Anthropometric Failure Research Articles

Examining the changing profile of undernutrition in the context of food price rises and greater inequality

This paper examines how the profile of undernutrition among children in two African countries (Ethiopia and Nigeria) changed over the period of the 2007/08 food, fuel and financial crisis. Using the Composite Index of Anthropometric Failure (CIAF), an indicator which allows for a comprehensive assessment of undernutrition in young children, we examine what changes occurred in the composition of undernutrition, and how these changes were distributed amongst children in different socio-economic groups. This is important as certain combinations of anthropometric failure (AF), especially the experience of multiple failures (dual and triple combinations of AF) are associated with higher morbidity and mortality risks, and are also related to poverty. Our hypothesis is that increases in food prices during the crisis contributed to an increase in inequality, which may have resulted in concurrent increases in the prevalence of more damaging forms of undernutrition amongst poorer children. While both countries witnessed large increases in food prices, the effects were quite different. Ethiopia managed reduce the prevalence of multiple anthropometric failure between 2005 and 2011 across most groups and regions. By contrast, in Nigeria prevalence increased between 2008 and 2013, and particularly so in the poorer, northern states. The countries studied applied quite different policies in response to food price increases, with the results from Ethiopia demonstrating that protectionist public health and nutrition interventions can mitigate the impacts of price increases on poor children.

Nutritional assessment among children (under five years of age) using various anthropometric indices in an urban area of district Rohtak, Haryana, India

Background: Reduction in child malnutrition is another MDG related to an improvement in child welfare. For India, this would imply a reduction in the child underweight rate from 54.8% in 1990 to 27.4% in 2015. National data on underweight provided under NFHS-3 (National Family Health Survey) (2005-06) revealed underweight prevalence rate around 40%. Methods: This cross sectional study was conducted in an urban area of district Rohtak during the months of January to March 2014 among children which were under five years of age. The anthropometric measurement and nutritional status categorization among children was done using WHO guidelines. Results: A total of 654 children participated in study. Around 32% of study participants were having stunting as there nutritional status while taking Composite Index of Anthropometric Failure for nutritional status into consideration nearly 45% participants were undernourished. The stunting and underweight were more prevalent among girls. Conclusion: Composite anthropometric index provides the actual prevalence or proportion of undernourished children in a community. So the policies should be based on the basis of Composite Index of Anthropometric Failure so to reduce the prevalence of under-nutrition in the community more effectively.

No Female Disadvantage in Anthropometric Status among Children in India

Female disadvantage in child mortality, intra-household allocation of food and coverage of health interventions has been shown to exist in India. At the same time, there has been limited examination of female disadvantage in nutritional status. Using measures of anthropometry and anthropometric failure, we study female disadvantage in child nutritional status from the data collected from the Indian National Family Health Survey (NFHS) undertaken in 1992–1993 and 2005–2006. Height and/or weight measurements were available on 70,148 children aged 0–47 months in both survey periods. Child anthropometry (height/length-for-age [HAZ], weight-for-age [WAZ], weight-for-height/length [WHZ]) and anthropometric failure (defined according to the 2006 WHO growth standards as stunting, wasting and underweight) were analysed using linear and logistic regression models. In pooled regression models, boys were more likely to have lower anthropometric scores and higher rates of anthropometric failure. Across survey periods, the change in anthropometric status was greater for boys compared to girls for WAZ/underweight and WHZ/wasting, but was similar for HAZ/stunting. Boy–girl differences in anthropometry (with boys doing worse) were greater at less than 24 months of age and narrowed over time particularly in the 0–5 and 6–11 month age groups, resulting in no gender differences in anthropometric status. Declines in anthropometric status in HAZ/stunting and WAZ/underweight were found among third or higher birth order boys and girls, especially within families with two preceding children of the same sex but also in households with preceding children of mixed genders, suggesting a birth order effect as opposed to a birth order and gender effect. In 1992–1993 and 2005–2006, levels of anthropometric failure were higher among boys compared to girls in a majority of states. Although girls had lower levels of anthropometric failure, the magnitude of the between survey period decline was higher in girls in fewer states compared to boys (5/20, 7/25 and 10/20 states for stunting, underweight and wasting, respectively). In summary, in the most recently available data, using measures of anthropometric status, we did not find consistent evidence for female disadvantage in nutritional status among girls in India.

Individual and Ecological Variation in Child Undernutrition in India

Despite the substantial burden of child undernutrition in South Asia, little is known on the relative importance and contribution of individual and micro/macro environments in shaping variation in child undernutrition. Using measures of anthropometry, we decompose the variation in child undernutrition in India to the levels of child, communities and states, quantifying the extent to which variation at each of these levels can be explained by known proximal and distal risk factors, measured at the individual (child/household) level. Data are from under-five singleton children participating in the 2005–2006 National Family Health Survey (NFHS-3). The outcome variables were: height-for-age z-score (HAZ), weight-for-age z-score (WAZ) and weight-for-height z-score (WHZ), as well as their associated measures of anthropometric failure: stunting, underweight and wasting, defined as more than two standard deviations below the median of the referred z-scores, respectively. We also considered the composite index of anthropometric failure (CIAF), defined by combinations of child anthropometric failure. After accounting for risk factors, of the total variation in HAZ, 93.2 per cent, 4.9 per cent and 1.9 per cent were attributable to the individual, community and state levels, respectively. The observed risk factors explained 6.3 per cent and 46.9 per cent of the variation at the individual and community level, respectively; however, between-state variation was not explained by these risk factors. Variability in other measures of anthropometry and anthropometric failure largely followed this pattern. Additionally, there were also considerable differences in the amount of variation at the individual and community levels among different states. Hence, there is a substantial variability at the community level compared to the state level, suggesting the presence of micro-geographies of undernutrition. Additionally, while a substantial majority of the variation in child undernutrition is at the individual level, our ability to explain variability in undernutrition at the individual-level risk factors is extremely limited. Further research is needed to explore community level or environmental factors affecting child undernutrition, generating evidence for policies to target these determinants.

Burden of Undernutrition, Composite Index of Anthropometric Failure (CIAF) and Perception of Caregivers about Undernutrition among Under Five Children in Rural India

Undernutrition interferes with growth and development of a child and may predispose to infection and/or chronic disease. The present study was undertaken to assess the nutritional status of under five children by the 2006 WHO growth standards; Composite Index of Anthropometric Failure (CIAF) which is a single aggregate indicator of undernutrition was calculated and the perception of caregivers about undernutrition and child development of a child were assessed. A cross sectional study was conducted in rural children in North India. Anthropometry was done according to the standard procedures. Overall, 938 children were included in the study. The prevalence of under nutrition was 25.3 % (22.4-28.1). CIAF showed a higher prevalence of undernutrition with 53.1% of the children suffering from anthropometric failure. The prevalence of stunting was highest in 36-47 months. There was a significant association between undernutrition and low literacy status of mother, duration of pregnancy, administration of pre lacteal feeds and time of initiation of weaning. More than half of the caregivers perceived that undernutrition was due to disease (55.5%), lack of food (35.5%) or congenital (31.6%). There was a high prevalence of undernutrition among rural under five children in North India. There was a lacuna in knowledge of caregivers about the causes of undernutrition and delayed development.

Nutritional status among boys and girls of a central Indian Town (Sagar)

The prevalence of undernutrition is a significant area of concern in many developing countries, where it is a major public health problem. The aim of the study was to assess the prevalence of undernutrition among school-going boys and girls of central Indian city Sagar, MP. A total of 612 individuals (312 girls and 300 boys) aged 5–18 years were examined and compared to the NCHS reference data. The nutritional status was assessed using following anthropometric indicators: body height and weight, body mass index (BMI) and composite index of anthropometric failure (CIAF). It was found that girls were heavier (1 kg) and taller (2–5 cm) than boys up to 15 and 13 years of age, respectively. After that, boys became taller with 1 to 13 cm. The mean BMI of boys was higher to girls up to 10 year of age after that the trend was reversed. Comparison of the present findings with NCHS reference data revealed that Indian girls and boys were lagging behind. The difference in body weight between the reference data and the present sample was around 5 to 6 kg. The pattern of difference in body height revealed small amount during early childhood (6.6.cm and 9.6 cm in girls and boys 5 years of age). This difference more than doubled at the age of 14 years in girls 16.7 cm and in boys 17.5 cm (p<0.01). Similar pattern was found for BMI with 6.5 kg/m2 and 6.3 kg/m2 in 14 years old girls and 16 years old boys (p<0.01). Z-score values of weight-for-age, height-for-age and BMI-for-age revealed that that boys were more likely to be stunted than girls whereas girls were more likely to be underweight and undernourished than boys. In terms of CIAF 10.6% girls and 10% boys were undernourished. The results of the present study indicate that there is great need for implementation of health programmes to eliminate gender inequalities and improve children’s health.

Short-term and long-term associations between household wealth and physical growth: a cross-comparative analysis of children from four low- and middle-income countries

BackgroundStunting, a form of anthropometric failure, disproportionately affects children in developing countries with a higher burden on children living in poverty. How early life deprivation affects physical growth over various life stages is less well-known.ObjectiveWe investigate the short- and long-run associations between household wealth in early life with physical growth in childhood in four low- and middle-income countries to understand the persistent implications of early life conditions of poverty and resource constraints on physical growth.DesignLongitudinal study of eight cohorts of children in four countries – Ethiopia, India, Peru, and Vietnam (n=10,016) – ages 6 months to 15 years, using data from the Young Lives project, 2002–2009. Physical growth outcomes are standardized height-for-age z-scores (HAZ) and stunting. The key exposure is household wealth measured at baseline using a wealth index, an asset-based indicator. Covariates include child's age and sex, caregiver's educational status, household size, and place of residence.ResultsBaseline wealth index is significantly associated with higher physical growth rates as suggested by higher HAZ and lower odds of stunting. We found these associations in all four countries, for younger and older cohorts and for children who experienced changes in living standards. For the older cohort, despite the timing of the first survey at age 7–8 years, which is beyond the critical period of 1,000 days, there are lasting influences of early poverty, even for those who experienced changes in wealth.ConclusionsHousehold wealth in early life matters for physical growth with conditions of poverty and deprivation influencing growth faltering even beyond the 1,000 days window. The influences of early childhood poverty, so prevalent among children in low- and middle-income countries, must be addressed by policies and programs targeting early life but also focusing on older children experiencing growth faltering.

Composite index of anthropometric failure and its important correlates: a study among under-5 children in a slum of Kolkata, West Bengal, India

Background: In India, undernutrition remains a major public health problem despite several national programs targeting vulnerable groups, especially children. Objectives: To assess the nutritional status and morbidity profile of under-5 children and to elicit the explanatory and contextual factors of this malady. Materials and Methods: An observational, cross-sectional, descriptive study was conducted among under-5 children in a slum area of Kolkata, West Bengal, India. Anthropometric measurements were made following standard operative procedures and recall period of morbidity profile of last 2 weeks was recorded. Results: Of total 100 under-5 children assessed, the mean (standard deviation) of the sample was 23.52 (15.65) months. About 55% children were found to have anthropometric failure using composite index of anthropometric failure. However, with standard anthropometric indices such as weight for age, weight for height, height for age, and mid upper arm circumference prevalence of malnutrition were 42% (underweight), 30% (wasting), 28% (stunting), and 48% (undernutrition), respectively. About 48% children had some kind of morbidity of which acute respiratory infection accounted for 9%, diarrhea 11%, fever 9%, and skin infection 6%. Age [OR = 5.17 (2.09–12.76)], family type [OR = 4.11 (1.77–9.49)], literacy of mother [OR = 15.79 (5.98–42.35)], birth weight [OR = 4.2 (1.74–10.13)], birth order [OR = 5.25 (1.41–19.51)], and morbidity profile [OR = 6.35 (2.62–15.36)] are significantly associated with nutritional status. Conclusion: Accelerating the reduction in under-5 mortality is possible by expanding effective preventive and curative interventions that target the main causes of undernutrition. All efforts must be made to improve the nutritional status of the children. This will in the long run help in making this nation healthier, stronger, and more prosperous.

Are we Underestimating the Real Burden of Malnutrition? An Experience From Community-Based Study.

Background:Since the inception of childhood nutritional programs in India, underweight has been taken to judge the nutritional status of children; but is it a true indicator of overall prevalence of malnutrition in a community?Objective:To estimate the overall prevalence of malnutrition by using Composite Index of Anthropometric Failure (CIAF) and to assess its usefulness over various conventional anthropometric indicators among under 5 children residing in Agra city.Materials and Methods:A cross-sectional, community-based study was conducted among under 5 years age children, from June 2012 to July 2013 in an urban slum of Agra. Nutritional status was assessed using anthropometry and clinical examination, and classified as per World Health Organization (WHO) 2006 Growth Standards and CIAF.Results:Of the 458 children studied, 42.8% were underweight, 41.9% had stunting, while 22.7% had wasting. However, 60.04% of children were found to be malnourished as per the CIAF. Unlike three conventional anthropometric indicators of malnutrition, CIAF was observed to have a much consistent association with morbidity like diarrhea episodes in past 3 months (odds ratio (OR) = 2.09), acute respiratory tract infection (ARI) episode in past 3 months (OR = 1.58), and any illness requiring hospitalization (OR = 1.29).Conclusion:The CIAF should supplement the conventional indices of malnourishment, to provide a single, aggregated figure of actual number of undernourished children in a given population.

Assessment of Under Nutrition Using Composite Index of Anthropometric Failure (CIAF) amongst Toddlers Residing in Urban Slums of Raipur City, Chhattisgarh, India.

Several indicators have been used for measurement of under nutrition in the past. They are overlapping and none individually provide a comprehensive number of under nourished in the community. The effort has been to discuss the use of an alternative indicator of malnutrition - the composite index of anthropometric failure (CIAF). To study the prevalence of under nutrition of Toddlers using CIAF and compare the prevalence of under nutrition obtained by primitive indicators and CIAF. Cross-sectional community based study was carried out in urban slums of Raipur (C.G) during Jan 01,2014 to Sept 30, 2014 using sample size of 602. Slums were selected by multistage random sampling and the subjects were selected by convenient sampling, i.e. starting from a random point house to house survey was carried out until desired number of subjects (According to PPS) were covered assuming that slum population is evenly distributed. Attendant of Toddlers were interviewed with semi structured proforma and Height and Weight were measured by measuring tape and Salter's weighing machine respectively. Informed consent was obtained. MS excel was used for data analysis after compilation. Girls and boys were 50% each. By CIAF the prevalence of under nutrition was found to be 62.1% while, Underweight, Stunting and Wasting showed it to be 45.2%, 46.6% and 17.8% respectively. Primitive indices under estimate the burden of under nutrition and CIAF should be used a screening tool for assessing under nutrition.

Determinants of malnutrition in Indian children: new evidence from IDHS through CIAF

The purpose of this paper is to highlight the determinants of malnutrition in children (under 5 years) in urban and rural areas of India. The ultimate objective is to frame policy proposals for children’s nutritional welfare. In this empirical study, logit model is applied to 9,381 observations of urban and 18,418 of rural areas. The composite index of anthropometric failure is constructed to use it as an indicator of malnutrition. The results revealed that probability for anthropometric failure increases by age, birth-order and duration of breastfeeding. The birth-interval, delivery of the child in hospital, wealth index of the household, mother’s BMI and mother’s education turned out to be negatively affecting children’s malnutrition in both urban and rural areas. Gender of the child has no significant effect on malnutrition in both urban and rural communities. From the policy perspective enlarging the birth-interval through family planning programs and squeezing the duration of breastfeeding by giving supplement food at subsidized rates may contribute to enhance children’s nutritional status. For the long-run socioeconomic status of the household and BMI of mothers require attention of policy makers. To break the intergenerational cycle of malnutrition, the nutritional status of today’s girls in the age of adolescent is recommended to be improved. The findings of study may support academicians, policy makers and social activists for human development programs in India.

Índice compuesto de fracaso antropométrico y altura geográfica en infantes jujeños (1-5 años)

The Composite Index of Anthropometric Failure (CIAF) is made up of typical anthropometric indicators and their combination into seven categories, and proposes an additional measure to study malnutrition as an alternative to the evaluation of stunting, wasting and underweight as separate measures. To assess the CIAF in the child population settled at different altitudinal zones in Jujuy. Weight and height were obtained from healthy 1 to 5 year-old control children, measured at primary healthcare centers (PHCCs) in Jujuy between 2005 and 2007. Nutritional status indicators such as underweight, stunting and wasting were determined as per the World Health Organization 2007 child growth standards. The CIAF and its seven categories were estimated by grouping data by gender, age and altitudinal zone (highlands: >2500 MASL; lowlands: <2500 MASL). The CIAF percentage differences for height, gender and age were verified using a chi-square test. A total of 8059 children were included. The CIAF for highland children (6.1%) doubled that for lowland children (3.4%) (p < 0.05), and underweight prevalence (group Y) was significantly higher in the highlands (p < 0.05). The CIAF value and stunting (group F) increased with age, but such increase was more significant in the highlands. A significantly higher CIAF was observed in highland children, at the expense of stunting. However, the index of anthropometric failure was not more than 10% at both the highlands and the lowlands, and this accounts for a scarcely significant malnutrition health status in the studied child population of Jujuy.

An epidemiological study of urban and rural children in Pakistan: examining the relationship between delayed psychomotor development, low birth weight and postnatal growth failure.

Low birth weight is known to be associated with postnatal growth failure. It is not yet established that both conditions are determinants of psychomotor development. The study investigated whether or not low birth weight leads to delayed psychomotor development of a child, and whether it can be mitigated by adequate postnatal growth. A cross-sectional study was conducted in 2002 in 15 rural and 11 urban communities of Sindh province, Pakistan. Assessment of 1234 children less than 3 years of age included Bayley's Scale of Infant Development II, socioeconomic questionnaire and anthropometry; WHO standards were used to calculate z-scores of height-for-age, weight-for-height and weight-for-age. The underlying study hypotheses were tested through multiple regression modelling. Out of 1219 children, 283 (23.2%) had delayed psychomotor development and 639 (52.4%) were undernourished according to the composite index of anthropometric failure. Strong negative associations with the psychomotor development index were detected between stunting and being underweight, with a larger magnitude of effect for stunting (p<0.001). The strong relationship persisted even when the analysis was restricted to non-malnourished children. The psychomotor index increased by 2.07 points with every unit increase in height-for-age z-score. The relationship between low birth weight and psychomotor development appears to be mediated largely by postnatal growth and nutritional status. This association suggests that among undernourished children there is significant likelihood of a group that is developmentally delayed. It is important to emphasize developmental needs in programmes that target underprivileged children.

Nutritional Status and its Correlates Among Tribal Children of Melghat, Central India

To find out the magnitude and epidemiological determinants of malnutrition among 0-6 y tribal children. A community based cross sectional study was done in the villages of Melghat in central India. The information of 540 children in the age group 0-6 y was collected. The newly developed WHO growth standards were used to calculate conventional indices of malnutrition (underweight, stunting and wasting) and composite index of anthropometric failure (CIAF). Univariate and multiple logistic regression analysis were used to find out the correlates of malnutrition. The prevalence of malnutrition among these tribal children in terms of underweight, stunting, and wasting were 60.9 %, 66.4 % and 18.8 % respectively. Malnutrition in terms of composite index of anthropometric failure (CIAF) was 76.3 %. The important correlates of malnutrition that emerged out of this study were the age of child, age of mother less than 20 y at her first pregnancy, practice of not feeding colostrum, calorie deficit diet, anemia and morbidities like diarrhea and acute respiratory illnesses. The prevalence of malnutrition was high in tribal children. The health care delivery at village level should be strengthened for early diagnosis and prompt treatment of anemia and other morbidities in children. The strategies are needed to delay the child bearing age in this community and improve breast feeding practices.

A survey of undernutrition in children under three years of age in rural Western China

BackgroundChildhood undernutrition adversely impacts child health and is one of China’s largest health burdens. However, there is limited information on the current rate of childhood undernutrition in rural Western China. The purpose of this study was to investigate the prevalence of childhood undernutrition and explore its association with socio-economic characteristics in Western China.MethodsA total of 13,532 children of 0 ~ 36 months of age were recruited as subjects from 45 counties and 10 provinces in Western China with a 3-stage probability proportion to size sampling. The composite index of anthropometric failure (CIAF) was used to assess the childhood undernutrition. The association between socio-economic characteristics and childhood undernutrition was analyzed using a two-level logistic regression.ResultsBased on CIAF, the prevalence of undernutrition among children under three years of age in rural Western China in 2005 was 21.7%. The two-level logistic analysis presented a large difference in undernutrition among the 10 provinces with the highest odds ratio in Guizhou (OR: 2.15, 95%CI: 1.50, 3.08). Older children had a higher prevalence of undernutrition. As compared to girls, boys were more likely to be undernourished (OR 1.27, 95% CI: 1.16, 1.39). The likelihood of undernutrition was lower in subjects of Han ethnicity as opposed to subjects of minority ethnicities (OR 0.77, 95%CI: 0.65, 0.90). In addition, the education levels of the mother as well as wealth index were both negatively associated with childhood undernutrition.ConclusionsChildhood undernutrition still remains a large health challenge in rural Western China. This study has important policy implications for the Chinese government to improve childhood undernutrition in the surveyed areas.

Undernutrition and anaemia among HAART-naïve HIV infected children in Ile-Ife, Nigeria: a case-controlled, hospital based study.

IntroductionCase control studies that assess the burden and factors associated with undernutrition and anaemia among HAART naïve HIV infected children in Nigeria is very sparse. This will help to formulate nutritional programs among these children.MethodsSeventy HAART naive HIV infected children aged 18 months and above were as well as seventy age and sex matched HIV negative children were recruited from August 2007 to January 2009 at Paediatric Clinic of Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. Their bio data, WHO clinical stage, anthropometric measurements, haematocrit, serum albumin and CD4 counts were taken with other parameters according to a study proforma.ResultsThe prevalence of stunting, underweight and wasting among the HIV infected subjects were 48. 6%,58. 6% and 31. 4% respectively which as significantly higher than 28. 1%, 7. 1% and 28. 1% among the HIV negative controls. 20. 1% of the HIV infected children were marasmic compared to 2. 3% of the controls. Triple anthropometric failure was found in 7. 1% of the subjects as compared to none among the controls. Anaemia is significantly more prevalent among the subjects than the controls (70. 0% vs 31. 4%; p<0. 001). The prevalence of anaemia was higher in the HIV infected subjects with undernutrition. Low socioeconomic status, hypoalbuminemia and severe immunosuppression are significantly associated with higher undernutrition prevalence.ConclusionSeveral years after availability of HAART, undernutrition and anaemia remain widely prevalent among newly presenting HAART naïve HIV infected Nigerian children. Nutritional supplementation and evaluation for anaemia still need close attention in the management of these children.

Overall burden of under-nutrition measured by a Composite Index in rural pre-school children in Purba Medinipur, West Bengal, India

Malnutrition is a leading cause of child mortality in India. To counteract this problem, a nutrition supplementation programme has been operating under the Integrated Child Development Service (ICDS) scheme in India since 1975. Recently, the Composite Index of Anthropometric Failure (CIAF) has been implemented to measure the seriousness and severity of overall under-nutrition in a population. Since this index presents a more complete picture than the previous three conventional measures. CIAF is utililized in this study which focuses on the overall burden of under-nutrition determination in pre-school children in Purba Medinipur, West Bengal, India. Our study was conducted in 10 Integrated Child Development Service (ICDS) centres, commonly known as “Anganwadi”, in the villages of the Argoal Gram Panchayat at Patashpur – II block. The total sample of 225 Bengalee ethnic children aged between 3 and 6 years was composed of 115 girls and 110 boys. The overall age and gender-combined prevalence of stunting, underweight and wasting recorded was 30.7%, 42.7% and 12.0%, respectively, and these rates were considered high (30–39%), very high (≥ 40%) and high (10–14%), respectively. CIAF results revealed the same trend, with 50.2% of these children affected by anthropometric failure, with the prevalence of underweight, wasting and CIAF higher in boys than in girls. This 50.2% CIAF result highlighted that approximately half the study children were undernourished. Since this figure is much higher than that estimated by any of the three conventional indicators,, CIAF has thus proven a far better indicator in assessing the overall burden of under-nutrition in a population. The nutritional status of the children in this study requires serious remedial action.

Relation of oxidative stress, zinc and alkaline phosphatase in protein energy malnutrition

Objective: To determine serum zinc (Zn), total anti-oxidant capacity (TAC), malondialdehyde (MDA), alkaline phosphatase (ALP) and albumin in protein energy malnutrition (PEM) and to analyse the appropriateness of using low weight-for-age for detecting childhood under-nutrition.Methods: This study comprised 455 children (355 malnourished and 100 normal). They were classified according to the Nutrition Subcommittee of Indian Academy of Pediatrics, Z-Score Classification and Composite Index of Anthropometric Failure. Serum Zn, TAC, MDA, ALP and albumin levels were determined.Results: The serum Zn, TAC, ALP and albumin levels were found to be significantly decreased and MDA levels were significantly increased in malnourished children as compared with control (P < 0.001).Conclusion: The significant increase in serum MDA concentration associated with the decrease in serum TAC, Zn and ALP in malnourished children suggest that these children were potentially susceptible to high oxidative stress. Current study also suggest that conventional measures of detecting under-nutrition (low weight-for-age) may be missing out a considerable proportion of undernourished children present in the population.

Role of new anthropometric indices, validity of MUAC and Weech’s formula in detecting under-nutrition among under-five children in Karnataka.

Background and Objective: There should be one comprehensive measure or index which can represent the overall prevalence of under-nutrition of all three forms (underweight, wasting and stunting). Composite index of anthropometric failure is one such indicator, proposed by Svedberg. Three new indices namely UI, WI and SI has also been proposed and used. The advantage of use of MUAC is its simplicity. Weech’s formula is an age old formula used by clinicians to identify undernourished children. Material and methods: The study included 171 children under the age of five years, who were referred from the anganwadis of Dakshina Kannada region during the period of January-March 2012. The proportion of underweight, wasting and stunting were calculated according to the new child growth standard of the WHO. CIAF, UI, WI and SI were calculated. Sensitivity, specificity, predictive value and likelihood ratios were calculated for MUAC and Weech’s formula. Results: 58.4% children belonged to category “D” of CIAF. Weech’s formula’s sensitivity in detecting underweight and stunted children was 100% and 96% respectively. Conclusion: Use of CIAF, UI, WI and SI is recommended to present the overall picture of undernutrition among under-five children. Weech’s formula is a sensitive and specific tool to identify to undernourished children.

The clinical and anthropometric profile of undernourished children aged under 5 admitted to Nyangabgwe Referral Hospital in Botswana

Background. Although Botswana is a middle-income country, undernutrition among children younger than 5 years of age is still seen in various parts of the country. There is little information on the clinical and anthropometric profile of undernourished children in this age group admitted to hospitals in Francistown, Botswana. Purpose. To determine the clinical profile and the severity of anthropometric failure of undernourished children aged under 5 admitted to Nyangabgwe Referral Hospital in Francistown. Method. Data were collected from 113 caregiver-child pairs using a researcher-administered questionnaire targeting caregivers together with the children’s hospital records. The children’s anthropometric measurements were taken. Data were analysed using the WHO Anthro 2006 software and Stata 10. Proportions were then calculated. Results. The median age of the children was 14 months and 55% were boys. The majority of the caregivers were single, younger than 30 years and lived in rural villages. The most common symptoms on admission were oedema (50%) and coughing (35%). Ten per cent of the children were HIV-infected and the HIV status of half the children was unknown. The majority (87%) did not present with secondary diagnoses. Severe wasting (<-3 standard deviations (SD)) (73%) was found in all age groups. Stunting (<-2 SD) was prevalent in 68% of the boys, and 95% of the children were severely underweight (<-3 SD). Conclusion. Oedematous undernutrition was common and 73% of the children presented with severe wasting (<-3 SD). In order to prevent severe forms of undernutrition, avoid the necessity for complicated care and improve the chances of survival, health education to caregivers on various forms of undernutrition is crucial.