Burden Of Undernutrition Research Articles

Ready-to-use therapeutic food as a promising therapy for the prevention and cure of undernutrition in pre-school children: A review

The nutritional status of pre-school children is a reflection of health of children in the world and forms the basis for the development of success-oriented interventional programs. This study indicates the prevalence of under-nutrition in under five children in the world, Africa and Nigeria. It also showed the prevalence of under-nutrition in the six geopolitical regions in Nigeria, with the Northern regions reported to have the highest burden of under-nutrition compared to the other regions due to several factors such as inadequate breast feeding, lack of access to healthcare, lack of clean water, armed conflict, inadequate dietary intake, inappropriate feeding, foetal growth restriction, inadequate sanitation, lack of parental education, large family size, incomplete vaccination, poverty and low socio-economic status and desire to have more children. Several nutritional interventions have been put in place to prevent and cure under-nutrition in pre-school children, which include Promotion of exclusive breastfeeding, Micronutrient supplementation, Food fortification, Nutrition education, Complimentary feeding, and Cash transfer programs, Ready-to-use therapeutics foods (RUTF), Nutritional rehabilitation centers, Parenteral nutrition, and Nutritional counseling and education. However, RUTF has been reported to have an effective intervention in the prevention and treatment of severe acute malnutrition (SAM) in pre-school children. It is an energy dense, shelf stable and ready to eat food which composed of peanut butter, sugar, full fat milk and mineral-vitamin premix. Other plant-based ingredients such as chickpea, soybean, sesame, maize, oats, sorghum and sunflower oil have also, been used in the production of RUTF and reported to be effective for complete recovery of SAM children.

The influence of minimum dietary diversity on undernutrition among children aged 6-23 months in Ethiopia: a multilevel mixed-effect analysis based on 2019 Ethiopian mini demographic and health survey.

Undernutrition persists as a critical issue in developing countries like Ethiopia due to poor feeding practices for infants and young children. The impact of dietary diversity on children's health in Ethiopia remains unclear, necessitating further investigation to develop effective prevention strategies. To examine the association between minimum dietary diversity and undernutrition among children aged 6-23 months in Ethiopia. Data from the 2019 Ethiopian Mini Demographic and Health Survey, including 1,501 women with children aged 6-23 months, were analyzed using STATA version 17 software. Child stunting, wasting, and underweight were assessed using Z-scores. Dietary diversity was measured using minimum dietary diversity. Multilevel logistic regression analysis determined associations, presenting results as crude odds ratios (COR) and adjusted odds ratios (AOR) with 95% confidence intervals (CI). Overall, 10.99% of children had adequate minimum dietary diversity, with Addis Ababa (44.57%) and Somalia (1.47%) showing the highest and lowest prevalences, respectively. The highest stunting prevalence was in the Amhara region (45.86%), while Addis Ababa had the lowest (9.78%). Wasting was lowest in Addis Ababa (1.09%) and highest in Tigray (17.07%). Underweight prevalence ranged from 2.17% in Addis Ababa to 33.33% in Tigray. Children with adequate minimum dietary diversity (MDD) had significantly lower odds of stunting (AOR = 0.68, 95% CI = 0.45, 0.96), underweight (AOR = 0.51, 95% CI = 0.27, 0.99), and wasting (AOR = 0.40, 95% CI = 0.17, 0.97) compared to those who had inadequate minimum dietary diversity (MDD). This study highlights the association between minimum dietary diversity and stunting, wasting, and underweight among Ethiopian children aged 6-23 months. Urgent nutrition-specific interventions are needed, particularly in regions with high undernutrition rates and low dietary diversity. Targeted interventions focusing on promoting diverse and nutritious diets for children, along with improving access to essential healthcare services, are imperative to mitigate the burden of undernutrition and ensure the well-being of Ethiopia's youngest population and reinforcing existing programs is crucial to address this public health issue effectively.

Malnutrition in tribal people living with tuberculosis in India: A systematic review & meta-analysis.

Background & objectives Tuberculosis (TB) remains a persistent public health challenge in India. The country also has high proportions of malnutrition in different areas, making the population susceptible to TB. Among vulnerable populations, such as tribal communities, TB and malnutrition pose significant threats. Tribal populations exhibit disproportionately higher TB prevalence rates compared to non-tribal groups. Also, malnutrition prevalence among tribal communities far exceeds national averages in India. Amidst fragmented data, a systematic review of nutritional status among tribal populations with TB in India is imperative to inform comprehensive intervention strategies. Methods Cross-sectional, case-control, cohort and interventional studies reporting the nutritional status of active TB affected individuals among tribal populations in India were specifically included if terms such as "malnutrition" or "low BMI" were used. This systematic review followed PRISMA guidelines and was registered with PROSPERO (CRD42020168328). The data was assessed using a random-effects model and standardized mean with 95% confidence interval (CI). The I2 statistics indicated heterogeneity. Publication bias was evaluated using funnel plots. Results Out of 124 studies, 20 were selected for initial screening, 15 were excluded due to a lack of appropriate data, and five were included for the final analysis. The pooled prevalence estimates of malnutrition among Indian tribes living with TB was 514 per 1000 people, with 95% CI: 232-791. The sensitivity analysis showed that no individual study influenced the estimation of pooled prevalence. Interpretation & conclusions In the background of India, contributing considerably to the burden of TB-related morbidity and mortality alongside undernutrition, reviews have underscored undernutrition as the predominant risk factor for TB, affecting over 50 per cent of the population in some States. This situation is exacerbated among the tribal communities in India due to the dual burdens of undernutrition and TB being more pronounced. Our systematic review consolidates evidence from five studies, revealing the prevalence of malnutrition among tribal TB patients. Conducting well-planned implementation research to address this dual burden among the underprivileged population would help achieve the ambitious goal of a TB-free India 2025.

Perspectives of mothers and primary caregivers on undernutrition in children under 5 years in the Northwest region of Cameroon: a community based cross-sectional study

Background: Cameroon is one of the sub-Saharan African countries where undernutrition is a significant public health concern, with a national prevalence of 29% among children under five. The Northwest Region of Cameroon in particular, faces a triple burden of undernutrition, with high rates of stunting (32%), wasting (6.5%) and underweight (17.2%). Caregivers play a critical role in the management of undernutrition. This study analyzed their knowledge, attitudes and predictors of knowledge levels on undernutrition. Methods: A community-based cross-sectional study was carried out among 1279 mothers and primary caregivers of under five children from six health districts. Data on their knowledge and attitudes towards undernutrition was collected using a pre-tested questionnaire. Binary logistic regression analysis was used to identify predictors of nutrition knowledge levels. Results: Overall, 78.5% of the caregivers had ‘good knowledge’ on undernutrition and 21.7% had ‘poor knowledge’. Correct knowledge was highest on the causes of undernutrition and incorrect knowledge was highest on prevention of undernutrition in children especially as 32.9% didn’t know that exclusive breastfeeding could prevent undernutrition in children below six months. Regarding attitude, 52.2% had a ‘positive attitude’ and 47.7% had a ‘less positive or negative attitude’. The main predictors of knowledge levels among primary caregivers were sex of carer (p=0.001), household size (p=0.001), religion (p=0.010), residence status (p<0.001), occupation (p<0.001), and degree of urbanization (p=0.002). Conclusions: Caregivers in Northwest Cameroon showed good undernutrition knowledge (78.5%), but lacked knowledge on prevention, especially breastfeeding benefits. Sociodemographic factors influenced knowledge. This could inform interventions to improve practices.

Cardiovascular Dynamics in HIV: The Influence of Adrenal Function and Nutritional Status.

This interdisciplinary review explores the intricate nexus between HIV infection, nutrition, adrenal gland function, and cardiovascular health, highlighting a critical aspect of HIV management often overlooked in current literature. With the advent of antiretroviral therapy, the life expectancy of people living with HIV has dramatically improved, transforming HIV into a manageable chronic condition. However, this success brings forth new challenges, notably an increased risk of cardiovascular diseases among people living with HIV. We examine the normal physiology of the adrenal gland, including its role in mineral metabolism, a crucial facet of nutrition. We discuss the evolution of knowledge tying adrenal pathology to cardiovascular disease. We explore the impact of HIV on adrenal gland findings from a gross pathology perspective, as well as the clinical impact of adrenal insufficiency in HIV. The review further elucidates the role of nutrition in this context, considering the double burden of undernutrition and obesity prevalent in regions heavily affected by HIV. By aggregating findings from longitudinal studies and recent clinical trials, the review presents compelling evidence of increased cardiovascular disease among people living with HIV compared with people without HIV. It highlights the critical role of the adrenal glands in regulating nutrient metabolism and its implications for cardiovascular health, drawing attention to the potential for dietary interventions and targeted therapies to mitigate these risks. This review urges a paradigm shift in the management of HIV, advocating for a holistic approach that incorporates nutritional assessment and interventions into routine HIV care to address the complex interplay between HIV, adrenal function, and cardiovascular health. Through this lens, we offer insights into novel therapeutic strategies aimed at reducing cardiovascular risk in people living with HIV, contributing to the ongoing efforts to enhance the quality of life and longevity in this population.

Temporal change in prevalence of BMI categories in India: patterns across States and Union territories of India, 1999–2021

BackgroundThe problem of overweight/obesity often coexists with the burden of undernutrition in most low- and middle-income countries. BMI change in India incorporating the most recent trends has been under-researched.MethodsThis repeated cross-sectional study of 1,477,885 adults in India analyzed the prevalence of different categories of BMI among adults (age 20–54) in 4 rounds of National Family Health Surveys (1998–1999, 2005–2006, 2015–2016, and 2019–2021) for 36 states/UTs. State differences across time were harmonized for accurate analysis. The categories were Severely/Moderately Thin (BMI < 17.0), Mildly Thin (17.0-18.4), Normal (18.5–24.9), Overweight (25.0-29.9), and Obese (≥ 30.0). We also estimated change in Standardized Absolute Change (SAC), ranking of states, and headcount burden to quantify the trend of BMI distribution across time periods for all-India, urban/rural residence, and by states/UTs.ResultsThe prevalence of thinness declined from 31.7% in 1999 to 14.2% in 2021 for women, and from 23.4% in 2006 to 10.0% in 2021 for men. Obesity prevalence increased from 2.9% (1999) to 6.3% (2021) for women, and from 2.0% (2006) to 4.2% (2021) for men. In 2021, the states with the highest obesity prevalence were Puducherry, Chandigarh, and Delhi. These states also had a high prevalence of overweight. Dadra and Nagar Haveli and Diu, Gujarat, Jharkhand, and Bihar had the highest prevalence of severe/moderately thin. Prevalence of extreme categories (severely/moderately thin and obese) was larger in the case of women than men. While States/UTs with a higher prevalence of thin populations tend to have a larger absolute burden of severe or moderate thinness, the relationship between headcount burden and prevalence for overweight and obese is unclear.ConclusionsWe found persistent interstate inequalities of undernutrition. Tailored efforts at state levels are required to further strengthen existing policies and develop new interventions to target both forms of malnutrition.

Targeting strategies of antenatal balanced energy and protein supplementation in Addis Ababa, Ethiopia: study protocol for a randomized effectiveness study

BackgroundAntenatal balanced energy and protein (BEP) supplements have well-documented benefits for pregnancy outcomes. However, considerable practical gaps remain in the effective and cost-effective delivery of antenatal BEP supplements at scale in low- and middle-income countries.MethodsA randomized effectiveness study will be conducted in two sub-cities of Addis Ababa, Ethiopia, to evaluate the effectiveness, cost-effectiveness, and implementation of different targeting strategies of antenatal BEP supplements. Pregnant women aged 18 to 49, with a gestational age of 24 weeks or less, and attending antenatal visits in one of the nine study health facilities are eligible for enrollment. In six of the health facilities, participants will be randomized to one of three study arms: control (Arm 1), targeted BEP provision based on baseline nutritional status (Arm 2), and targeted BEP supplementation based on baseline nutritional status and monthly gestational weight gain (GWG) monitoring (Arm 3). In the remaining three facilities, participants will be assigned to universal BEP provision (Arm 4). Participants in Arms 2 and 3 will receive BEP supplements if they have undernutrition at enrollment, as defined by a baseline body mass index less than 18.5 kg/m2 or mid-upper arm circumference less than 23 cm. In Arm 3, in addition to targeting based on baseline undernutrition, regular weight measurements will be used to identify insufficient GWG and inform the initiation of additional BEP supplements. Participants in Arm 4 will receive BEP supplements until the end of pregnancy, regardless of baseline nutritional status or GWG. All participants will receive standard antenatal care, including iron and folic acid supplementation. A total of 5400 pregnant women will be enrolled, with 1350 participants in each arm. Participants will be followed up monthly during their visits to the antenatal facilities until delivery. Maternal and infant health status will be evaluated within 72 h after delivery and at 6 weeks postpartum. The effectiveness and cost-effectiveness of the different BEP targeting strategies in preventing adverse pregnancy outcomes will be compared across arms. Qualitative data will be analyzed to assess the feasibility, acceptability, and implementation of different supplementation strategies.DiscussionThis study will inform global recommendations and operational guidelines for the effective and cost-effective delivery of antenatal BEP supplements. The targeted approaches have the potential for broader scale-up in Ethiopia and other low-resource settings with a high burden of undernutrition among pregnant women.Trial registrationClinicalTrials.gov registration number: NCT06125860. Registered November 9, 2023.

Theories, determinants, and intervention models and approaches on inequalities of undernutrition amongst under fives: A literature review.

One of the greatest public health problems of the 21st century is undernutrition in children under the age of 5 years (CAUFY). Globally, over 232 million CUAFY are undernourished and approximately 45% of mortality in this population are undernutrition-induced. This paper reviewed and critically explained the factors perpetuating undernutrition in CUAFY in the global space. It further explained the multi-level determinants that influence health inequalities and consequently exacerbate undernutrition amongst CUAFY globally. It also went further to explain the intervention models and approaches that can be used to tackle undernutrition in CUAFY. Demiris et al.'s approach to narrative review was utilized for this paper. Relevant articles on child nutrition were retrieved from multiple credible databases and websites of foremost health organizations. Using an iterative process, multiple combinations of search terms were done by stringing relevant key terms and their synonyms with Boolean Operators. This process was constantly refined to align search results with the study aim. Database search produced relevant and resourceful publications which were utilized to develop this review. The global burden of undernutrition remains high, especially in Oceania with the highest prevalence of stunting and wasting (41.4% and 12.5%), with Africa and Asia following closely. Malnutrition eradication is a global health issue of high priority as demonstrated by the "Goal 2" of the Sustainable Development Goals (SDGs), and the United Nations (UN) Decade of Action on Nutrition 2016-2025. The review identified no significant positive outcome from previous interventions due to the endemic health inequalities. Determinants of the multi-level health inequalities associated with undernutrition in CUAFY, and probable solutions are explained with theoretical models of health inequalities. A diagonal intervention approach was proposed as a viable solution to ending undernutrition in CUAFY. The application of relevant theoretical models and context-specific intervention approaches can be utilized by stakeholders to close the existing inequality gaps, thereby reducing undernutrition amongst CUAFY globally.

Burden of undernutrition among under-five Bengali children and its determinants: Findings from Demographic and Health Surveys of Bangladesh and India.

Globally, undernutrition is the leading cause of mortality among under-five children. Bangladesh and India were in the top ten countries in the world for under-five mortality. The aim of the study was to investigate the nutritional status of Bengali under-five children. Data on 25938 under-five children were retrieved from the Bangladesh Demographic and Health Survey 2017-18 (BDHS) and the National Family Health Survey of India 2015-16 (NFHS-4). Stunting, wasting, underweight and thinness were considered to understand the nutritional status of under-five children. Binary logistic regression was used to identify associated factors of undernutrition among children. Over one-quarter of Bengali under-five children were found to be suffering from the problem of stunting (31.9%) and underweight (28.1%), while other nutritional indicators raised serious concern and revealed inter-country disparities. In the cases of wasting, underweight and thinness, the mean z-scores and frequency differences between Bangladesh and India were significant. The nutritional status of Bengali under-five children appeared to have improved in Bangladesh compared to India. Child undernutrition had significant relations with maternal undernutrition in both countries. Girls in Bangladesh had slightly better nutritional status than boys. In Bangladesh, lack of formal education among mothers was a leading cause of child undernutrition. Stunting and underweight coexist with low household wealth index in both counties. The research revealed that various factors were associated with child undernutrition in Bengalis. It has been proposed that programmes promoting maternal education and nutrition, along with household wealth index be prioritised. The study recommends that the Governments of Bangladesh and India should increase the budget for health of children so as to reach the sustainable development goals.

The double burden of malnutrition in individuals: Identifying key challenges and re-thinking research focus.

The 'double burden of malnutrition' is a global health challenge that increasingly affects populations in both low- and middle-income countries (LMICs). This phenomenon refers to the coexistence of undernutrition and overweight or obesity, as well as other diet-related non-communicable diseases, in the same population, household or even individual. While noteworthy progress has been made in reducing undernutrition in some parts of the world, in many of these areas, the prevalence of overweight and obesity is increasing, particularly in urban areas, resulting in greater numbers of people who were undernourished in childhood and have overweight or obesity in adulthood. This creates a complex and challenging situation for research experts and policymakers who must simultaneously address the public health burdens of undernutrition and overweight/obesity. This review identifies key challenges and limitations in the current research on the double burden of malnutrition in individuals, including the need for a more comprehensive and nuanced understanding of the drivers of malnutrition, the importance of context-specific interventions and the need for greater attention to the food environment and food systems. We advocate for the re-evaluation of research strategies and focus, with a greater emphasis on multidisciplinary and systems approaches and greater attention to the synergistic relationship between the biological, environmental, commercial and socio-economic determinants of malnutrition. Addressing these key challenges can enable us to better comprehend and tackle the multifaceted and dynamic issues of the double burden of malnutrition, particularly in individuals and work towards more effective and sustainable solutions.

Overlooked Burden of Undernutrition Among Older Adults in India

The underweight status among older adults in India and its association with other health risks has received little attention. Using nationally representative data from the first wave of the Longitudinal Aging Study in India (LASI, 2017-18), this study examined the underweight status among the Indian older adults and investigated its relationship with various health outcomes. The effective sample size of this study was 28,050 older adults aged 60 years or above. Multivariable logistic and linear regression models were employed to meet the objectives of the study. Underweight status was found to be negatively associated functional health, cognitive function, and grip strength. However, no significant association was observed between underweight status and depressive symptoms. Moreover, socioeconomic, demographic, and geographic factors were identified as strong determinants of underweight status among Indian older adults. India has implemented a wide range of nutrition policies that primarily focus on children, mothers, and adolescents. While these policies are important, it is equally crucial to develop interventions specifically tailored for adults and older adults.

IJCM_21A: How do under-five children belonging to scheduled tribes compare with the non- tribal children: a secondary data analysis using the Comprehensive National Nutritional Survey (CNNS) 2016-18.

Background: Scheduled tribes (ST) constitute 8.6% of India’s population. Disproportionate burden of undernutrition is found among these socially disadvantaged population. objectives: To compare the nutritional status of under-5 ST children with children belonging to other castes (non-tribal) using data from Comprehensive National Nutritional Survey (CNNS) 2016-18. Methodology: We selected relevant demographic and anthropometric variables from the CNNS dataset and dichotomized it into non-tribal and tribal. World Health Organization (WHO) Anthro software was used to calculate the z-scores; weight-for-height (WHZ), weight-for-age (WAZ), height-for-age (HAZ). We estimated the proportion of wasting, underweight and stunting in these two sets of children. The mean z-scores between non-tribal and tribal children and that between girls and boys within these subsets were tested using student t-test. Results: Valid heights were available in 28,568 non-tribal and 7155 tribal children and the corresponding weights were available in 28144 and 6956 children respectively. The mean (SD) HAZ, an indicator of long-term nutrition, was -1.12 (1.58) in non-tribal children and -1.21 (1.71) in tribal children (p:&lt;0.001) Prevalence of stunting in tribal children (31.6%; 95%CI: 30.6, 32.7) was higher than that in non-tribal (27.1%; 95%CI: 26.6, 27.6). Due to poor heights, wasting was less in tribal children (12.8%; 95%CI: 12, 13.6) compared to the non-tribal (14.5%; 95%CI: 14.1, 15). The non- tribal girls had better mean (SD) WHZ, -0.75 (1.3) and WAZ, -1.17 (1.26) than boys (p=0.01, 0.045 respectively). The heights between the boys and girls were comparable in the non-tribal subset whereas, it was better in tribal girls; mean HAZ being -1.15 (SD:1.69) in girls and -1.27, (SD:1.72) in boys (p&lt;0.0029). Conclusion: The under-5 tribal children were significantly shorter than their non-tribal counterparts. Long term nutrition as depicted by heights was similar in boys and girls in non-tribal subset but tribal girls performed better than the boys.

Prevalence and Correlates of Malnutrition in Nuh District, Haryana State, India.

India has a substantial burden of undernutrition coupled with overweight and obesity at the other end of the spectrum of malnutrition. Nuh district, in the Haryana State in northern India, is an impoverished district in India. With an aim to investigate the problem of malnutrition in the community, a cross-sectional study was conducted in four villages of the Nuh district. Height/length, weight, and age data of children under 5 years were used to calculate three indices: weight-for-age, height-for-age, and weight-for-height. The body mass index was calculated for individuals older than 6 years. Associations between malnutrition and other factors were assessed using simple and multiple logistic regression to get adjusted coefficients. The total surveyed population comprised 11,496 individuals. Over 51% were female, and 13.2% of the surveyed population were children under 5 years. Almost half of the population was illiterate and unemployed. The prevalences of underweight, stunting, and wasting in children under 5 years were 37%, 53%, and 21%, respectively. The prevalences of underweight and stunting in the 6- to 19-year-old age group were 29% and 38%, respectively. The prevalence of overweight was 36% in the 20- to 40-year-old and > 60-year-old age groups, and 44% in the 41- to 60-year-old age group. Our findings reveal a considerable burden of undernutrition among children under 5 years and a dual burden of undernutrition and overnutrition in adults, highlighting the need to map these areas and sharpen our responses to mitigate the overwhelming and long-term consequences of malnutrition in the Nuh district.

Spatial Clustering of Malnutrition and Anemia Among Reproductive Women and Its Associated Risk Factors in India: Evidence From National Family Health Survey-5.

Malnutrition and anemia are 2 severe public health concerns, predominantly in low-and middle-income nations. Malnutrition is defined as poor nutritional condition that encompass both under nutrition and over nutrition. The prevalence of overweight or obesity and anemia has increased in India from 2016 to 2021. The study aims to investigate the spatial clustering and factors responsible for underweight, overweight/obesity, and anemia among reproductive women (15-49 years) in India using the data from National Family and Health Survey-5 (2019-2021). We conducted hot-spot analysis using Moran's Index (MI) with the help spatial analysis software (i.e., GeoDa 1.18 and ArcGIS 10.8). It also demonstrates the autocorrelation. Multivariable logistic regression analysis has been performed to examine different determinants and risk associated with underweight, overweight/obesity, and anemia with various dependent variable by using Stata-14 software. Moran's Index for underweight (MI = 0.68), overweight/obesity (MI = 0.72), and anemia (MI = 0.62) indicates a high level of spatial-autocorrelation (P < .001) exists across the districts in India. As a result, a total of 156, 143, and 126 hot-spot districts are detected for underweight, overweight/obesity, and anemia, respectively. The burden of undernutrition and anemia is higher in rural areas. Risk of under nutrition and anemia are both reduced by media exposure and eating habits. Moreover, low income and low education level raises the risk of anemia and undernutrition, while obesity shows an inverse trend with income and education level. The study recommends targeting hot-spot districts for malnutrition and anemia, and policy level initiatives by addressing the responsible risk factors.

Prevalence and determinants of under-nutrition among children on ART in Ethiopia: A systematic review and meta-analysis.

Children living with HIV/AIDS are particularly vulnerable to under-nutrition. Under-nutrition associated with HIV/AIDS infection increases the rate of morbidity and mortality in children. To reaffirm a future objective, there needs to be evidence regarding the current national burden of under-nutrition and related factors among children infected with HIV. Hence, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of under-nutrition, and the pooled effect sizes of associated factors among HIV-infected children in Ethiopia. We searched Ethiopian universities' online libraries, Google, Google Scholar, PubMed, CINAHL, Cochrane Library, and Scopus to find the primary studies for this review. Publication bias was checked through Egger's regression test. Heterogeneity among the included studies was assessed using the I2 test. The data were extracted using Microsoft Excel and exported to STATA Version 14 statistical software. A random effect meta-analysis model was performed to estimate the pooled prevalence of Under-nutrition. After reviewing 1449 primary studies, 16 articles met the inclusion criteria and were included in the final meta-analysis. The estimated pooled prevalence of stunting, underweight, and wasting among children living with HIV/AIDS was 32.98% (95% CI: 22.47, 43.50), 29.76% (95% CI: 21.87, 37.66), and 21.16% (95% CI: 14.96, 27.35) respectively. This study showed that under-nutrition among HIV-infected children in Ethiopia was significantly high. Under-nutrition is more common among HIV-infected children with opportunistic infections, child feeding problems, do not adhere to dietary recommendations, and have diarrhea. The national policies and strategies for ART service- provider centers should maximize their emphasis on reducing under-nutrition among HIV-infected children. Based on this finding, we recommend HIV intervention programs to address nutritional assessment and interventions for HIV-infected children. The protocol has been registered in the PROSPERO database with a registration number of CRD-394170.

Pediatric Nutritional Assessment

Background: Pediatric nutrition plays a vital role in the growth and development of children. It not only meets the daily nutritional needs of healthy children but also supports their normal growth. In contrast, for unhealthy children, it aims to prevent growth delays and developmental issues, especially in cognitive functions. The situation in Indonesia presents a unique challenge with the coexistence of undernutrition and overnutrition, both having significant short-term and long-term health impacts. Discussion: In the realm of pediatric nutrition, malnutrition manifests in various forms. Nutritional deficiencies such as wasting, stunting, and being underweight arise from inadequate dietary intake. Additionally, there are concerns about micronutrient malnutrition, which includes both deficiencies and excesses of vital nutrients. Overnutrition, leading to obesity and associated chronic diseases, is also a significant problem. The approach to pediatric nutritional care is multi-faceted, involving the assessment of nutritional status, determination of individual caloric needs, and selecting the appropriate method for nutrition delivery, whether it be oral, enteral, or parenteral. Monitoring and evaluating the effectiveness of these interventions is a critical ongoing process. An important aspect of preventive care includes educating parents about proper feeding techniques, such as establishing regular meal times and understanding the child's hunger and satiety signals, to avoid feeding difficulties. For cases like Failure to Thrive (FTT), where children do not meet standard growth metrics, careful management is necessary to ensure adequate nutrition and to prevent complications like refeeding syndrome. Conclusion: Effective pediatric nutrition requires a holistic and personalized approach. It is crucial in addressing the dual burden of undernutrition and overnutrition in Indonesia. By implementing proper nutritional care and structured feeding practices, children's health outcomes can be significantly improved, supporting their growth and developmental processes.

Examining the prevalence and patterns of malnutrition among children aged 0–3 in India: Comparative insights from NFHS-1 to NFHS-5

BackgroundThis study aims to analyse the undernutrition burden in India and assess the state-level distribution of nutritional indicators among children under three, using data from NFHSs. MethodsThis analysis focused on children under three years old and examined the prevalence and trend of undernutrition indicators in India at national and state levels. Changes over a decade were assessed to determine the burden. The study employed a multilevel logistic regression model to measure undernutrition burden, incorporating household and individual factors. ResultsFrom NFHS-1 to NFHS-5, wasting prevalence increased slightly from 19.9 % to 20.5 %, while stunting and underweight decreased from 51.9 % to 34.1 % and 45.8 %–29.4 %, respectively. Stunting and underweight saw a decrease of 6.36 % (↓) and 5.86 % (↓), respectively, while wasting showed a slight increase of 0.21 % (↑). Mother's education and the child's sex were significant factors influencing children's nutritional status. ConclusionDespite advancements in reducing undernutrition indicators in India through national nutrition programs, the pace of progress remains slow. Prioritizing the fulfillment of nutrition-related SDG goals is crucial. Policymakers can leverage the study's results to create interventions for improving children's nutritional status. Coordinated efforts at both state and national levels are essential to achieve specific improvements in undernutrition indicators across programs.

Gender-specific disaggregated analysis of childhood undernutrition in Ethiopia: evidence from 2000–2016 nationwide survey

IntroductionChildhood undernutrition has been investigated extensively in previous literature but gender inequality detailing the burden of undernutrition has not been adequately addressed in scientific papers, especially in Ethiopia, where undernutrition is known to be a public health problem of high significance, necessitating increased efforts to address it and reduce this inequality. This study was carried out to: (1) explore gender differences in the prevalence of stunting, wasting, and underweight, and (2) compare the factors associated with childhood undernutrition between boys and girls in Ethiopia.MethodsThe study used a dataset of more than 33,564 children aged under 5 years (boys: 17,078 and girls: 16,486) who were included in the nationally representative Ethiopia Demographic and Health Survey (EDHS) from 2000 to 2016. The outcome variables were anthropometric indices: stunting (height-for-age < -2 standard deviations), wasting (weight-for-height < -2 standard deviations), and underweight (weight-for-age < -2 standard deviations). Gender-specific multilevel analyses were used to examine and compare the factors associated with child undernutrition.ResultsThe overall prevalence of stunting (49.1% for boys vs 45.3% for girls, p < 0.001), wasting (11.9% for boys vs 9.9% for girls, p < 0.001), and underweight (33.1% for boys vs 29.8% for girls, p < 0.001) higher among boys compared to girls. Boys significantly had higher odds of stunting (aOR: 1.31, 95%CI: 1.21–1.42), wasting (aOR: 1.35, 1.23–1.48), and underweight (aOR: 1.38, 95%CI: 1.26–1.50) than girls. The common factors associated with childhood undernutrition for male and female children were the child's age, perceived size of the child at birth, breastfeeding status, maternal stature, maternal education, toilet facility, wealth index, and place of residence. Boys who were perceived by their mothers to be average sized at birth and were born to uneducated mothers had a higher likelihood of experiencing wasting, in contrast to girls. Among boys, birth order (firstborn), household size (1–4), and place of residence (urban) were associated with lower odds of being underweight. Boys living in cities had lower odds of being stunted. While girls born to mothers with no education and worked in agriculture were at a higher odd of being stunted.ConclusionOur study revealed that boys were more likely to be malnourished than girls, regardless of their age category, and there were variations in the factors determining undernutrition among boys and girls. The differences in the burden of undernutrition were significant and alarming, positioning Ethiopia to be questioned whether it will meet the set Sustainable Development Goals (SDGs), including SDG 2 of zero hunger by 2030. These findings call for more effort to address malnutrition as a significant public health issue in Ethiopia, and to urgently recognise the need for enhanced interventions that address the gender gap in childhood undernutrition.

Longitudinal Growth and Undernutrition Burden Among Term Low Birth Weight Newborns Reared in Adverse Socioeconomic Conditions in Delhi

Longitudinal Growth and Undernutrition Burden Among Term Low Birth Weight Newborns Reared in Adverse Socioeconomic Conditions in Delhi

Undernutrition in children aged 0–59 months by region and over time: secondary analysis of the Burkina Faso 2012–2018 National Nutrition Surveys

The global burden of undernutrition remains high, responsible for significant under-five mortality in resource-limited settings. Numerous sustainable development goals (SDGs) are linked to nutrition, and nationally representative nutrition surveillance is...