Acute Malnutrition In Children Research Articles

Chronic Pathologies Associated with Severe Acute Malnutrition in Children Hospitalised at the Ureni Reference Health Centre in Commune V

Introduction: The objective was to study chronic pathologies associated with severe acute malnutrition in children aged 6 to 59 months hospitalized at URENI. Methodology: This was a retrospective, descriptive and analytical study running from January 1 to December 31, 2017. Results: During the study period 352 children were hospitalized for severe acute malnutrition at the URENI of the CSREF CV. Among them, 18 presented a chronic pathology, i.e. a frequency of 5.11%. The male gender was predominant, i.e. 61.1% with a sex ratio of 1.57. The 12-24 month age group represented 50% of cases. Thirty-three percent of children had a history of neonatal resuscitation and 16.7% were formerly premature babies. Marasmus was of the severe acute malnutrition type the most represented, i.e. 77.8% of the cases. The association of malnutrition with HIV infection and Cerebral Palsy (CP) were accounted for 27.8% each. More than half of the patients (55.6%) stayed between 15 - 21 days in the structure. Conclusion: HIV infection and cerebral palsy constitute the chronic pathologies most associated with severe acute malnutrition in children at the Csref of commune V.

Artificial intelligence for the practical assessment of nutritional status in emergencies

AbstractThis paper describes a novel method for detecting child malnutrition based on artificial intelligence and facial photography. Estimates of severe and moderate acute malnutrition in children are critical for rapid emergency responses. However, the two traditional measurement methods, mid‐upper arm circumference (MUAC) and weight‐for‐height (WFH), are impractical in conflict and catastrophic disaster situations. They require well‐trained enumerators, cumbersome equipment, and close supervision. The Method for Extremely Rapid Observation of Nutritional Status (MERON) addresses the problem, using simple facial photographs. Facial features are extracted to predict Body Mass Index (BMI) in adults and Weight for Height Z Score (WFHZ) in children under five. MERON correctly predicts adult BMI classification with 78% accuracy. A variant of the model, trained on a sample of 3167 children in Kenya, successfully classified 60% of cases. On most measures, MERON was easier and more culturally acceptable to use than the traditional measurement methods. If MERON were to be trained and validated on a larger sample, with more extreme cases, it would provide a practical solution to a recurrent humanitarian problem.

Prevalence of malnutrition in children in Narsingdi district, Bangladesh: An observational study

Background: A pathological condition called malnutrition arises when there is a relative or absolute lack or excess of one or more nutrients. In low-income nations, it is a serious public health issue for children under ten years. Malnutrition is a state of nutritional deficit brought on by insufficient consumption of protein or energy. Primary acute malnutrition in children is a prevalent condition in underdeveloped nations due to insufficient food supply resulting from social, economic, and environmental causes. An underlying illness that results in aberrant nutritional loss, increased energy expenditure, or decreased food intake is typically the cause of secondary acute malnutrition. Method: This was an observational, descriptive study conducted in Bangladesh's Narsingdi area from September to October 2023. All records of children with complications of malnutrition, between the ages of 2 and 10 were included in the study. Result: 142 children fall in the category of underweight, 166 children possess suitable BMI and 8 of them were heavyweight with BMI more than 23. Nearly one third of the children faces physical problems some times in their life time. Among all of the children 139 (43.98%) had perfect physical status with good health and diarrhea is the most common problem they caught by 118 respondents. Conclusion: In the district, its severity and prevalence can be decreased with increased community knowledge and stronger preventive efforts.

Determinants of mortality during severe acute malnutrition in children under 5 years old in Mahajanga Madagascar

Determinants of mortality during severe acute malnutrition in children under 5 years old in Mahajanga Madagascar

Management of Acute Malnutrition in Children Aged 0 to 24 Months Boulbinet Health Center

Management of Acute Malnutrition in Children Aged 0 to 24 Months Boulbinet Health Center

Strengthening the Diagnosis and Treatment of Malnutrition Through Increased Nurse Involvement: A Quality Improvement Project From Pediatric Wards in Mozambique.

Childhood acute malnutrition continues to be a serious health problem in many low-resource settings in Africa. On pediatric wards in Mozambique, missed opportunities for timely diagnosis and treatment of malnutrition may lead to poor health outcomes. To improve inpatient nutritional care, a quality improvement (QI) project was implemented that aimed to engage pediatric nurses in inpatient malnutrition diagnosis and treatment. In 2 Mozambican referral hospitals, for 6 months, the Plan-Do-Study-Act framework for QI was implemented to identify key drivers of the following measures: having complete anthropometric evaluation documented at admission, 3 or more weight measurements per hospitalization week, documentation of nutritional therapy for eligible patients, and documentation of referral for outpatient nutritional rehabilitation after discharge. Clinical data were abstracted from hospital charts and entered into an EpiInfo database, including a 3-month observation period after the project, and analyzed retrospectively. A total of 2,208 children from wards other than malnutrition were included in the analysis. Complete anthropometric evaluation at admission improved from 24.4% 2 months before the QI project to 80.1% during and 75.2% in the 3 months after the project (P<.001). The percentage of patients with 3 or more weight measurements per hospitalization week rose from 22.3% to 82.8% during and 75.0% after the project (P<.001). Documentation of nutritional therapy increased from 58.8% before to 67.1% during and 70.6% after the project (P=.54), and documentation of referral for outpatient nutritional rehabilitation after discharge decreased from 55.9% to 54.9% during and increased to 70.6% after the project, (P<.001). Nurse engagement may lead to important advancements in the diagnosis and treatment of acute malnutrition in pediatric wards other than malnutrition in Mozambique. Task-sharing, particularly nurse engagement, in combination with QI methodology, may be considered for wards in similar settings with a high burden of malnutrition.

Forecasting Seasonal Acute Malnutrition: Setting the Framework.

Malnutrition is an umbrella term that refers to an impairment in nutrition indicative of subsequently compromised human well-being. The term covers the full spectrum of nutritional impairments from a small yet detectable departure from a "norm" to a terminal stage when severe malnutrition could result in death. This broad spectrum of nutritional departures from "the optimum" dictates the need for an ensemble of metrics to capture the complexity of involved mechanisms, risk factors, precipitating events, short-term, and long-term consequences. Ideally, these metrics should be universally applicable to vulnerable populations, settings, ages, and times when people are most susceptible to malnutrition. We should be able to characterize and intervene to minimize the risk of malnutrition, especially child acute malnutrition that could be assessed by anthropometric measurements. The main challenge in reaching such an ambitious goal is the complexity of measuring, characterizing, explaining, predicting, and preventing malnutrition at any dimension: temporal or spatial and at any scale: a person or a group. The expansive body of literature has been accumulated on many temporal aspects of malnutrition and seasonal changes in nutritional (anthropometric) status. The research community is now shifting their attention to predictive modeling of child malnutrition and its importance for clinical and public health interventions. This communication aims to provide an overview of challenges for understanding child malnutrition from a perspective of predictive modeling focusing on well-documented seasonal variations in nutritional outcomes and exploring "the systems approach" to tackle underlining conceptual and practical complexities to forecast seasonal malnutrition in an accurate and timely manner. This generalized approach to forecasting seasonal malnutrition is then applied specifically to child acute malnutrition.

A Relational Approach to the Drivers of Child Acute Malnutrition.

This article presents a new analytical approach to acute malnutrition causal analysis that is different from the orthodox approach in 2 respects. First, it engages with basic causes, that is, beyond the usual focus on individuals and households. Second, it uses a relational view in the causal analysis. The orthodox approach identifies the malnourished and their individual and household characteristics. In contrast, a relational approach explores the ways in which the relationships between people, their livelihoods, and the environment, mediated by systems and institutions, create the underlying drivers associated with acute malnutrition for some, while simultaneously creating better conditions for others. The article draws on 2 case study communities in West Darfur, Sudan, first considering the Darfur context and the inequitable policies and weakened institutions that have led to ethnic polarization, multilayered conflict, and humanitarian crises. The article explores how this context has played out differently in each community, contrasting their livelihood specializations, conflict-related losses, and livelihood diversification over time. This analysis shows how the relative vulnerability of some people versus others is strongly influenced by their social, economic, and political relationships, as reflected in their shifting power relations and uneven control over livelihood resources. Shifting the focus to the basic drivers, especially the institutional structures, processes, and relationships, will deepen the causal analysis of child acute malnutrition, make it more meaningful, and provide a new direction for engagement, learning, and action to address the deepening problem of child acute malnutrition.

UNVEILING THE PRESENT LANDSCAPE OF MALNUTRITION IN INDIA: A COMPREHENSIVE ASSESSMENT

Achieving healthy diets and ending malnutrition, particularly among children, remains a formidable challenge, even as India, the worlds second-most populous nation, has witnessed consistent economic growth and attained food grain self-sufficiency. Despite these advancements, high poverty levels, food insecurity, and malnutrition persist. This article highlights the pressing issues of malnutrition in India. Undernourished children are more susceptible to infectious diseases, leading to higher mortality rates and diminished productivity in adulthood, further perpetuating the cycle of undernutrition. Based on NFHS surveys, the article presents a detailed analysis of crucial malnutrition indicators, including stunting, wasting, and underweight children. It reveals that Indias performance on global hunger indices remains a cause for concern, with the highest child-wasting rate globally and a serious hunger level. At the same time, some indicators have shown marginal improvement, but acute malnutrition in children under five remains challenging. The article emphasizes the role of non-economic factors such as gender discrimination, hygiene, and maternal education in perpetuating malnutrition. Additionally, it discusses the governments initiatives, including the Integrated Child Development Services (ICDS) and POSHAN Abhiyaan, in addressing the issue. The article calls for a renewed focus on the critical first 1000 days of a childs life and the effective promotion of intensive breastfeeding to combat malnutrition. It advocates for targeted interventions, improved data management, strengthened governance, and systematic monitoring to ensure a healthier future for Indias children and address the pressing issue of malnutrition.

Evidences of Widespread Hunger in Gbeo Community, North East Region, Ghana; the Determinants of Malnutrition and Susceptibility to Extreme Hunger

Background: The global community aspires towards zero hunger and minimized prevalence of various metrics of malnutrition by 2030 and beyond. Despite mainstream routine nutrition/food surveillance interventions carried out by provincial, national and civil society bodies, the markers of global hunger are rife. This study sought to investigate with the aid of household food insecurity experience scale (HFIES) and nutrition indices, the evidence of hunger, child malnutrition and other forms of extreme household deprivation in Gbeo; a rural hard-to-reach community in the Mamprugu East Municipality, North East Region. Methods: This study was a case analysis of Gbeo community using cross-sectional modalities. Mother – child dyads from 235 systematically selected households were recruited for one-on-one interviews including anthropometric/dietary assessments. Data were obtained on household hunger (using HFIES as proxy), child (6 – 59 months) malnutrition and their potential predictors (SE characteristics, IYCF, WASH, etc.). Child anthropometric growth indices were computed in accordance with WHO (2017) revised standard protocols. Findings: Out of 235 children 34.4% were stunted, 18.8% underweight and 37.9% wasted; these are elevated above Ghana Demographic and Health Survey (GDHS) data for Northern Region, Ghana as a whole and WHO/UNICEF/World Bank (2021) latest global estimates. Four (1.8%) children had all growth failure and in 5.6% of cases, underweight co-occur with stunting and wasting. The proportion of HHs in the 3rd tertile [T3], 2nd tertile [T2] and 1st tertile [T1] of food insecurity were 33%, 29% and 38% respectively. Multiple logistic regression models showed that mean HFIES scores were higher among households that; has a female food-based decision maker [t (degrees of freedom=1, n=235) = 1.93, significance level p =.000], have not received any form of remittances within the past 12 months [t (1, 235) = 2.65, p = .016], source their food stuffs from predominantly purchasing [t (1, 235) = 2.65, p = .009] and has a caregiver or household head that is an alcoholic [t (1, 235) = 4.01, p = .000]. Conclusion: Food insecurity predicts acute child malnutrition. Social protection and economic empowerment interventions should be integrated with nutrition-based initiatives for holistic household improvement.

Epidemiological and Clinical Aspects of Severe Acute Malnutrition in Children Aged 0 to 59 Months Hospitalized at the Reference Health Center of the Commune I of Bamako (Mali)

Severe acute malnutrition (SAM) is characterized by a weight/height (W/T) ratio below -3Zscore and/or nutritional edema and/or arm circumference (MUAC) below 115 mm. This is a priority public health problem in Mali, because the nutritional situation remains very worrying for years. During our study period, 159 children suffering from severe acute malnutrition (SAM) with medical complications were hospitalized in the pediatric department. Materials and method: This is a prospective and descriptive study of children aged 0 to 59 months hospitalized for severe acute malnutrition with medical complications at the pediatrics department of the commune I from June 1, 2018 to May 31, 2019. All children from 0 to 59 months hospitalized in pediatrics during the study period and having parameters in favor of SAM were included. Results: We have a hospital prevalence of 14.7%. The average age of the children was 18 months with extremes of 3 to 59 months. Children aged 12-24 months were in the majority 55% and children under 12 months accounted for 40%. Most of the children were male with a sex ratio of 1.17. The majority of children (61.6%) came from the health district of the commune I. The frequency of admissions was higher in July and August (15.7% and 19.5%). The reasons for consultation were: anorexia (lack of appetite) 32.7%, diarrhea 26.4%, cough 9.4%, edema 8.2%, fever 7.6%, vomiting 7.6%, weight loss 5%. Marasmus was the most noticed form of malnutrition with 83.6%. The average length of hospitalization was 8 days with extremes of 3 to 17 days. Lethality reached 6.9%. The state of shock was the most marked factor of death 54.5%, cases of false route (food inhalation) 27.3% and respiratory distress 18.2%.

Feasibility trial for the management of severe acute malnutrition in older children with sickle cell anemia in Nigeria

AbstractChildren with sickle cell anemia (SCA) living in Nigeria are at an increased risk of malnutrition, which contributes to increased morbidity and mortality. However, evidence-based guidelines for managing malnutrition in children with SCA are lacking. To address this gap, we conducted a multicenter, randomized controlled feasibility trial to assess the feasibility and safety of treating children with SCA aged from 5 to 12 years and having uncomplicated severe acute malnutrition (body mass index z score of <−3.0). Children with SCA and uncomplicated severe acute malnutrition were randomly allocated to receive supplemental ready-to-use therapeutic food (RUTF) with or without moderate-dose hydroxyurea therapy (20 mg/kg per day). Over a 6-month enrollment period, 3190 children aged from 5 to 12 years with SCA were evaluated for eligibility, and 110 of 111 children who were eligible were enrolled. During the 12-week trial, no participants withdrew or missed visits. One participant died of unrelated causes. Adherence was high for hydroxyurea (94%, based on pill counts) and RUTF (100%, based on the number of empty sachets returned). No refeeding syndrome event or hydroxyurea-related myelosuppression occurred. At the end of the trial, the mean change in body mass index z score was 0.49 (standard deviation = 0.53), and 39% of participants improved their body mass index z score to ≥−3.0. Our findings demonstrate the feasibility, safety, and potential of outpatient treatment for uncomplicated severe acute malnutrition in children with SCA aged from 5 to 12 years in a low-resource setting. However, RUTF sharing with household and community members potentially confounded the response to malnutrition treatment. This trial was registered at clinicaltrials.gov as #NCT03634488

Strong seasonality in diets and alarming levels of food insecurity and child malnutrition in south-eastern Madagascar

Rural areas of Madagascar face a tense food and nutrition security situation. The country reports some of the highest rates of undernourishment and malnutrition worldwide. Evidence is scant, however, about how the rural people’s diets vary over the course of the agricultural year, and how different household types deal with fluctuating food availability. This lack of detailed understanding of the food and nutrition security situation across time and social strata currently limits development stakeholders’ ability to tailor interventions to local needs. Using randomly sampled survey data from Farafangana District in south-eastern Madagascar, this study analyzes rural households’ diets across three time points within one year (minor lean period, major lean period, main post-harvest period). In addition, anthropometric data on children aged 6–59  months were collected during the major lean period to determine levels of chronic and acute child malnutrition. Overall, food insecurity stood at high levels at all times, but with substantial variation across the year. Shortly before the main rice harvest, the prevalence of moderate and severe food insecurity was 78%, twice as high as shortly after harvest. With 57% of children stunted and a 17% prevalence of wasting, the observed levels of chronic and acute child malnutrition exceed levels reported previously. By studying what households eat and how they source it (own production vs. purchases), we found distinct patterns of food acquisition between the three periods. Diminishing food security is reflected by substituting rice by cassava, unripe jackfruit (minor lean period), and local tuber tavolo (major lean period), as well as by lower diversity of side dishes. Our results underline the need for long-term agricultural development strategies that contribute to greater household food self-sufficiency especially during the lean periods. But the alarming level of acute child malnutrition also calls for more immediate humanitarian aid and public health interventions.

Various Risk Factors of Severe Acute Malnutrition in Children Under 5 Years of Age Presenting at a Secondary Care Hospital

Aim: To assess the various risk factors of severe acute malnutrition in children under 5 years of age presenting at a secondary care hospital Study design: A cross-sectional study Place and duration: Nutritional stabilization centre, Pediatric department, civil hospital Mirpur Khas from January to June 2022 Methodology: A total of 321 children (both males and females) below the age of 5 years were enrolled in this study. Severe acute malnutrition was diagnosed on the basis of weight for height/length Z score criteria. (ie &lt; - 3 SD). Children were managed at a nutritional stabilization centre according to WHO management criteria. History was taken regarding breastfeeding, age of complementary feeding, immunization, maternal education level and repeated diarrhea. Counts with percentages were reported on age group, sex, mother education, lack of breastfeeding, delayed weaning, lack of immunization, and diarrhea. Association was tested with sex and mother education status using the Pearson Chi-Square test. P-values less than 0.05 were considered statistically significant. The bar chart also reported the study outcomes with gender. Results: In the present study, there were three hundred twenty children with mean age 17.9 of (SD=±10.3) months, 30.6% were aged 9 – 12 months, 55.9% were male gender, and 65.6% of mothers were uneducated. Lack of breastfeeding was observed in 10.3% of children, delayed weaning was 12.5%, lack of immunization was 14.1%, and diarrhea was found in 20.6% of children. Children with uneducated mothers 11% were found to have a lack of breastfeeding, 84.2% with delayed complementary feeding, 81% with a lack of immunization and 26.2% with diarrhea. Conclusion: According to our study lack of breast feeding, delayed weaning, lack of immunization, recurrent diarrhea and maternal education are strongly associated with severe acute malnutrition in children. Uneducated women breastfeed their children more, but they start complementary feeding late and their children are more unvaccinated and had more frequent diarrhea which leads to severe acute malnutrition. Keywords: severe acute malnutrition, breastfeeding, diarrhea, complementary feeding

Akut Malnütrisyonlu Çocuk Hastalarda Albumin ve İskemi Modifiye Albumin Düzeylerinin Değerlendirilmesi

Background: Children are significantly more likely to be malnourished due to their special nutritional needs for growth. Ischemia Modified Albumin (IMA) is a new marker of ischemia that occurs when serum albumin comes in contact with the heart's ischemic tissues. IMA has been used to measure several acute conditions but has never been used to measure acute malnutrition in children. This study aims to examine albumin and IMA in malnourished children to see if they can be used as markers of malnutrition in children. Materials and Methods: 84 children were examined (41 boys and 43 girls, mean age (SD): 6.18 (3.89); range: 0.92-16.75 years) who were referred to the hospital from 20 October to May 20, 2020. A physician performed nutrition examinations on children. BMI of less than 18.5 was considered malnourished children. The hypothesis of the normality of variables was accepted with the Kolmogorov–Smirnov test. To study the difference in variables means at groups, the T-test and Phi-Correlation were used. The ANCOVA was used to study the relationship between variables and Albumin and IMA values at different levels. Results: The amount of albumin in the study group ranged from 4.10 to 5.15 (mean ± SD 4.82± 0.17), and the IMA range in the study group was 0.56 to 1.25 (mean ± SD 0.74± 0.13). The amount of albumin in the control group ranged from 4.19 to 5.19 (mean ± SD 4.83± 0.18), and the IMA range in the control group was 0.44 to 1.11 (mean ± SD 0.67± 0.13). No significant difference was observed between the albumin values (p-value = 0.752) between malnourished and healthy children. However, the IMA level in malnourished children was significantly higher (p-value = 0.19) than in healthy children. Conclusions: Although albumin was not significantly different between the two groups, the IMA of malnour-ished children was significantly higher than that of healthy children. This result means that IMA can be used as a marker for malnutrition in children. This study is a preliminary study showing that IMA can be used as a malnutrition marker in children with malnutrition and we believe that it will contribute to the literature.

Prevalence and multi-level factors associated with acute malnutrition among children aged 6–59 months from war affected communities of Tigray, Northern Ethiopia, 2021: a cross-sectional study

BackgroundArmed conflicts greatly affect the health, nutrition, and food security of conflict affected settings particularly children. However, no empirical data exist regarding context specific factors contributing towards acute malnutrition in the war-torn Tigray, Ethiopia. Thus, this study aimed to identify individual and community level factors associated with acute malnutrition among children aged 6–59 months from armed conflict affected settings of Tigray, Ethiopia.MethodsA community based cross-sectional study was conducted among 3,614 children aged 6–59 months in Tigray, from July 15 to Aug 15, 2021. Study participants were selected using a two-stage random sampling method. A structured questionnaire was used to collect data by interviewing mothers/caregivers. Mid upper arm circumference (MUAC) measurements were taken from upper left arm of the children using MUAC tapes. Multivariable multilevel logistic regression analysis was used to determine factors associated with acute malnutrition. Adjusted Odds ratio (AOR) with 95% CI were estimated to describe the strength of associations at p < 0.05.ResultsMore than half (52.5%) of the sampled children were males in sex. Immediately after the first nine months into the conflict, the prevalence of severe, moderate, and global acute malnutrition was very high (5.1%, 21.8%, and 26.9%, respectively) in Tigray. The lowest and highest burden of child acute malnutrition was reported from Mekelle zone (13.3%) and Southeastern zone (36.7%), respectively. Individual-level factors such as older child age (AOR = 0.13, 95% CI: 0.10, 0.18), female child sex (AOR = 1.24, 95% CI 1.05, 1.480.95), Vitamin-A supplementation (AOR = 1.3, 95% CI: 1.05, 1.65), and history of diarrhea (AOR = 1.22, 95%CI: 1.02, 1.53) and community-level factors like unimproved drinking water source (AOR = 1.31, 95%CI: 1.08, 1.58), unimproved toilet facility (AOR = 1.24, 95% CI: 1.01, 1.52), and severe food insecurity (AOR = 1.55, 95% CI: 1.16. 2.07) were significantly associated with childhood acute malnutrition.ConclusionsThe burden of acute malnutrition is a severe public health problem in Tigray. To prevent the untimely suffering and death of children, regular nutrition screening, speedy, and appropriate referral of all malnourished children to nutritional services and large-scale humanitarian assistance including access to food; nutrition supplies; water, sanitation and hygiene supplies; and health care in a timely manner are required. In the prevailing armed conflict, these have been very difficult to achieve. Thus, immediate international intervention is needed.

Prevalence, severity, and predictors of malnutrition in Indian children with cerebral palsy and their impact on health-related quality of life.

Although several studies have shown that undernutrition is frequent in children with cerebral palsy (CP), studies determining predictors of undernutrition and its impact on health-related quality of life (HRQoL) are scarce. This study aimed to assess the prevalence, severity, and predictors of malnutrition in children with CP and its impact on quality of life. This prospective study was performed between August 2019 and December 2021 in children with a clinical diagnosis of CP aged 2-18years. We also intended to determine the socio-demographic and clinical predictors of undernutrition in these children and its impact on HRQoL, measured by the cerebral palsy quality of life (CPQoL)-Primary Caregiver reported version. Out of 569 (5.4 ± 2.8years of age, 74% boys) children with CP, 71%, 44%, and 72% children were underweight, wasted, and stunted respectively, whereas 22%, 11%, and 21% were severely underweight, wasted and stunted respectively. Lower socioeconomic status, higher Gross Motor Function Classification System, and Manual Ability Classification System level were found to be significantly associated with the severity of stunting and underweight (p < 0.05), but not with wasting. CPQoL score in children with CP aged > 4years was lower in patients with severe wasting, stunting, and underweight, as compared to their rest of the counterparts when adjusted for socio-demographic and other clinical variables (p < 0.05). Conclusion: Chronic undernutrition is more common than severe acute malnutrition in children with CP. The severity of undernutrition is an important predictor of impaired HRQoL in children with CP. What is Known: • Several studies have shown that undernutrition is frequent in children with cerebral palsy; however, studies determining predictors of undernutrition and its impact on health-related quality of life are scarce. What is New: • Our study identifies that lower socioeconomic status, higher Gross Motor Function Classification System, and Manual Ability Classification System level are significantly associated with the severity of stunting and being underweight. • Chronic undernutrition is more common than severe acute malnutrition in children with cerebral palsy. Its severity is an important predictor of impaired health-related quality of life in children with cerebral palsy.

Using participatory epidemiology to investigate women’s knowledge on the seasonality and causes of acute malnutrition in Karamoja, Uganda

The Karamoja region of northeast Uganda had been characterized by high levels of acute malnutrition (AM) for decades, despite substantial aid investment in nutrition programmes. Participatory epidemiology (PE) was used to understand the seasonality of child AM from the perspective of women agro-pastoralists and understand their knowledge and prioritization of the causes of child AM. Women provided highly plausible descriptions and analysis of monthly variations in the occurrence of AM, livelihood factors related to the temporal variation in AM occurrence, the root causes of AM and relationships between these causes. Overall, AM was strongly attributed to declining livestock ownership and access to cow milk and normalized gender discrimination. Monthly calendars revealed important monthly patterns in AM, births and women’s workload that had not been previously reported. There was significant agreement (p < 0.01) between independent women’s groups (n = 16) for the monthly calendars and causal diagrams, indicating strong reproducibility of the methods. Triangulation indicated good validity of the monthly calendar method. The PE approach demonstrated that agro-pastoralist women with limited formal education could describe and analyse the seasonality of AM and related factors and identify and prioritize the causes of AM. Indigenous knowledge should be valued and respected, and nutrition programmes should shift the emphasis towards far more participatory and community-based approaches. The timing of conventional nutrition surveys in agro-pastoral settings should be based on an understanding of the seasonality of livelihoods.

Nutritional and dietary diversity status of under-5 children and adolescent girls among forcibly displaced Myanmar nationals living in Bhasan Char relocation camp, Bangladesh: a cross-sectional survey

ObjectiveTo generate baseline evidence regarding the nutritional and dietary diversity status of under-5 children and adolescent girls among forcibly displaced Myanmar nationals (FDMN) relocated to Bhasan Char relocation camp of...

Relapse of acute malnutrition and associated factors after discharge from nutrition stabilization centers among children in Eastern Ethiopia.

Acute malnutrition is a major global health problem primarily affecting under-five children. In sub-Saharan Africa, children treated for severe acute malnutrition (SAM) at an inpatient have high case fatality rate and is associated with relapse of acute malnutrition after discharge from inpatient treatment programs. However, there is limited data on the rate of relapse of acute malnutrition in children after discharge from stabilization centers in Ethiopia. Hence, this study aimed to assess the magnitude and predictors of relapse of acute malnutrition among children aged 6-59 months discharged from stabilization centers in Habro Woreda, Eastern Ethiopia. A cross-sectional study was conducted among under-five children to determine the rate and predictors of relapse of acute malnutrition. A simple random sampling method was used to select participants. All randomly selected children aged 6-59 months discharged from stabilization centers between June 2019 and May 2020 were included. Data were collected using pretested semi-structured questionnaires and standard anthropometric measurements. The anthropometric measurements were used to determine relapse of acute malnutrition. Binary logistic regression analysis was used to identify factors associated with relapse of acute malnutrition. An odds ratio with 95% CI was used to estimate the strength of the association and a p-value less than 0.05 was considered statistically significant. A total of 213 children with mothers/caregivers were included in the study. The mean age in months of children was 33.9 ± 11.4. More than half (50.7%) of the children were male. The mean duration of children after discharge was 10.9 (± 3.0 SD) months. The magnitude of relapse of acute malnutrition after discharge from stabilization centers was 36.2% (95% CI: 29.6,42.6). Several determinant factors were identified for relapse of acute malnutrition. Mid-upper arm circumference less than 110 mm at admission (AOR = 2.80; 95% CI: 1.05,7.92), absence of latrine (AOR = 2.50, 95% CI: 1.09,5.65), absence of follow-up visits after discharge (AOR = 2.81, 95% CI: 1.15,7.22), not received vitamin A supplementation in the past 6 months (AOR = 3.40, 95% CI: 1.40,8.09), household food insecurity (AOR = 4.51, 95% CI: 1.40,15.06), poor dietary diversity (AOR = 3.10, 95% CI: 1.31,7.33), and poor wealth index (AOR = 3.90, 95% CI: 1.23,12.43) were significant predictors of relapse of acute malnutrition. The study revealed very high magnitude of relapse of acute malnutrition after discharge from nutrition stabilization centers. One in three children developed relapse after discharge in Habro Woreda. Programmers working on nutrition should design interventions that focus on improving household food insecurity through strengthened public Safety Net programs and emphasis should be given to nutrition counseling and education, as well as to continuous follow-up and periodic monitoring, especially during the first 6 months of discharge, to reduce relapse of acute malnutrition.