica, el régimen de salud, el nivel educativo de la madre y el área de residencia.(AU)


The first years of life are dynamic compared to the entiregrowth process, which is characterized by its vulnerability tosocial, economic and environmental conditions, which makesit necessary to have an adequate nutritional status. The ob-jective of the present research consisted of analyzing the fac-tors associated with acute malnutrition in children under fiveyears of age in Valle del Cauca between 2016 and 2019. A de-scriptive cross-sectional study was conducted with correla-tional analysis in light of the social determinants of health.The population consisted of 2,237 children registered in thebasic and complementary database of the epidemiologicalrecord of event 113 of the Public Health Surveillance. The in-formation related to weight, 78,6% had normal weight atbirth, 88% were enrolled in the Growth and DevelopmentProgram and most of them lived in the area of the municipal capital. The mothers or caregivers had 56,73% secondaryschooling. Thus, in Valle del Cauca, the presence of acutemalnutrition is related to the length of breastfeeding, enroll-ment in the Growth and Development Program, age of thechild, ethnicity, health regime, educational level of the motherand area of residence. It was concluded that the most af-fected by malnutrition were males (55.4%) and aged be-tween six and 12 months (62%).(AU)


Asunto(s)
Humanos , Niño , Desnutrición Aguda Severa , Colombia , Trastornos de la Nutrición del Niño , Crecimiento , Péptidos y Proteínas de Señalización Intercelular , Estado Nutricional , Factores de Riesgo , Condiciones Sociales , Nutrición del Niño , Epidemiología Descriptiva , Correlación de Datos
15.
PLoS One ; 17(8): e0272634, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35930584

RESUMEN

BACKGROUND: Child undernutrition is a burden and the leading cause of child mortality in low-and middle-income countries like Bangladesh and India. Currently, this issue is a matter of great concern, inasmuch as achieving the Sustainable Development Goals (SDGs). The study intends to determine the factors of child undernutrition using a single composite index of anthropometric failure (CIAF) among the Bengali population. METHODS: Unit level data on 14055 under 5 children were extracted from the Bangladesh Demographic and Health Survey 2017-18 (BDHS) and the 4th National Family Health Survey of India (NFHS-4). To understand child undernutrition and generate CIAF, data on height-for-age (stunting), weight-for-height (wasting), and weight-for-age (underweight) were used by WHO guidelines. These three undernutrition indicators were combined into a single undernutrition indicator called anthropometric failure (anth-failure) using the CIAF concept. Explanatory factors of anth-failure included data on maternal health, socio-demographic and birth-related variables. Differences of frequency were determined by Z-proportional and Chi-square tests; predictors of anth-failure were determined by binary logistic regression. Cut off point of p-value was taken as 0.05 to test the significance. RESULTS: Inter-country disparities were revealed, about half of Bengali children in India and two-fifths in Bangladesh being prone to anth-failure. Stunting and underweight were more prevalent in both countries than wasting. Maternal undernutrition, lack of maternal education, and poor wealth index were common factors of anth-failure for both countries. Children in Bangladesh developed anth-failure after the end of breastfeeding period, indicating a lack of nutritious food. Lack of antenatal care was another significant factor in Bangladesh. In India, the first child suffered from anth-failure due to lack of maternal education. CONCLUSIONS: This study provides a better understanding of multifactorial impact on child undernutrition. It is proposed that the emphasis should be on initiatives that improve maternal education and nutrition, child food security, boost household wealth index, and enhance mothers' access to health care. The study strongly recommends that the governments of Bangladesh and India invest financially in preventing child malnutrition, which will contribute to achieving the first four SDGs.


Asunto(s)
Trastornos de la Nutrición del Niño , Desnutrición , Bangladesh/epidemiología , Niño , Trastornos de la Nutrición del Niño/epidemiología , Femenino , Trastornos del Crecimiento/etiología , Humanos , India/epidemiología , Lactante , Desnutrición/complicaciones , Desnutrición/epidemiología , Embarazo , Prevalencia , Delgadez/complicaciones , Delgadez/epidemiología
16.
J Nutr Sci ; 11: e63, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35992573

RESUMEN

Child malnutrition is the leading public health problem in Sub-Saharan Africa, resulting in poor health and economic losses. Ethiopia has one of the highest child undernutrition rates in the world that occurs to multifaceted factors, including food insecurity. Thus, we performed a cross-sectional study to assess the prevalence and risk factors for child undernutrition in largely food insecure areas of Ethiopia. Data were collected from 354 mother-child pairs from the Siraro district. Both bivariate and multivariate logistic regression was used for statistical analysis. Variables with a P-value of <0⋅05 in multivariate analysis were used to detect statistical significance at a 95 % confidence level. About 67 % of households are food insecure. The prevalence of stunting wasting and underweight were 42⋅7, 9⋅9 and 27⋅7 %, respectively. Female gender, higher age of the child (12-23 months v. 6-11 months), living in a household with five or more siblings, not getting therapeutic zinc supplement at least once, inadequate diet diversity, lack of growth monitoring service, and maternal own income increases the likelihood of child undernutrition. It can be concluded that child undernutrition is a severe public health problem in the study area. Improving primary healthcare services related to zinc supplementation, growth monitoring and promotion, and improving infant and child feeding practices can be considered as a strategy to address the problem.


Asunto(s)
Trastornos de la Nutrición del Niño , Desnutrición , Trastornos de la Nutrición del Niño/complicaciones , Trastornos de la Nutrición del Niño/epidemiología , Preescolar , Estudios Transversales , Etiopía/epidemiología , Femenino , Inseguridad Alimentaria , Humanos , Lactante , Desnutrición/epidemiología , Zinc
17.
Public Health Nutr ; 25(11): 3016-3024, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36008100

RESUMEN

OBJECTIVE: To examine the association between childhood stunting and grade completion (as educational outcome) in South Africa. DESIGN: Longitudinal study. Data were obtained using the National Income Dynamics Study over five waves (2008 to 2017). Children were tracked at wave 1 in 2008 until wave 5 in 2017 to determine their total years of schooling. We controlled for time-variant and time-varying confounding with a marginal structural model to estimate the associations between childhood stunting and subsequent grade completion. SETTING: Nationally representative study of South African households. PARTICIPANTS: A total of 2629 children aged 2 and 3 years in 2008. RESULTS: We observed a substantial decrease in the prevalence of stunting between wave 1 (28·2 %) and wave 4 (8·6 %). Our marginal structural model results suggest that childhood stunting was significantly associated with decreased odds (22 % less likely) of grade completion (OR = 0·78; 95 % CI: 0·40, 0·86; P = 0·015), while those who were only stunted during early childhood had a 29 % reduction in the odds of grade completion (OR = 0·71; 95 % CI: 0·51, 0·82; P = 0·020). CONCLUSION: These findings underscore the fact that stunting is a significant predictor of academic achievement, whose effects might be long-lasting.


Asunto(s)
Trastornos de la Nutrición del Niño , Niño , Trastornos de la Nutrición del Niño/epidemiología , Preescolar , Trastornos del Crecimiento/complicaciones , Trastornos del Crecimiento/etiología , Humanos , Estudios Longitudinales , Modelos Estructurales , Prevalencia , Sudáfrica/epidemiología
18.
Malawi Med J ; 34(2): 111-117, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-35991816

RESUMEN

Aim: To analyse the trends and patterns of stunted only and stunted-underweight children in Malawi between the 2000 and 2015. Methods: The study used the 2000 and 2015 Malawi Demographic and Health Survey data and employed bivariate and multivariate statistical analysis techniques to explore the difference in the levels of stunted only and stunted-underweight children and key socio-economic factors between 2000 and 2015 and identify key attributes of being stunted only and being stunted-underweight. Results: The percentage of stunted only was 37.2% in 2000 and 26.8% in 2015 and the stunted-underweight percentage was 14.5% in 2000 and 8.8% in 2015. Out of the 6.9% children classified as wasted, 2.4% were also underweight and stunted, 2.4% were underweight and 2.1% did not have any other forms of undernutrition. The analysis did not identify any children that were both stunted and wasted. Only 0.7% in 2000 and 0.4% in 2015 were underweight and free of any other forms of undernutrition. There were improvements in mother education level and mother weight during this time-period which may explain the improvements in child nutritional status. Conclusion: The most common form of undernutrition is stunting and nearly all children that are underweight are also stunted. Child nutrition practitioners and health professionals should consider focusing on tackling child stunting.


Asunto(s)
Trastornos de la Nutrición del Niño , Desnutrición , Niño , Trastornos de la Nutrición del Niño/epidemiología , Femenino , Trastornos del Crecimiento/epidemiología , Humanos , Lactante , Malaui/epidemiología , Desnutrición/epidemiología , Estado Nutricional , Prevalencia , Delgadez/epidemiología
19.
An. pediatr. (2003. Ed. impr.) ; 97(1): 12-21, jul. 2022. tab, ilus
Artículo en Español | IBECS | ID: ibc-206083

RESUMEN

Introducción: Existen diversas escalas diseñadas para determinar el riesgo de desnutrición al ingreso hospitalario en población infantil, sin embargo, la mayor parte de estos instrumentos se desarrollan y publican en lengua inglesa, siendo preceptiva su adaptación transcultural y validación para poder ser utilizados en nuestro país.Objetivos: Adaptar transculturalmente 3 escalas diseñadas para determinar el riesgo de desnutrición ligada a la enfermedad y determinar la validez de su contenido.Material y métodos: Adaptación transcultural mediante el método de traducción-retrotraducción de acuerdo con las recomendaciones de la International Test Commission Guidelines for Translating and Adapting Tests. Se midió la validez de contenido a través de un panel de expertos (bajo 7 criterios básicos de selección adaptados del modelo Fehring) que evaluaron cada ítem de las escalas midiendo 4 criterios: ambigüedad, sencillez, claridad y relevancia. Con la puntuación extraída se obtuvo el estadístico V de Aiken para cada ítem y para las escalas completas.Resultados: Partiendo de 3 traducciones independientes por escala se obtuvieron 3 versiones definitivas en castellano de las escalas PNRS, STRONGkids y STAMP semánticamente equivalentes a sus versiones originales. Las escalas PNRS y STRONGkids presentaron una V de Aiken superior a 0,75 en todos sus ítems, mientras que escala STAMP presentó un valor inferior a 0,75 para el ítem «peso y altura».Conclusión: Este estudio aporta las versiones en castellano adaptadas transculturalmente de las escalas PNRS, STRONGkids y STAMP. Las escalas PNRS y STRONGkids presentan un contenido válido para ser aplicadas en el contexto hospitalario estatal. STAMP requiere la adaptación de su ítem «peso y altura» para considerar adecuado su uso en población infantil española. (AU)


Introduction: There are various scales designed to determine the risk of malnutrition at hospital admission in children. However, most of these instruments are developed and published in English. Their cross-cultural adaptation and validation being mandatory in order to be used in our country.Objectives: Cross-culturally adapt three scales designed to determine the risk of malnutrition linked to the disease and determine the validity of their content.Material and methods: Cross-cultural adaptation using the translation-back-translation method in accordance with the recommendations of the International Test Commission Guidelines for Translating and Adapting Tests. Content validity was measured by a panel of experts (under seven basic selection criteria adapted from the Fehring model) who evaluated each item of the scales by measuring 4 criteria: ambiguity, simplicity, clarity and relevance. With the extracted score, Aiken's V statistic was obtained for each item and for the complete scales.Results: Starting from three independent translations per scale, 3 definitive versions in Spanish of the PNRS, STRONGkids and STAMP scales were obtained semantically equivalent to their original versions. The PNRS and STRONGkids scales presented an Aiken's V greater than 0.75 in all their items, while the STAMP scale presented a value less than 0.75 for the item “weight and height”.Conclusion: This study provides the transculturally adapted Spanish versions of the PNRS, STRONGkids and STAMP scales. The PNRS and STRONGkids scales present valid content to be applied in the state hospital context. STAMP requires the adaptation of its item “weight and height” to consider its use in a Spanish child population adequate. (AU)


Asunto(s)
Humanos , Preescolar , Niño , Desnutrición , Transculturación , Hospitalización , Traducción , España , Trastornos de la Nutrición del Niño
20.
BMC Pediatr ; 22(1): 385, 2022 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-35778675

RESUMEN

BACKGROUND: Childhood undernutrition is a major public health concern that needs special attention to achieve 2025 global nutrition targets. Moderate acute malnutrition (MAM), manifest as wasting (low weight-for-height), affects 33 million children under 5, yet there are currently no global guidelines for its treatment. We recently performed a randomized-controlled clinical study of a microbiota-directed complementary food formulation (MDCF-2) in 12-18-month-old Bangladeshi children with MAM. The results revealed that MDCF-2, freshly prepared each day, produced a significantly greater improvement in ponderal growth than a standard ready-to-use supplementary food (RUSF), an effect that is associated with repair of the disrupted gut microbial community development that occurs in children with MAM. To test the generalizability of these results in acutely malnourished children at other sites, there is a pressing need for a packaged, shelf-stable, organoleptically-acceptable formulation that is bioequivalent to MDCF-2. This report describes the protocol for a clinical study to evaluate candidate formulations designed to meet these criteria. METHODS: A randomized single-blind study will be conducted in 8-12-month-old Bangladeshi children with MAM to compare the efficacy of alternative shelf-stable MDCF prototypes versus the current MDCF-2 formulation that is produced fresh each day. V4-16S rDNA amplicon and shotgun sequencing datasets will be generated from faecal DNA samples collected from each child enrolled in each group prior to, during, and after treatment to determine the abundances of MDCF-2-responsive bacterial taxa. Efficacy will be assessed by quantifying the change in representation of MDCF-2-responsive gut bacterial taxa after 4-weeks of treatment with freshly prepared MDCF-2 compared to their changes in abundance after treatment with the prototype MDCFs. Equivalence will be defined as the absence of a statistically significant difference, after 4-weeks of treatment, in the representation of faecal bacterial taxa associated with the response to MDCF-2 in participants receiving a test MDCF. DISCUSSION: This trial aims to establish acceptability and equivalence with respect to microbiota repair, of scalable, shelf-stable formulations of MDCF-2 in 8-12-month-old Bangladeshi children with moderate acute malnutrition. TRIAL REGISTRATION: ClinicalTrials.gov (NCT05094024). The trial has been registered before starting enrolment on 23 October 2021.


Asunto(s)
Trastornos de la Nutrición del Niño , Desnutrición , Microbiota , Niño , Trastornos de la Nutrición del Niño/terapia , Alimentos Fortificados , Humanos , Lactante , Ensayos Clínicos Controlados Aleatorios como Asunto , Método Simple Ciego
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