Child Anthropometric Outcomes Research Articles

IJCM_23A: Long-Term Maternal and Childhood Outcomes Among Women with Post-Partum Depression in Rural and Urban Areas of Khordha, Odisha.

Background: The prevalence of Postpartum Depression in India varies from 6.8-21.5%. About 5% women reported persistent PPD symptoms even three years after childbirth. PPD increases the suicide risk among mothers. It not only affects the psychological health but also physical health & quality of life of mother. Maternal PPD affects the mother child bonding and also the child growth & development. Objective: To assess the long-term effects of post-partum depression on the mothers and the children at 1 year-5 years. Methodology: We have done a Cohort study with 290 mother-child dyads in both rural and urban area of Khordha, Odisha. Mothers were screened using EPDS for PPD at 6wk to 6 months after delivery. The outcome for mothers and children were assessed at one year to five years after delivery. Chronic depression was assessed with EPDS, confirmed by psychiatric evaluation and suicidality of the mother with SBQ-R; child anthropometric outcomes with WHO growth charts and development with Bayley Scale of Infant and Toddler Neurodevelopment. Results: Among the 62 mothers screened positive for post-partum depression, 18 (29%) were found to have Chronic depression and a significant association was found between post-partum and chronic depression (OR=11.25, CI- 4.60- 27.69, p-value <0.001]. Conclusion: Maternal post-partum depression had significant impact on the maternal and child child-health in the long term.

In utero exposure to violence and child health in Iraq

This paper examines the impact of exposure to violence during pregnancy on anthropometric and cognitive outcomes of children in the medium run. I combine detailed household-level data on more than 36,000 children with geo-coded information on civilian casualties in the aftermath of the US invasion of Iraq between 2003 and 2009 and exploit within-mother differences in prenatal exposure to violence. I find that one violent incident during pregnancy decreases height- and weight-for-age z-scores by 0.13 standard deviations and lowers cognitive and behavioral skills of children. Leveraging information on the severity, type and perpetrator of violence, I isolate the effect of stress from access to prenatal care. The analysis reveals that stressful events, particularly those involving direct threats to personal safety (violence directed at the civilian population and involving execution and torture), exert an even larger negative impact on child health than those incidents that disrupt health infrastructure and access to prenatal care.

Powering Up Child Growth: The Impact of Electricity Outages on Children’s Anthropometric Outcomes in the Kyrgyz Republic

ABSTRACT Using household-level panel data and a coarsened exact matching procedure, this paper investigates the relationship between frequent electricity outages and the anthropometric outcomes of children. Specifically, we study the differences in the anthropometric outcomes of children aged under 5 in the Kyrgyz Republic. We find that children living in households with frequent outages have z-scores of height-for-age (HAZ) that are 0.37 units lower compared to the children living in similar households but without frequent outages. We also document that HAZ values of girls are more sensitive toward frequent outages, which indicates a possible presence of gender bias among Kyrgyz households.

Effect of a Center-Based Early Childhood Care and Education Program on Child Nutritional Status: A Secondary Analysis of a Stepped-Wedge Cluster Randomized Controlled Trial in Rural Sindh, Pakistan

BackgroundHigh-quality early childhood care and education (ECCE) programs can positively impact children’s development. However, as an unintended consequence, ECCE attendance may also affect children’s nutritional status. ObjectiveWe evaluated the effect of a center-based ECCE intervention on child nutritional outcomes in rural Pakistan. MethodsThis study utilized data from a stepped-wedge cluster randomized controlled trial of a center-based ECCE program that trained female youth to run high-quality preschools for children aged 3.5–5.5 y (Youth Leaders for Early Childhood Assuring Children are Prepared for School (LEAPS) program) in rural Sindh, Pakistan. The program did not include any school meals. A total of 99 village clusters were randomized to receive the LEAPS intervention in 3 steps, and repeated cross-sectional surveys were conducted to assess the impact on children (age: 4.5–5.5 y) at 4- time points. ITT analyses with multilevel mixed-effect models were used to estimate the effect of the intervention on child anthropometric outcomes. ResultsThe analysis included 3858 children with anthropometric data from 4 cross-sectional survey rounds. The LEAPS intervention was found to have a positive effect on child height-for-age z score (mean difference: 0.13 z-scores; 95% confidence interval [CI]: 0.02, 0.24). However, there was a negative effect on weight-based anthropometric indicators, −0.29 weight-for-height z score (WHZ) (95% CI: −0.42, −0.15), −0.13 BMI z score (BMIZ) (95% CI: −0.23, −0.03), and −0.16 mid-upper arm circumference-for-age z score MUACZ (95% CI: −0.25, −0.05). An exploratory analysis suggested that the magnitude of the negative effect of LEAPS on WHZ, BMIZ, and weight-for-age z score (WAZ) was greater in the survey round during the COVID-19 lockdown. DiscussionThe LEAPS intervention positively affected child linear growth but had negative effects on multiple weight-based anthropometric measures. ECCE programs in low- and middle-income country settings should evaluate the integration of nutrition-specific interventions (eg school lunch, counseling on healthy diets) and infection control strategies to promote children's healthy growth and development. Clinical Trial Registryclinicaltrials.gov, NCT03764436, https://clinicaltrials.gov/ct2/show/NCT03764436

The final 28 Days:Prenatal exposure to air pollution and child anthropometric outcomes

This study examines the health consequences of prenatal exposure to air pollution by combining child health data from an original survey with the Air Pollution Index (API) from official Chinese statistics. Our results show that exposure to air pollution in late trimester (four-week windows before delivery) is negatively associated with health outcomes in children in the short and long terms. One standard deviation increase in the API in the final 28 days before delivery decreased birth weight and length by 0.388 and 0.458, respectively, in z-scores and lowered the weight-for-age and height-for-age by 0.370 and 0.441, respectively, in z-scores at 13–15 years post-exposure. Although the timing of exposure and its consequences have been the subject of debate in existing literature, our results focus on four-week windows and demonstrate that exposure during the late pregnancy period may have adverse health effects on children. We conducted analyses that accounted for potential covariates and omitted variables, and our results remain robust and statistically significant. We also found gender heterogeneous effects that girls are more vulnerable to fetal air pollution exposure than boys. Our findings uncover fetal and child health risks regarding air pollution and reinforce the importance of policies for mitigating air pollution in developing countries.

Effectiveness of multiple eHealth-delivered lifestyle strategies for preventing or intervening overweight/obesity among children and adolescents: A systematic review and meta-analysis.

ObjectiveTo investigate the effect of multiple eHealth-delivered lifestyle interventions on obesity-related anthropometric outcomes in children and adolescents.MethodsThe Medline (via PubMed), Embase, Cochrane Library, Web of Science, CBM, VIP, CNKI, and Wanfang electronic databases were systematically searched from their inception to March 18, 2022, for randomized controlled trials (RCTs). Meta-analyses were performed to investigate the effect of multiple eHealth-delivered lifestyle interventions on obesity-related anthropometric outcomes (body mass index [BMI], BMI Z-score, waist circumference, body weight, and body fat%). Two independent investigators reviewed the studies for accuracy and completeness. All included studies were evaluated using the Cochrane Risk-of-Bias (ROB) Tool.ResultsForty trials comprising 6,403 patients were selected for the meta-analysis. The eligible trials were published from 2006 to 2022. Compared with the control group, the eHealth-intervention group was more effective in reducing BMI (weighted mean difference [WMD] = −0.32, 95% confidence interval [CI]: −0.50 to −0.13, I2 = 85.9%), BMI Z-score (WMD = −0.08, 95% CI: −0.14 to −0.03, I2 = 89.1%), waist circumference (WMD = −0.87, 95% CI: −1.70 to −0.04, I2 = 43.3%), body weight (WMD = −0.96, 95% CI: −1.55 to −0.37, I2 = 0.0%), and body fat% (WMD = −0.59, 95% CI: −1.08 to −0.10, I2 = 0.0%). The subgroup analysis showed that parental or school involvement (WMD = −0.66, 95% CI: −0.98 to −0.34), eHealth-intervention duration of >12 weeks (WMD = −0.67, 95% CI: −0.96 to −0.38), and mobile-based interventions (WMD = −0.78, 95% CI: −1.13 to −0.43) had a significantly greater intervention effect size on BMI.ConclusionsThis review recommends that multiple eHealth-delivered lifestyle strategies may be useful for preventing or treating overweight and obesity among children and adolescents. However, our results should be cautiously interpreted due to certain limitations in our study.

Child health and maternal health knowledge: evidence from Vietnam

The care and protection of children are vital because children are the future of the country. Their health links to the development of adult human capital and the national economy. Informal maternal education is the major driver of child health but has never been formalized. This paper investigates the effects of maternal health knowledge on child health using a survey of 200 households in Ho Chi Minh City, Vietnam. The theory of household production has been applied to create a child health model. Anthropometric indicators of weight-for-age and height-for-age are set as the proxies for child health. The models are regressed separately for the weight-for-age and height-for-age Z-scores of children under five. The research results showed that the number of years of maternal schooling does have a positive impact on child anthropometric outcomes but its effects are crowded out by maternal health gained from the mother’s access to health information through pubic media and genetic inheritance, but these are inferior to environmental factors such as housing, sanitation, and health knowledge. The findings confirm that Vietnam can improve the status of child care and protection can be improved even under the constraints of limited access to maternal formal education).

Early Childhood Neurodevelopmental Outcomes in Children with Prenatal Zika Virus Exposure: A Cohort Study in Puerto Rico

To describe anthropometric, sensory, and neurodevelopmental outcomes of children who were Zika virus-exposed from birth to 36months. The study cohort included 114 children born to mothers with confirmed and probable Zika virus pregnancy infection in 2016-2017. Children attending study visits from May 2017 through February 2020 underwent physical/neurologic, sensory examinations, and neurodevelopmental assessments with the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) and Ages and Stages Questionnaires, Third Edition (ASQ-3). Three of the 114 children (2.6%) had microcephaly (z-score for head circumference≤-2) at birth, 19 of 35 (54.3%) had posterior eye abnormalities in retinal images, and 11 of 109 (10.1%) had nonspecific findings on brain ultrasound. Three of 107 children (2.8%) failed hearing screening at birth. Of those children with follow-up data, 17 of 97 (17.5%) failed age-appropriate vision screening. The BSID-III identified developmental delay in at least 1 domain in at least one-third of children, with higher prevalence in the language domain. ASQ-3 screen positive delay peaked at around 24 or 36months, with some domains showing a decrease at older ages. Correlations among BSID-III and ASQ-3 scores were observed, representing professional and parental perspectives at 24 and 36months (r=0.32-0.78; P<.05). The presence of neurodevelopmental sequelae in early childhood suggests that identification of long-term impairment remains critical to attaining optimal child development. Long-term follow-up highlights vulnerability in the language domain, which likely could be influenced by early intervention, promoting cognitive development and school readiness in exposed children.

The Effectiveness of Wearable Devices as Physical Activity Interventions for Preventing and Treating Obesity in Children and Adolescents: Systematic Review and Meta-analysis.

BackgroundThe prevalence of obesity in children and adolescents remains a global public health issue. Wearable devices may offer new opportunities for prevention and intervention in obesity. Previous systematic reviews have only examined the effect of the wearable device interventions on preventing and treating obesity in adults. However, no systematic review has provided an evaluation of wearable devices as physical activity interventions for preventing and treating obesity in children and adolescents.ObjectiveThe purpose of this review and meta-analysis was to evaluate the effectiveness of wearable devices as physical activity interventions on obesity-related anthropometric outcomes in children and adolescents.MethodsResearch articles retrieved from PubMed, EMBASE, Cochrane Library, Scopus, and EBSCO from inception to February 1, 2021, were reviewed. The search was designed to identify studies utilizing wearable devices for preventing and treating obesity in children and adolescents. The included studies were evaluated for risk of bias following the Cochrane recommendation. Meta-analyses were conducted to evaluate the effectiveness of wearable devices as physical activity interventions on body weight, body fat, BMI z-score (BMI-Z), BMI, and waist circumference. Subgroup analyses were performed to determine whether the characteristics of the interventions had an impact on the effect size.ResultsA total of 12 randomized controlled trials (3227 participants) were selected for meta-analysis. Compared with the control group, wearable device interventions had statistically significant beneficial effects on BMI (mean difference [MD] –0.23; 95% CI –0.43 to –0.03; P=.03; I2=2%), BMI-Z (MD –0.07; 95% CI –0.13 to –0.01; P=.01; I2=81%), body weight (MD –1.08; 95% CI –2.16 to –0.00; P=.05; I2=58%), and body fat (MD –0.72; 95% CI –1.19 to –0.25; P=.003; I2=5%). However, no statistically significant effect was found on waist circumference (MD 0.55; 95% CI –0.21 to 1.32; P=.16; I2=0%). The subgroup analysis showed that for participants with overweight or obesity (MD –0.75; 95% CI –1.18 to –0.31; P<.01; I2=0%), in the short-term (MD –0.62; 95% CI –1.03 to –0.21; P<.01; I2=0%), wearable-based interventions (MD –0.56; 95% CI –0.95 to –0.18; P<.01; I2=0%) generally resulted in greater intervention effect size on BMI.ConclusionsEvidence from this meta-analysis shows that wearable devices as physical activity interventions may be useful for preventing and treating obesity in children and adolescents. Future research is needed to identify the most effective physical activity indicators of wearable devices to prevent and treat obesity in children and adolescents.

Differences in nutritional status between rural and urban Yucatec Maya children: The importance of early life conditions

Early‐life conditions shape childhood growth and are affected by urbanization and the nutritional transition. To investigate how early‐life conditions (across the “first” and “second” 1000 days) are associated with rural and urban children's nutritional status, we analyzed anthropometric data from Maya children in Yucatan, Mexico. We collected weight, height and triceps skinfold measures, then computed body mass and fat mass indices (BMI/FMI), in a cross‐sectional sample of 6‐year‐olds (urban n = 72, rural n = 66). Demographic, socioeconomic and early‐life variables (birthweight/mode, rural/urban residence, household crowding) were collected by maternal interview. We statistically analyzed rural‐urban differences in demographic, socioeconomic, early‐life, and anthropometric variables, then created linear mixed models to evaluate associations between early‐life variables and child anthropometric outcomes. Two‐way interactions were tested between early‐life variables and child sex, and between early‐life variables and rural‐urban residence. Results showed that rural children were shorter‐statured, with lower overweight/obesity and cesarean delivery rates, compared to urban children. Household crowding was a negative predictor of anthropometric outcomes; the strongest effect was in boys and in urban children. Birthweight positively predicted anthropometric outcomes, especially weight/BMI. Birth mode was positively (not statistically) associated with any anthropometric outcome. Cesarean delivery was more common in boys than in girls, and predicted increased height in urban boys. In conclusion, urbanization and household crowding were the most powerful predictors of Maya 6‐year‐old anthropometry. The negative effects of crowding may disproportionately affect Maya boys versus girls and urban versus rural children. Early‐life conditions shape Maya children's nutritional status both in the “first” and “second” 1000 days.

How does baseline anthropometry affect anthropometric outcomes in children receiving treatment for severe acute malnutrition? A secondary analysis of a randomized controlled trial.

Mid‐upper arm circumference (MUAC) < 11.5 cm and weight‐for‐height Z‐score (WHZ) < −3 are used for screening for severe acute malnutrition (SAM). Underweight and concurrent wasting and stunting may better target those at the highest risk of mortality. We compared anthropometric outcomes in children enrolled in a trial of antibiotics for SAM based on categories of baseline anthropometry, including indicators for programme admission (WHZ < −3, MUAC < 11.5) and alternative indicators (weight‐for‐age Z‐score [WAZ] < −3, concurrent wasting and stunting [WHZ < −3 and height‐for‐age Z‐score < −3]). Participants were followed weekly until nutritional recovery and at 8 weeks. We evaluated changes in weight gain (g/kg/day), MUAC, and WHZ in children admitted by admissions criteria (MUAC only, WHZ only, or MUAC and WHZ) and by underweight or concurrent wasting and stunting. Of 301 admitted children, 100 (33%) were admitted based on MUAC only, 41 (14%) WHZ only, and 160 (53%) both MUAC and WHZ, 210 (68%) were underweight and 67 (22%) were concurrently wasted/stunted. Low MUAC and low WHZ children had the lowest probability of nutritional recovery (17% vs. 50% for MUAC‐only and 34% for WHZ‐only). There was no difference in weight gain velocity or WHZ by admissions criteria (WHZ and/or MUAC). Underweight and concurrently wasted/stunted children had lower MUAC and WHZ at 8 weeks compared with those who were not underweight or concurrently wasted and stunted. Children with both low MUAC and low WHZ had the worst outcomes. Relying on MUAC alone may miss children who have poor outcomes. Other indicators, such as WAZ, may be useful for identifying vulnerable children.

A quantile regression analysis of dietary diversity and anthropometric outcomes among children and women in the rural–urban interface of Bangalore, India

Based on a primary survey conducted in the rural–urban interface of Bangalore, this study contributes to the understanding of the relationship between dietary diversity (DD) and anthropometric outcomes of young children (6 months – 5 years) (measured by weight-for-age (WAZ), weight-for-height (WHZ), and height-for-age (HAZ) z-scores), school-aged children (6–14 years) (measured by Body Mass Index (BMI) z-scores and HAZ scores), and women (15 years and above) (measured by BMI). We examine this association not just at the mean, but also at different points of the conditional distribution of anthropometric outcomes using the quantile regression (QR) method. We use six different measures of individual- and household-level DD to check whether the estimated association depends on the choice of the metric used. Our results show that increased DD is associated with higher z-scores at the lower quantiles of the WAZ distribution. In addition, we find a positive association between DD and upper quantiles of WHZ and BMI z-scores of young and school-aged children, respectively. Except for these, no other associations at any other quantile for any anthropometric outcome of young children, school-aged children, and women are consistently significant for various measures of DD. Our results suggest that policies that focus on improving DD might not be effective in improving (most) anthropometric outcomes especially in areas facing multiple burdens of malnutrition.

Impact of methylprednisolone pulse therapy on anthropometric outcomes in children with immunoglobulin A nephropathy and Henoch-Schönlein purpura nephritis.

Impact of methylprednisolone pulse therapy on anthropometric outcomes in children with immunoglobulin A nephropathy and Henoch-Schönlein purpura nephritis.

Cohort‐based analysis of maternal age at menarche in relation to young adult offspring anthropometric and metabolic parameters

Age of menarche is a determinant factor of cardiometabolic risk, adiposity and stature at adulthood. However, little is known about the transgenerational effects of age of menarche, especially beyond childhood of any offspring, and the studies remain limited to anthropometric outcomes in children at birth or before adolescence. In the present study, we aim to investigate the relationship of maternal age at menarche (MAM) with anthropometric and metabolic parameters in the young adult offspring (aged 15-35 years) in a Persian population. In this cohort-based cross-sectional study, we recruited 1139 mother-young adult dyads enroled in Rafsanjan Cohort Study (RCS) at adult RCS (aged 35-70 years) and youth RCS (aged 15-35 years) as part of the comprehensive PERSIAN (Prospective Epidemiological Research Studies in IrAN). In this study, MAM was categorized to early (MAM < 12 years), normal (12 ≤ MAM ≤ 14) and late menarche (MAM > 14 years). For these analyses, bivariate and multiple logistic regression models were used to investigate the relationships between late or early MAM and offspring anthropometric and metabolic parameters. Early MAM displayed a significant association with an increased odds ratio (OR) of tall stature adjusting for sex, age, socioeconomic status index, maternal age at birth and maternal height (as genetically determined factor). Sensitivity analysis by sex indicated this relationship to be specific to male offspring only (adjusted OR: 1.84 95% CI: 1.13-3.00, p value: .014). In addition, late MAM displayed a significant association with reduced OR of overweight/obesity and abdominal obesity in daughters only (obesity adjusted OR: 0.49, 95% CI: 0.27-0.88, p value: .018, abdominal obesity adjusted OR: 0.44, 95% CI: 0.23-0.82, p value: .010). dose-response analysis by categorization of MAM, further supported our results. On the contrary, our analyses do not support a significant relationship between MAM and youth metabolic indices, that is, metabolic syndrome, fasting blood sugar (FBS), high-density lipoprotein (HDL) and triglyceride (TG). The results of the present study indicate an association of maternal age of menarche with anthropometric measures of offspring in young adulthood in a sex differential manner. The data does not support a significant relationship between the metabolic indices FBS, TG and HDL in offspring with MAM. Overall, this study provides evidence for the intergenerational effects of age at menarche in the development of anthropometric measures in offspring in young adulthood (15-35), which is the first study of this kind in this age range.

The effectiveness of interventions on nutrition social behaviour change communication in improving child nutritional status within the first 1000 days: Evidence from a systematic review and meta-analysis.

This systematic review and meta‐analysis aimed to assess the robustness of designs and tools used in nutrition social behaviour change communication (NSBCC) interventions and establish their effectiveness. EBSCOhost as an umbrella database including Medline (Ovid) and CINAHL, EMBASE, and ProQUEST databases were searched for peer‐reviewed articles from January 1960 to October 2018. Additional sources were searched to identify all relevant studies including grey literature. Studies' biases were assessed according to Cochrane handbook. Pooled estimate of effectiveness of interventions on infant and young child feeding (IYCF) practices and child nutritional status with 95% confidence intervals were measured using random‐effects models. Eighty studies were included in this review: Fifty‐one (64%) were cluster randomised controlled trials (RCTs), 13 (16%) were RCTs and 16 (20%) quasi‐experimental. Of the included studies, 22 (27%) measured early initiation of breastfeeding, 38 (47%) measured exclusive breastfeeding, 29 (36%) measured minimum dietary diversity, 21 (26%) measured minimum meal frequency, 26 (32%) measured height for age z‐scores (HAZ), 23 (29%) measured weight for height z‐scores (WHZ), 27 (34%) measured weight for age z‐scores (WAZ), 20 (25%) measured stunting, 14 (17%) measured wasting, and 11 (14%) measured underweight. The overall intervention's effect was significant for exclusive breastfeeding (EBF) (odds ratio = 1.73; 95% confidence interval [CI]: 1.35–2.11, p < 0.001), HAZ (standardized mean differences [SMD] = 0.19; 95% CI: 0.17–0.21; p < 0.001), WHZ (SMD = 0.02; 95% CI: 0.004–0.04; p < 0.001), and WAZ (SMD = 0.04; 95% CI: 0.02–0.06; p < 0.001). Evidence shows the effectiveness of NSBCC in improving EBF and child anthropometric outcomes. Further research should test the impact on child nutritional status with clearly specified and detailed NSBCC interventions.

The Danish HIV Birth Cohort (DHBC) - a nationwide, prospective cohort

PurposeThe purpose of the Danish HIV Birth Cohort (DHBC) is to investigate the significance of HIV-1 infection in pregnancy and after delivery in women living with HIV (WLWH) in Denmark...

Factor Analysis Reduces Complex Measures of Nutrition Environments in US Elementary and Middle Schools into Cohesive Dimensions in the Healthy Communities Study

BackgroundAlthough it has been recommended that schools be the hub of efforts to improve child nutrition, research describing school nutrition environments in US public schools and their associations with child health is limited. ObjectiveThis study aimed to evaluate the applicability of factor analysis methods to characterize school nutrition environments by identifying underlying factors, or dimensions, in the observed data and to examine the relation between school nutrition environment dimensions and child anthropometric and dietary outcomes. MethodsThis study examined a cross-sectional sample of 4635 US children aged 4–15 y from 386 US elementary and middle schools from the Healthy Communities Study (2013–2015). Data collected from schools were used to create 34 variables that assessed the school nutrition environment. To identify dimensions of school nutrition environments, exploratory factor analysis was conducted with orthogonal rotation, and factor scores were derived using methods to account for sporadic missing data. Mixed-effects regression models adjusted for child- and community-level variables and clustered by community and school examined the associations of school nutrition environment dimensions with child anthropometric and dietary outcomes. ResultsSix dimensions of school nutrition environments were derived: nutrition education, food options, wellness policies, dining environment, unhealthy food restriction, and nutrition programs. The unhealthy food restriction dimension was negatively associated with added sugar intake (β = –1.13, P < 0.0001), and the wellness policies dimension was positively associated with waist circumference (β = 0.57, P = 0.01). ConclusionsThis study demonstrates how factor analysis can reduce multiple measures of complex school nutrition environments into conceptually cohesive dimensions for purposes of assessing the relation of these dimensions to student health-related outcomes. Findings were mixed and indicate that the restriction of unhealthy foods in school is associated with lower added sugar intake. Additional, longitudinal studies are needed to substantiate the utility of this method for identifying promising school nutrition environments.

Association of Dental Caries and Anthropometric Measures among Primary School Children.

Aim: This study aimed to investigate an association between dental caries status and anthropometric measures in primary school children. Methods and Materials: An analytical cross-sectional study (n = 376) was conducted among primary school children (age range = 6–9 years) registered in private schools. Non-clinical data was gathered from parents of participating children through a self-administered structured questionnaire as well as from the children through an interviewer-administered questionnaire. Clinical data included the examination of dental caries using dmft/DMFT index and anthropometric measures including calculated z-scores of height-for-age (HAZ), weight-for-age (WAZ), BMI-for-age (BAZ), and physical examination. Inferential statistics included Kruskal Wallis and linear regression for univariate and multivariate analysis respectively. Results: The proportion of dental caries in primary and secondary dentition was 67.6% and 8.2% respectively. A significant association was observed between dental caries status and HAZ, WAZ, and BAZ (p < 0.001). An inverse relation was found between low, medium, and high dental caries categories and anthropometric measures. Conclusions: In the primary dentition, dental caries were significantly and inversely related to weight-for-age, height-for-age, and BMI-for-age. Hence, it can be concluded that among the low-income population dental caries is associated with lower anthropometric outcomes in children and therefore caries management should be considered an approach impacting overall health and quality of life.

Effect of a Short-Message-Service (SMS) and Inter-Personal Communication (IPC) Strategy on Maternal and Child Nutrition Outcomes: A Factorial Design Cluster Randomized Trial

Background: Sub-optimal infant and child feeding and growth faltering persist in Tanzania. We evaluated the effects of delivering nutrition/health messages through short-message-service (SMS) and interpersonal communication (IPC) strategies, separately and in combination, on maternal and child dietary diversity and nutritional status. Methods: This study was a 2×2 factorial, 40-cluster-randomized trial (10 clusters per group) with three intervention groups (SMS, IPC, and SMS+IPC) and a usual care (or ‘control’) among households containing a pregnant woman and/or a child <12 m of age at baseline (600 per group). Results: Data were complete for 2245 woman-child pairs. Compared to the control group, the odds of consuming a diet that met the women’s minimum dietary diversity (MDD) threshold were 1·46 (95%CI: 1·02, 2·09) and 2·03 (95%CI: 1·41, 2·92) times higher in IPC and SMS+IPC groups, respectively. Relative to the control group, the odds of meeting child’s MDD, minimum meal frequency, and minimum acceptable diet, respectively were 1·33 (95%CI: 0·99, 1·80, not significant), 1·77 (95%CI: 1·42, 2·21), and 1·65 (95%CI: 1·35, 2·03) times higher in the IPC and 1·90 (95%CI: 1·49, 2·41), 1·75 (95%CI: 1·38, 2·23), and 2·22 (95%CI: 1·71, 2·90) times higher in the SMS+IPC group. There were significant improvements in maternal nutrition knowledge, relative to the control group, in all intervention groups but no effects on maternal or child anthropometric outcomes. Conclusions: An interactive IPC strategy significantly improved maternal and young child diets. Combining IPC with an SMS component appeared to improve diets slightly more, but SMS alone had no impact. Funding: This research was funded by the Eleanor Crooke Foundation (grant number 66450). Conflict of Interest: None to declare. Ethical Approval: This study was registered on ClinicalTrials.gov (NCT03297190). Ethical approval was obtained from the Medical Research Coordinating Committee of Tanzania’s National Institute for Medical Research (NIMR/HQ/R.8a/Vol.IX/2684).

Maternal HIV and child anthropometric outcomes over time: an analysis of Zimbabwe demographic health surveys.

To understand the association between children's anthropometric measures and maternal HIV status in Zimbabwe and to determine whether these relationships changed over time. Data from Demographic Health Surveys in Zimbabwe rounds 2005, 2010, and 2015 were used to conduct cross-sectional analyses of child anthropometric measures (stunting, underweight, and wasting). Using separate logistic regression models for each of the anthropometric measures, we estimated the adjusted prevalence odds ratio (OR) of stunting, underweight, and wasting in children according to maternal HIV status. Moreover, we evaluated an interaction by survey year to evaluate change over time. Children of mothers with HIV had 32% greater odds [OR = 1.32, 95% confidence interval (CI) 1.16-1.5] of stunting, 27% greater odds (OR = 1.27, 95% CI 1.1-1.48) of underweight status and 7% greater odds (OR = 1.07, 95% CI 0.81-1.42) of wasting status, than children of mothers without HIV. These associations between maternal HIV status and child undernutrition did not differ by year (P > 0.05 for all interaction terms). In Zimbabwe, having a mother who tested positive for HIV at the time of the survey has been associated with greater child undernutrition over the last two decades with no significant change by survey round. This emphasizes the need for continued programming to address nutritional deficiencies, sanitation, and infectious disease prevention in this high-risk population. The greatest impact of maternal HIV status has been on child stunting and underweight, associated with poor long-term child development.