Acute Undernutrition Research Articles

Measuring Food Insecurity in Children under 5 Years of Age with Acute Undernutrition in Valle Del Cauca-Colombia.

Our objective was to assess food insecurity among children under 5 years old with moderate, and severe malnutrition from Valle del Cauca, a state located in the southwestern region of Colombia. A descriptive observational study was conducted, including children whose weight-for-height (W/H) indicator was below 2 SD, as recorded on the World Health Organization (WHO) growth charts, or who exhibited severe malnutrition phenotypes such as marasmus or Kwashiorkor. Family and child food security were evaluated using the Latin American and Caribbean Food Security Scale (ELCSA). 58.6% of households with acutely malnourished children experienced food insecurity. A statistically significant relationship was found between food insecurity and children of Afro-Colombian and Indigenous descent. According to caregivers' perceptions, 30.2% of child malnutrition cases were related to poor feeding and caregiving practices. Not all children with acute malnutrition suffer from food insecurity. Therefore, the findings of this research suggest that governmental efforts should focus not only on ensuring food availability, but also on educating caregivers about the importance of a balanced and nutritious diet tailored to the specific characteristics of each region and promoting appropriate caregiving practices.

Intimate partner violence and childhood health outcomes in 37 sub-Saharan African countries: an analysis of demographic health survey data from 2011 to 2022

Understanding the contribution of intimate partner violence (IPV) to childhood health outcomes (eg, morbidity and mortality) is crucial for improving child survival in sub-Saharan Africa. This comprehensive study aimed to explore the associations between maternal exposure to physical, sexual, or emotional violence and adverse childhood health outcomes in sub-Saharan Africa. We analysed Demographic Health Survey datasets from 37 sub-Saharan African countries from 2011 to 2022. A generalised linear mixed model was used to examine the associations between maternal physical violence, sexual violence, or emotional violence, and early childhood health outcomes (eg, acute respiratory infection, diarrhoea, undernutrition, and child mortality). A random effects meta-analysis was used to calculate pooled odds ratios (ORs) for adverse childhood health outcomes. The odds of undernutrition and mortality were 55% and 58% higher among children younger than 5 years born to mothers who were exposed to physical and sexual violence, respectively. 238 060 children younger than 5 years were included. Children whose mothers experienced physical violence (adjusted OR 1·33, 95% CI 1·29-1·42), sexual violence (1·47, 1·34-1·62), emotional violence (1·39, 1·32-1·47), or a combination of emotional and sexual violence (1·64, 1·20-2·22), or a combination of all the three forms of violence (1·88, 1·62-2·18) were associated with an increased odds of developing diarrhoeal disease. Similarly, children whose mothers experienced physical violence (1·43, 1·28-1·59), sexual violence (1·47, 1·34-1·62), emotional violence (1·39, 1·32-1·47), or a combination of emotional and sexual violence (1·48, 1·16-1·89), or a combination of all three forms of violence (1·66, 1·47-1·88) were positively associated with symptoms of acute respiratory infection. We found a strong link between maternal exposure to IPV and health outcomes for children younger than 5 years in sub-Saharan Africa, with minor variations across countries. To address childhood morbidity and mortality attributed to IPV, interventions need to be tailored for specific countries. Burkina Faso, Burundi, Chad, Comoros, Gabon, Liberia, Nigeria, Sierra Leone, South Africa, and Uganda should be priority nations. None.

Determinants of Undernutrition among Children Admitted to a Pediatric Hospital in Port Sudan, Sudan.

Severe acute undernutrition (SAU) is still a crucial global health issue in the 0-59 months population, increasing the risk of mortality as well as of long-term consequences. In Sudan, 3.3 million children suffered from acute malnutrition between 2018 and 2019. This study was planned to evaluate, in the area of Port Sudan, the prevalence of acute undernutrition after the COVID-19 pandemic and to identify the most important factors favoring the development of acute undernutrition. The available clinical records of all the under-five children (n = 1012) admitted to the Port Sudan Emergency Pediatric Hospital from 1 February 2021 to 31 January 2022 were analyzed. The presence of wasting and kwashiorkor was assessed and children were categorized according to age, gender, place of residence, main reason for hospitalization, and underlying comorbidities. Acute undernutrition was evidenced in 493 (48.7%) children. Of them, only 16 (3.2%) were diagnosed with kwashiorkor. Children with SAU had a higher prevalence of acute gastroenteritis (p < 0.05) and parasitosis (p < 0.05). Infants aged 0-6 months were those with the lowest risk of undernutrition, whereas those aged 7-12 months were those with the greater risk. In these patients, multivariate analysis revealed that SAU and MAU were 2.5 times (OR 2.51; 95% CI, 1.79-3.55) and 5.5 times (OR 5.56; 95% CI, 2.59-18.7) higher. This study shows that the area of Port Sudan is still suffering from an alarming prevalence of severe wasting and the risk of developing acute undernutrition seems strictly related to the introduction of complementary feeding and tends to reduce with increasing age. Measures already in place to prevent acute malnutrition should be reinforced with improvement of mother education on child feeding.

Prospective evaluation and follow-up of nutritional status of children hospitalized in secondary-care level hospitals: a multicentre study.

Although disease-associated undernutrition is still an important problem in hospitalized children that is often underrecognized, follow-up studies evaluating post-discharge nutritional status of children with undernutrition are lacking. The aim of this multicentre prospective observational cohort study was to assess the rate of acute undernutrition (AU) and/or having a high nutritional risk (HR) in children on admission to seven secondary-care level Dutch hospitals and to evaluate the nutritional course of AU/HR group during admission and post-discharge. STRONGkids was used to indicate HR, and AU was based on anthropometric data (z-score < -2 for weight-for-age (WFA; <1 year) or weight-for-height (WFH; ≥1 year)). In total, 1985 patients were screened for AU/HR over a 12-month period. On admission, AU was present in 9.9% of screened children and 6.2% were classified as HR; 266 (13.4%) children comprised the AU/HR group (median age 2.4 years, median length of stay 3 days). In this group, further nutritional assessment by a dietitian during hospitalization occurred in 44% of children, whereas 38% received nutritional support. At follow-up 4-8 weeks post-discharge, 101 out of orginal 266 children in the AU/HR group (38%) had available paired anthropometric measurements to re-assess nutrition status. Significant improvement of WFA/WFH compared to admission (-2.48vs. -1.51 SD; p<0.001) and significant decline in AU rate from admission to outpatient follow-up (69.3%vs. 35.6%; p<0.001) were shown. In conclusion, post-discharge nutritional status of children with undernutrition and/or high nutritional risk on admission to secondary-care level pediatric wards showed significant improvement, but about one-third remained undernourished. Findings warrant the need for a tailored post-discharge nutritional follow-up.

Why Acute Undernutrition? A Qualitative Exploration of Food Preferences, Perceptions and Factors Underlying Diet in Adolescent Girls in Rural Communities in Nigeria.

Adolescent girls are nutritionally vulnerable due to their rapid growth and increased nutrient requirements. Nigeria has the sixth-largest population in the world. This study qualitatively explored the food preferences, perceptions of nutritive value and factors underlying food consumption of adolescent girls in rural communities in Nigeria. The data were collected via the free listing of foods and focus group sessions conducted in the Hausa language with 48 unmarried adolescent girls. The discussions were audio-recorded, transcribed, translated into English, and analyzed using a deductive thematic framework. The mean age of the respondents was 13.0 ± 2.7, and almost half (48%) had a primary school education. A total of 19 and 23 foods were identified as preferred, and perceived as nourishing, respectively. The top 10 foods present on both free lists overlapped considerably in terms of cognitive salience. The focus group themes included nutrition knowledge, food preferences, autonomy, household food allocation, courtship practices, and agricultural landscapes and economic access. The participants had minimal knowledge of nutrients and food groups, and their preferred foods were limited in diversity. The key factors in food preferences were desirable health effects, sensory attributes, and the contribution of foods to a desirable body image for marriage. Household food choices depended on parents. Thus, a desire for independence was an incentive for early marriage, mostly at 13 to 17 years. Gender inequities in household food distribution (quantity) and animal protein intake were reported. The participants believed that boys need more food for strength to impregnate girls. As part of a courtship practice, the girls received gifts of animal source foods from potential suitors. The food options were limited by financial challenges and low agricultural diversity. To interrupt the cycle of inadequate food consumption and undernutrition in these adolescent girls, policy makers need to promote nutrition education and address the underlying determinants of inequitable access to nutritious foods.

An analysis of the dual burden of childhood stunting and wasting in Myanmar: a copula geoadditive modelling approach.

To analyze the spatial variation and risk factors of the dual burden of childhood stunting and wasting in Myanmar. Analysis was carried out on nationally representative data obtained from the Myan-mar Demographic and Health Survey conducted during 2015-2016. Childhood stunting and wasting are used as proxies of chronic and acute childhood undernutrition. A child with standardized height-for-age Z score (HAZ) below -2 is categorized as stunted while that with a weight-for-height Z score (WHZ) below -2 as wasted. A nationally representative sample of households from the 15 states and regions of Myanmar. Children under the age of five (n 4162). Overall marginal prevalence of childhood stunting and wasting were 28.9% (95% CI 27.5, 30.2) and 7.3% (95% CI 6.5, 8.0) while their concurrent prevalence was 1.6% (95% CI 1.2, 2.0). The study revealed mild positive association between stunting and wasting across Myanmar. Both stunting and wasting had significant spatial variation across the country with eastern regions having higher burden of stunting while southern regions having higher prevalence of wasting. Child age and maternal weight-for-height Z score had significant non- linear association with both stunting and wasting while child gender, ethnicity and household wealth quintile had significant association with stunting. The study provides data-driven evidence about the association between stunting and wasting and their spatial variation across Myanmar. The resulting insights can aid in the formulation and implementation of targeted, region-specific interventions towards improving the state of childhood under-nutrition in Myanmar.

Incorrect Feeding Practices, Dietary Diversity Determinants and Nutritional Status in Children Aged 6-23 Months: An Observational Study in Rural Angola.

More than a quarter of children who are affected by severe acute undernutrition reside in Sub-Saharan Africa. Incorrect feeding practices have a negative impact on a child's health in both the short and the long term, and the interval from conception to two years is the most critical for the development of undernutrition-related complications. These first 1000 days of life also represent an "opportunity window" for early interventions, hence, having a clear insight into dietary habits and the determinants of diet quality is fundamental to improving nutritional counseling practices. To investigate incorrect feeding practices, dietary diversity determinants and nutritional status in children aged 6-23 months. Prospective quali-quantitative observational study conducted at the Missionary Catholic Hospital of Chiulo (Angola) from March to April 2023. Of 250 children, global acute malnutrition affected 25.2% and was associated with starting complementary feeding at <4 months of age (p = 0.007) and not achieving the minimum meal frequency (p < 0.0001). Minimum dietary diversity was found in 11.2%, minimum meal frequency was experienced by 72.8%, and the minimum acceptable diet was found in 11.2% of participants. The minimum dietary diversity was reached only by households with access to food from five or more major food groups (p = 0.007) or the money to buy food from five or more major food groups (p = 0.008) and was higher in households where the householder had a higher educational level (p = 0.002). Regarding the determinants linked to family traditions and beliefs, the main religion-associated beliefs concerned the impurity of pork (n = 25) and fish (n = 8), while eggs (n = 19) and cow milk (n = 8) were the main food types that were deemed harmful for children. Although some factors (economic and religious) may be difficult to overcome, other factors linked to erroneous beliefs (dangerous foods) or incorrect feeding practices (early weaning and an incorrect frequency of meals) can be targeted, to improve the effectiveness of nutritional counseling practices.

Implementation of STRONGkids for identifying nutritional risk in outpatients of child health care clinics: Results of a multicentre study

To investigate nutritional risk across children in their first 2 years at child health care clinics in Jiangsu, China, and to highlight the importance of nutritional risk screening in outpatient clinics. A multi-centre, cross-sectional, observational study was conducted among outpatients in child health care clinics. Nutritional risk screening using the STRONGkids tool and anthropometric assessments were performed on children under 2 years old at outpatient initial visits in ten hospitals from March 2021 to March 2022. There were 11,454 children enrolled. The percentages of children with high, moderate and low nutritional risk were 2.0% (228), 28.2% (3229) and 69.8% (7997), respectively. The occurrence rate of high nutritional risk was higher in female children than in male children (p<0.05). The incidence of moderate nutritional risk in infants was significantly higher than in children aged ≥12 months (p<0.01). Children with moderate or high nutritional risk more frequently answered 'yes' to the STRONGkids item 'high risk disease or major surgery planned'. The top three diagnoses related to nutritional risk were prematurity (50.5%), food allergy (14.3%) and recurrent respiratory disease (10.7%). In addition, the incidence of chronic undernutrition in children with moderate (14.0%) or high nutritional risk (36.4%) was significantly higher than acute undernutrition (p<0.01). Among children up to 2 years of age seen in child health clinics, nutritional risk associated with prematurity and potential disease requires special attention. Nutritional risk screening should be part of child health care, and STRONGkids is a useful screening tool.

Determinants of acute undernutrition among pregnant women attending primary healthcare unit in Chinaksen District, Eastern Ethiopia: a case-control study.

Women's undernutrition during pregnancy increases the risks and burdens of maternal and neonatal morbidity, death, and disability through its vicious cycles of irreversible intergenerational negative effects. Despite the high burden of maternal undernutrition during pregnancy in semi-pastoral communities of eastern Ethiopia, there is a paucity of information on its major risk factors. This study revealed determinants of acute undernutrition among pregnant women attending primary healthcare units in Chinaksen district in rural eastern Ethiopia. A facility-based case-control study was conducted among 113 cases and 113 controls in Chinaksen district from February 01 to March 30, 2017. Data were entered using EpiData version 3.1 and analyzed using SPSS version 24. Multivariable logistic regression analyses conducted to identify significant determinants of acute undernutrition. Adjusted odds ratio (AOR) with a 95% confidence interval was used to report the strength of association and statistical significance declared at p value<0.05. Sixty (53.1%) of cases and 56 (49.6%) of controls were in the age group of 25-34 years and their mean±SD age of cases and controls were 26.6±5.7 and 28±5.5 years, respectively. In this study, larger family size (AOR = 6.98, 95 CI [2.82-17.27]), lack of prenatal dietary advice (AOR = 3.68, 95% CI [1.67-8.00]), did not participate in a cooking demonstration (AOR = 5.41, 95% CI [2.39-12.24]), used substances (AOR = 3.65, 95% CI [1.30-10.23]), absence of basic latrine (AOR = 2.91, 95% CI [1.28-6.58]), low minimum dietary diversity of women (AOR = 2.48, 95% CI [1.20-5.12]), and household food insecurity (AOR = 3.06, 95% CI [1.44-6.51]) were significantly increased the odds of acute undernutrition among pregnant women. The study revealed that living in crowded families, lack prenatal dietary advice, did not participate in cooking demonstrations, substances use; lack of toilet, low minimum dietary diversity, and household food insecurity were significant risk factors for acute undernutrition among pregnant women. Strengthening multi-sectoral approaches through improving dietary diversity/quality and food access/quantity would be essential to prevent, and reduce the risks, burdens, and impacts of maternal undernutrition during pregnancy.

Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: a global analysis for selected adverse health outcomes

Assessments of disease burden are important to inform national, regional, and global strategies and to guide investment. We aimed to estimate the drinking water, sanitation, and hygiene (WASH)-attributable burden of disease for diarrhoea, acute respiratory infections, undernutrition, and soil-transmitted helminthiasis, using the WASH service levels used to monitor the UN Sustainable Development Goals (SDGs) as counterfactual minimum risk-exposure levels. We assessed the WASH-attributable disease burden of the four health outcomes overall and disaggregated by region, age, and sex for the year 2019. We calculated WASH-attributable fractions of diarrhoea and acute respiratory infections by country using modelled WASH exposures and exposure-response relationships from two updated meta-analyses. We used the WHO and UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene public database to estimate population exposure to different WASH service levels. WASH-attributable undernutrition was estimated by combining the population attributable fractions (PAF) of diarrhoea caused by unsafe WASH and the PAF of undernutrition caused by diarrhoea. Soil-transmitted helminthiasis was fully attributed to unsafe WASH. We estimate that 1·4 (95% CI 1·3-1·5) million deaths and 74 (68-80) million disability-adjusted life-years (DALYs) could have been prevented by safe WASH in 2019 across the four designated outcomes, representing 2·5% of global deaths and 2·9% of global DALYs from all causes. The proportion of diarrhoea that is attributable to unsafe WASH is 0·69 (0·65-0·72), 0·14 (0·13-0·17) for acute respiratory infections, and 0·10 (0·09-0·10) for undernutrition, and we assume that the entire disease burden from soil-transmitted helminthiasis was attributable to unsafe WASH. WASH-attributable burden of disease estimates based on the levels of service established under the SDG framework show that progress towards the internationally agreed goal of safely managed WASH services for all would yield major public-health returns. WHO and Foreign, Commonwealth & Development Office.

Undernutrition among children living in refugee camps: a systematic review of prevalence

ObjectivesThis review aimed to provide an overview of the prevalence of undernutrition in children under 5 years old in refugee camps according to the different indicators. In addition, we aimed...

Magnitude of undernutrition and associated factors among adult tuberculosis patients attending public health facilities in Haramaya District, Eastern Ethiopia

BackgroundTuberculosis is one of the top ten causes of illness, death, and disability throughout the world. Undernutrition reduces immunity, which makes latent tuberculosis more likely to become active tuberculosis. Tuberculosis makes these conditions worse. The body of a person suffering from TB has an increased demand for energy, which often causes a TB patient to lose a significant amount of weight and this can worsen acute undernutrition. The aim of this study was to assess the magnitude of undernutrition and its associated factors among adult TB patients in public health facilities in Haramaya district, eastern Ethiopia.MethodsInstitution-based cross-sectional study was conducted among 330 adult tuberculosis patients on follow-up in public health facility of Haramaya District, eastern Ethiopia from January 10, 2021 to February 20, 2021. An anthropometric assessment was done after a face-to-face interview using a pretested structured questionnaire. SPSS 24 was used to analyze the data. Bivariable and multivariable logistic regression model was used to identify factors associated with undernutrition.ResultsThe overall prevalence of undernutrition was 43.6% (95% CI 38.2–49.1%). Proportion of severe, moderate and mild undernutrition was 11.8%, 12.4%, and 19.4%, respectively. Age group of 18–24 years (AOR = 4.12; 95% CI 1.36–12.51), not have formal education (AOR = 1.76; 95% CI 1.01–3.08), having large family size (AOR = 2.62; 95% CI 1.43–4.82), low dietary diversity (AOR = 2.96; 95% CI 1.75–4.99), lack of latrine (AOR = 2.14; 95% CI 1.26–3.65), history of TB treatment (AOR = 2.56; 95% CI 1.19–5.54) and taking intensive phase of anti-TB drugs (AOR = 3.18; 95% CI 1.62–6.25) were factors found significantly associated with under nutrition.ConclusionThe prevalence of undernutrition was high. Age, educational status, family size, dietary diversity, toilet facility, history of tuberculosis medication and intensive phase of anti-TB drugs were found significantly associated with undernutrition. The nutritional derangement could call for fast nutritional intervention in the management of pulmonary tuberculosis patients.

Severe acute malnutrition and associated factors among children under-five years: A community based-cross sectional study in Ethiopia

BackgroundDespite consistent efforts to reduce child undernutrition, severe acute malnutrition (SAM) continues to be a serious obstacle to child survival and development in Ethiopia. This study aimed to identify severe acute malnutrition and associated factors among children aged 6–59 months in Ethiopia. MethodsA cross-sectional study was undertaken with 384 under-five children from February to March, 2020 in Ethiopia. A mid-upper arm circumference (MUAC) tape, weight scale, height board (standing) and recumbent length measurements (for children <24 months) were measured. To determine the variables associated with SAM, adjusted odds ratio was computed using multivariable analysis and p < 0.05 was declared as significant. ResultsThe prevalence of acute undernutrition was 26%; 18% and 8% of the children were moderately and severely undernourished, respectively. Family size (≥5 members) (AOR: 3.71, 95% CI: 1.55–8.89), younger age group (6–11 months) (AOR: 4.80, 95% CI: 1.61–14.31) and history of diarrhea in the two weeks prior to the survey (AOR: 5.36, 95% CI: 1.97–14.61) were independently associated with SAM in the study population. ConclusionLarge family size, child age, diarrheal and household insecurity were important determinants of SAM among children. Therefore, aligning social protection programmes and improving health related interventions along with improving optimal breastfeeding, prevention and control of child morbidity, and strengthening family planning services are recommended to reduce child SAM.

Association of trends in child undernutrition and implementation of the National Rural Health Mission in India: A nationally representative serial cross-sectional study on data from 1992 to 2015.

BackgroundIndia launched the National Rural Health Mission (NRHM) in 2005 to strengthen its primary healthcare system in high-focus and northeast-focus states. One of the NRHM objectives was to reduce child undernutrition in India.Methods and findingsWe used data from 1992, 1998, 2005, and 2015 National Family Health Survey (NFHS) of India to evaluate trends in child undernutrition prevalence before and after NRHM and across different categories of focus states. Stunting, Wasting, and Comprehensive Index of Anthropometric Failure (CIAF) were assessed using the World Health Organization (WHO) growth curves to assess chronic, acute, and overall undernutrition. The study included 187,452 children aged 3 years or under. Survey-weighted and confounder-adjusted average annualized reduction rates (AARRs) and predicted probability ratios were used to assess trends and socioeconomic disparities for child undernutrition, respectively. Nationwide, the prevalence of all types of undernutrition decreased from 1992 to 2015. However, the trends varied before and after NRHM implementation and differentially by focus states. After NRHM, acute undernutrition declined more rapidly among high-focus states (AARR 1.0%) but increased in normal-focus states (AARR −1.9% per year; p-value for the difference <0.001). In contrast, the prevalence of chronic undernutrition declined more rapidly (AARR 1.6%) in the normal-focus states in comparison to high-focus states (0.3%; p-value for the difference = 0.01). Income and caste-based disparities in acute undernutrition decreased but did not disappear after the implementation of the NRHM. However, similar disparities in prevalence of chronic undernutrition appear to be exacerbated after the implementation of the NRHM. Major limitations of this study include the observational and cross-sectional design, which preclude our ability to draw causal inferences.ConclusionsOur results suggests that NRHM implementation might be associated with improvement in wasting (acute) rather than stunting (chronic) forms of undernutrition. Strategies to combat undernutrition equitably, especially in high-focus states, are needed.

Determinants of severe acute malnutrition among children aged 6\u201336\xa0months in Kalafo district (riverine context) of Ethiopia

Malnutrition remains prevalent and existing health problem globally. Particularly Undernutrition is a major public health issue in developing countries. Globally the causes of severe acute undernutrition varies across context. The aim of this study was to identify the determinants of severe acute malnutrition to uncover contextual factors based on UNICEF conceptual framework, as there was no study done in a similar context in Ethiopia. Health facility based (health post) un-matched case control study with Key informant interview was conducted to identify determinant factors of severe acute malnutrition (SAM) among children between 6 and 36 months. 246 children (82 cases and 164) with their mothers or care takers participated the study which was conducted between December 20, 2019 to January 20, 2020 in Kalafo district in Shebele River. Odds ratio with 95% confidence interval was calculated to identify the determinants of SAM among children aged 6–36 months using multivariate logistic regression. The odds of severe acute malnutrition was 2.28 (1.22, 4.26); 4.68 (2.29, 9.58); 2.85 (1.26, 6.45); 2.39 (1.16, 4.96) and 3.262 (1.46, 7.31) and 3.237 (1.45, 7.23); respectively for mothers with three or more under five children, Children with inadequate dietary diversity, experienced diarrhea in past 2 weeks, their mothers had not nutrition counselling during pregnancy and younger (6–11 and 12–17 months) children as compared to controls. The finding of this study reveals the main determinants of severe acute malnutrition in riverine context are multi-level. In addition to this, poor childcare and polygamy identified in qualitative finding. Decisive and multi-sectoral approach is required to addressing SAM in the riverine area.

Households' Food Insecurity and Their Association With Dietary Intakes, Nutrition-Related Knowledge, Attitudes and Practices Among Under-five Children in Gaza Strip, Palestine.

The present study aimed to determine the households' food insecurity and their association with dietary intakes, nutrition-related knowledge, attitudes and practices (KAP) among under-five children in the Gaza Strip, Palestine. This cross-sectional study was conducted in 2021 among a representative sample of under-five children. A total of 350 children and their proxy were selected from all Gaza strip governorates, using a cluster random sampling method. The Radimer/Cornell food-security scale was used. A 24-h dietary recall was employed for dietary intakes assessment. Nutrition-related KAP for feeding under-five children, anthropometric measurements, and demographic-socioeconomic characteristics were obtained with an interview-based questionnaire. Statistical analysis was performed using SPSS version 25. The children from food-insecure households had a high prevalence of moderate underweight (30.4%), stunting (32.8%), wasting (9.6%), and acute undernutrition (30.4%). Between food-insecure and food-secure groups there were significant differences in weight, height/length, mid-upper arm circumference, weight-for-age and mid-upper arm circumference z-scores, underweight, acute undernutrition, intakes of protein, fat, vitamin D, zinc, continued breastfeeding, having nutrition-related adequate knowledge, having nutrition-related positive attitudes, and achieved minimum dietary diversity score (P < 0.05 for all). Additionally, about (56.0%) food-insecure households have inadequate nutrition-related knowledge, (77.6%) have nutrition-related negative attitudes, and (95.2%) did not achieve a minimum dietary diversity score. In conclusion, the children from food-insecure households had a high prevalence of moderate underweight, stunting, wasting, and acute undernutrition. Moreover, low economic status, poor dietary intakes, low levels of nutrition-related KAP, and lack of dietary diversity could contribute to the high levels of food insecurity among under-five children.

Early life migration and undernutrition among circular migrant children: An observational study in the brick kilns of Bihar, India.

BackgroundIndia holds the world's largest burden of chronic and acute child undernutrition. Poverty and systemic inequities are basic causes of undernutrition that also drive households to engage in circular migration for livelihood. Short-term, temporary movement of the whole family, including young children, is common; yet, the nutritional implications of recurrent movements beginning in early life has not been studied. We sought to estimate the association of repeat and early life migration with stunting and wasting outcomes among circular migrant children under three.MethodsUsing a stratified cluster design, we conducted two waves of primary data collection among 2564 randomly selected circular migrant children under three years of age temporarily residing across 1156 brick kilns in Bihar, India. We conducted multilevel modeling to estimate the association of the number of migration episodes and age at first migration with stunting (<-2 standard deviations (SD) height-for-age z scores (HAZ)) and wasting (<-2 SD weight-for-height z-scores (WHZ)) and examined the determinants of nutrition status among migrant children, including diet, illness, food security and the health environment.ResultsThe overall prevalence of stunting was 51.6%. Among children who were either born during migration or first migrated before six months of age, those who experienced multiple episodes of migration were more likely to be stunted compared to those who migrated once (adjusted odds ratio (aOR) = 2.10; 95% confidence interval (CI) = 1.30-3.41). Children were over three times as likely to be wasted in the summer compared to the winter (aOR = 3.28; 95% CI = 2.68-4.01); in the summer, the overall prevalence of wasting was 38.8%. Public health access indicators such as interaction with frontline health workers at the destination was low (5.3%), whereas feeding indicators such as exclusive breastfeeding among 0-5 months was high (81.1%).ConclusionsPolicy efforts should ensure continuity of social protection and welfare entitlements between home and destinations for circular migrant families, with an explicit focus on rural-to-rural movement.

Underweight and associated factors among children under five years in North Shewa Zone, Oromia, Ethiopia: An observational community-based study

Background: Acute and chronic child undernutrition is a continuous problem in Ethiopia. Therefore, this study was initiated to compare the prevalence of underweight and its associated factors among children aged 6-23 months in the Kuyu district, North Shewa zone, Oromia, Ethiopia. Methods: An observational community-based study was conducted on 612 children (304 from household security and 308 from household food insecurity). A structured and standardize questionnaire was used in this study. Anthropometric measurements were generated using WHO standardize. Data was analyzed using SPSS version 20.0. Bivariate and multivariate logistic regression analysis was used to identify the independent variables associated with underweight (weight-for-age) among children in household food security and insecurity, a p value less than 0.05 with 95%CI was considered as statistically significant. Results: The results indicated that 30.9% [95%CI; 25.7, 36.2] and 36.7% [95% CI; 31.8, 42.5] of children were underweight for their age in household food security and insecurity. Low wealth status (AOR=3.2; 95%CI: 1.099, 9.275), poor dietary diets (AOR=5.2; 95%CI: 2.046, 13.27), and lack of breastfeeding for two years (AOR= 2.1; 95%CI= 1.78, 5, 42) were associated with underweight children in household food security. Whereas lack of antenatal care visits (AOR=0.52; 95%CI: 0.12, 0.68) and poor dietary diets (AOR=3.01; 95%CI= 2.1, 17.4) were other independent variables associated with underweight children in household food insecurity. Conclusions: This study established that there was a high prevalence of underweight in children from Oromia. Therefore, introducing household income generating activities are vital interventions in order to overcome the problem of undernutrition in this region.

Évolution du statut nutritionnel d’une cohorte d’enfants tunisiens au cours de l’hospitalisation : facteurs de risque de la dénutrition hospitalière

ObjectivesStudy the evolution of the nutritional status of a cohort of hospitalized children and identify the risk factors of hospital malnutrition. MethodsProspective, cross-sectional study carried out in a pediatric department over a period of six months, including all children aged≥30days, hospitalized for a period≥six days. Anthropometric data were assessed on admission and discharge. Food consumption was assessed using the flower tool. We identified the risk factors for hospital undernutrition (HUN) by multivariate analysis. ResultsWe included 120 patients with a mean age 46.3months. The prevalence of acute undernutrition at admission was 21.7% and that of chronic undernutrition was 10%. The prevalence of acute undernutrition at discharge rose to 34%. Weight loss during hospitalization was noted in 68.3% of cases. The prevalence of HUN was 55% considering a decrease in BMI or P/PAT z-score≥25%. The risk factors for HUN were: age≤24months (P=0.039; OR 95% CI=2.67 [1.05–6.82]), the presence of undernutrition on admission (P=0.002; OR 95% CI=2.32 [0.93–6.51]) and average food consumption<50% during hospitalization (P<10−3; OR 95% CI=6.69 [2.57–17.40]). ConclusionScreening for undernutrition on admission to hospital as well as assessment of the nutritional risk in hospitalized children is essential so that preventive or curative nutritional care can be taken.

Biological Markers of Undernutrition and Risk of Complications in Children Hospitalized at the Teaching Hospital of Brazzaville

Introduction: Undernutrition is a condition frequently encountered in pediatrics. It leads to an increased morbidity and mortality regardless of the underlying condition or other risk factors such as age. In countries with limited resources such as ours, the diagnosis of undernutrition is often limited to the clinical presentation, and the contribution of biology is not often taken into account. Objectives: To establish the relationship between anthropometric parameters and biological markers in the diagnosis and classification of undernutrition and to assess the risk of infectious complications during undernutrition in children. Materials and Methods: A cross-sectional study conducted in Brazzaville among undernourished children aged 1 - 59 months between October 2018 and April 2019. Clinical diagnosis was based on WHO growth charts. The CRP, orosomucoid, albumin and transthyretin were obtained using the Cobas c311 analyzer, which enabled the calculation of Prognostic Inflammatory and Nutritional Index (PINI). The comparison of the means of the biological markers used the Student’s t-test, the risk of infectious complications the chi-square. The correlation of the diagnostic value of Z-score weight/height and PINI was also investigated. The significance level was set at 0.05. Results: Of the 95 children enrolled 63 (66.3%) were clinically severely malnourished, including 26 acute (41.3%) and 37 chronic (58.7%). The PINI revealed severe undernutrition in 85 children (89.4%) including 50 acute (58.8%) and 35 chronic (41.2%). CRP and orosomucoid were statistically higher in severe acute undernutrition (p < 0.001). Serum albumin levels varied between severe and non-severe undernutrition only in the acute form (p < 0.001); transthyretin was decreased to a lesser degree (p < 0.05) in both forms of undernutrition. All children with severe undernutrition were at risk of infectious complications (p < 0.05). PINI had a positive predictive value for the detection of severe undernutrition of 87%. Conclusion: Anthropometric parameters have a front-line advantage for assessing and classifying undernutrition. However, biological markers of undernutrition with PINI should be systematized in the diagnosis and management of undernutrition.