Malnourished Pre-school Children Research Articles

Dietary intervention with edible film-coated multistrain probiotic Lacticaseibacilli in nondairy food matrices significantly increased the recovery of fecal viable Lacticaseibacilli and improved the performance of several colonic biomarkers among slightly malnourished preschool children.

Probiotic enriched dairy products are widely consumed in Western countries for their beneficial effects on the gastrointestinal tract and overall health. The present study aims to investigate the beneficial effects of probiotic Lacticaseibacilli (LAB) strains in non-dairy food matrices. A blend of edible film-coated probiotic LAB, L. plantarum, L. paracasei, and L. rhamnosus, were incorporated into plain biscuits and dry dates. Design of the randomized controlled study: Children of both sexes (mean age 55.7 ± 14.5 months) attending kindergarten in Tersa, a poor urban Giza district, were recruited and randomized into 5 groups of equal numbers. Treatment groups: (1) placebo biscuits, (2) functional probiotic biscuits (0.18 billion colony forming units (cfu) of LAB) (3) functional probiotic + inulin biscuits (0.2 billion cfu of LAB + 2 g of chicory inulin); (4) placebo dates and (5) functional probiotic dates (0.3 billion cfu of viable multistrain LAB). The supplements were served 5 days a week and each child had to consume 21 servings of the supplement. The primary outcome was an increase in the fecal recovery of viable LAB after the intake of 21 servings (T1) compared to the respective baseline counts (T0). The secondary outcomes include the determination of fecal short-chain fatty acids (SCFA) and secretory immunoglobulin A (s-Ig A) using ELISA and fecal ammonia excretion. Results: Statistically significant % increases in the recoveries of fecal viable LAB were found among the children consuming 21 servings of supplements 2, 3, and 5 compared to the respective count at T0. Similar significant increases were found in the fecal concentrations of SCFA and s-Ig A among the children consuming 21 servings of supplements 2, 3 and 5 compared to the respective counts at T0. On the other hand, the concentration of toxic ammonia excretion decreased significantly in the feces of all children consuming probiotic-containing supplements (groups 2, 3, and 5) at T1 compared to the respective concentrations obtained at T0. Conclusion: Multistrain microencapsulated probiotic Lacticaseibacilli in functional biscuits and dry dates successfully tolerated the acidic gastric transit and exerted their bioactive action on the colonic microbiome. The synbiotic supplement exhibited a higher production rate of colonic SCFA. Probiotic-enriched products that confer definitive health benefits are convenient and do not need to be kept under refrigeration. Manipulating the composition and function of the microbiome in childhood through probiotic/+ prebiotic interventions is cost-effective with long-term beneficial health outcomes. This study was approved by the Medical Research Ethics Committee, National Research Center and registered as Clinical Trial 16/422. Written informed consent was obtained from the mothers of all participating children.

Effect of Home-Made Formula on Growth Performance of Malnourished Pre-School Children (24-36 Months of Age) in Yobe State Nigeria

Aim: The insurgency in the north-east zone of Nigeria has aggravated rate of malnourished children and many are roaming the streets unattended. This study determined the effect of home-made formula on growth performance of malnourished pre-school children in Yobe State, Nigeria.
 Study Design: A factorial experiment.
 Place and Duration of Study: Yobe state, Nigeria, 6 weeks.
 Methodology: Three local Government Areas (LGA) of Yobe state, Nigeria (Bade, Bursari and Potiskum) used. A formulated home-made formula (HMF) was compared with therapeutic milk powders (TMPs). Twenty malnourished pre-school children were purposefully selected in each LGA and were grouped into two. Each group was randomly allotted to a dietary treatment, a child stood as replicate. At commencement children with complications were treated in the hospital. They were fed at 16.88 ml/kg body weight at 3 hours interval daily throughout a 6th week study using plastic cups. Parameters studied included weight, height, mid-upper arm circumference (MUAC) and W/HZ-score. A SPSS statistical package was used to analyze the results.
 Results: All the parameters were (p>0.05) affected with dietary treatments among districts. However, children fed HMF had higher final MUAC (127.50±2.04mm), higher height gain (3.45±0.18cm) and higher MUAC gain (13.76±0.22mm) among districts while those fed TMPs had higher final weight (10.74±0.25kg), higher final height (83.77±0.16cm) and higher weight gain (2.11±0.01kg). Based on average, the children fed HMF had higher final MUAC (127.50±2.04mm), height gain (3.45±0.18cm) and MUAC gain (13.76±0.22mm) while their counterparts fed TMPs had higher final weight (10.74±0.25kg), final height (83.77±0.83) and weight gain (2.11± 0.01kg). The children fed TMPs had slightly higher daily weight gain (50.23g) than those fed HMF (48.81g); and all the children were discharged with -2<z-score. 
 Conclusion: It can be concluded that HMF was effective in managing malnutrition in pre-school children. Therefore, it is recommended as alternative therapeutic food.

Effect of nutrition intervention on cognitive development among malnourished preschool children: randomized controlled trial

Childhood malnutrition impairs health, development, and productivity in adulthood. Underweight children have been found to have a variety of cognitive abnormalities. The present study examined the effect of a nutrition-focused intervention on cognitive development among malnourished preschool children between 3 and 5 years of age residing in selected villages of Udupi district, Karnataka. A cluster of 12 villages was chosen randomly. The trial had enrolled preschool children (n = 253) from randomly assigned selected villages to intervention (n = 127) and control arms (n = 126). The mothers in the intervention arm received nutrition-focused intervention and reinforcement of health teaching for 12 months. The post-intervention outcome on the cognitive development of malnourished children was measured at 6 months and 12 months. Statistical analyses indicated that 52% of children in the intervention group had average cognitive development scores on the pre-test, whereas on the post-test, only 5.5% were in the average level of cognitive development. In the control group, the average cognitive development status of the children decreased from 44.4% in the pretest to 26.2% in the post-test. The cognitive development of malnourished children in the intervention group improved compared to the control group (p < 0.001). This study revealed that home-based nutrition-focused food helps to enhance children’s cognitive development.Trial registration: ctri@gov.in. CTRI/31/03/2017/008273 [Registered on: 31/03/2017].

Anemia in African malnourished pre-school children: A systematic review and meta-analysis.

Generating accurate epidemiological data on the magnitude of anemia in malnourished children is a vital step for health policymakers. Therefore, this study is aimed to synthesize the overall magnitude of anemia in African malnourished pre-school children. We have searched the databases PubMed/MEDLINE, Embase, Scopus, Web of Science, Google Scholar, and Google to identify relevant articles. Joana Brigg’s Institute critical appraisal tool was used to assess the quality of articles. A random-effects model was applied to estimate the pooled prevalence of anemia in malnourished children. The I2 statistics were used to examine heterogeneity among the included studies. In the presence of heterogeneity, a subgroup analysis has been used. The funnel plot analysis and Egger’s tests were used to investigate the presence of publication bias. A total of 15 articles with 12,211 study participants were included in this study. Anemia was observed in 57.53% (95% CI: 47.05, 68.01) of African malnourished pre-school children. Moreover, the prevalence of anemia was 58.52% (95% CI: 43.04, 73.81) and 56.18% (95% CI: 40.24, 72.13) in HemoCue and auto-machine diagnosis method of anemia, respectively. This review showed that the magnitude of anemia was high among African malnourished pre-school children. Therefore, planning preventive measures to decrease anemia and its complications in malnourished children in Africa is an important step.

Study on impact of feeding soyaladoo and soyaflakes chiwada to malnourished pre-school children and their biochemical analysis

To prevent malnutrition among children in the country in a sustainable manner are a critical component in this endeavor. This would require a multipronged effected in the form of capacity building for nutritional research, programme intervention development and evaluation. To treat malnutrition among the preschool children the formulation of locally based protein rich product is done. Hence attempt was made to formulate soyabased food products such as soyaladoo and soyaflakes chiwada. Soya products were formulated and prepared by standard methods. Organoleptically selected soya products were analyzed for its chemical composition such as protein, fat, vitamins, minerals, and ant nutritional factors. These products were supplemented to pre-school malnourished children @ 40 g/head/day for six months. Preschool malnourished children were graded according to grade of malnutrition. Their biochemical parameter such as serum iron (μg/dl) serum proteins (gl/dl), serum vitamin A (IO/dl), serum zinc (μg ml), blood glucose mg/dl and Haemoglobin g/dl had done monthly for six months. It had shown highly significant changes on blood glucose level, haemoglobin, serum protein, serum vitamin A, serum iron and serum zinc states of pre-school children after supplementation of soyaproducts.

Comparative study of feeding soyladoo and soychakali to malnourished pre-school children and its impact on their biochemical analysis

Malnutrition is a worldwide health issue. It imposes a toll on child mortality, 53 per cent of deaths in children under 5 years in age are nutrition related in worldwide. It may be due to the role of nutrients in disease and immunity. To treat malnutrition among the preschool children the formulation of locally based protein rich product is must hence attempt was made to formulate soybased food products such as soyladoo and soychakali. These soyabased food products formulated and prepared by standard methods. Organoleptically selected soya products were analyzed for its chemical composition such as protein, fat, vitamins, minerals, and ant nutritional factors. These products were supplemented to pre-school malnourished children @ 40 g/head/day for six months. Pre-school malnourished children were graded according to grade of malnutrition. Their biochemical parameter such as serum iron (μ g/dl) serum proteins (gl/dl), serum vitamin A (IO/dl), serum zinc (μ g ml), blood glucose mg/dl and Haemoglobin g/dl had done monthly for six months. It had shown highly significant changes on blood glucose level, haemoglobin, serum protein, serum vitamin A, serum iron and serum zinc states of pre-school children after supplementation of soyaproducts.

Study of cereal and legume intake by 24 hrs diet recall method of pre-school malnourished children after supplementation of soya products

Malnutrition among pre-school children is global problem to cope with this problem formulation of locally available protein and cereal base traditional products is done. The products are affordable and rich in nutrient content. The infant and pre-school children are extremely vulnerable. Hence, it is very essential to supply energy protein rich food products for better health and good nutritional status of the children. Hence, soya based food products are prepared such as soyaladoo, soyachakali and soyaflakes chiwada. These products were evaluated for its minor, major nutrients and antinutrients. The cereal and legume intake recorded by 24 hrs diet recall method. The intake of cereal and legume significantly increased after supplementation of soya products to pre-school malnourished children for six months. These products were given to at @40 g product/day /child. It provides energy, protein and fat as per ICMR recommendation. The malnourished pre-school children were classified as grade II and III. The intake of cereal and legume significantly increased after supplementation.

Impact of soya products supplementations on vitamin intake of malnourished pre-school children

Protein calorie malnutrition is major nutritional problem of the world. To treat malnutrition among the pre-school children the formulation of locally based protein rich product is must, hence, attempt was made to formulate soyabased food products such as soyaladoo, soyachakali and soyaflakes chiwada. These products were evaluated for its minor and major nutrients. The status of vitamins like vitamin B 1 , vitamin B 2 , vitamin C, niacin and β-carotene etc. consumption significantly increased after supplementation of these soya products to pre-school malnourished children for six months, respectively. The malnourished pre-school children were classified as grade II and III. These products were given to preschool malnourished children @50 g product / day /child. It provides energy, protein and fat as per ICMR recommendation.

Daily Supplementation with Iron Plus Folic Acid, Zinc, and Their Combination Is Not Associated with Younger Age at First Walking Unassisted in Malnourished Preschool Children from a Deficient Population in Rural Nepal1–4

A community-based, cluster-randomized, placebo-controlled trial of daily zinc and/or iron+folic acid supplementation was conducted in rural southern Nepal to examine motor milestone attainment among 3264 children 1–36 mo of age between 2001 and 2006. Treatment groups included placebo, zinc (10 mg), iron+folic acid (12.5 mg iron + 50 μg folic acid), and zinc+iron+folic acid (10 mg zinc + 12.5 mg iron + 50 μg folic acid). Infants received half of these doses. The iron arms were stopped November 2003 by recommendation of the Data Safety and Monitoring Board; zinc and placebo continued until January 2006. A total of 2457 children had not walked at the time of entry into the trial and 1775 were followed through 36 mo. Mean age at first walking unassisted did not differ among groups and was 444 ± 81 d (mean ± SD) in the placebo group, 444 ± 81 d in the zinc group, 464 ± 85 d in the iron+folic acid group, and 446 ± 87 d in the iron+folic acid+zinc group. Results were similar after adjustment for age at enrollment, asset ownership, maternal literacy, and prior child deaths in the household and in children who consumed at least 60 tablets. Compared with placebo, iron+folic acid was associated with an adjusted mean delay of 28.0 d (95% CI: 11.3, 44.7) in time to walking among infants and the delay was more pronounced with mid-upper arm circumference (MUAC) ≤ 9.5 cm [60.6 d, (95% CI: 28.5, 92.6)]. Risks and benefits of universal iron+folic acid supplementation of infants beyond improved hematologic status deserve further consideration. J. Nutr. 140: 1317–1321, 2010.

Variables socionutricionales de hogares mazahuas integrados por preescolares desnutridos con madres con obesidad y sin obesidad.

The first objective was to know the prevalence of Mazahua households living in extreme poverty, and where malnourished preschool children co-exist with overweight and obese mothers, in this study three socio-nutritional variables were compared (family income, mother's education and nutritional adequacy of the daily diet) among these households and those formed by malnourished children and non-obese mothers. A transversal study was carried out (2006-2007) in the Mazahua community of San Francisco Tepeolulco, Municipality of Temascalcingo; which included 85 households integrated by malnourished preschoolers registered to the Opportunities program. The nutritional status of preschool children was determined using anthropometric indicators and the BMI of the mothers of the infants was obtained. A socio-nutritional survey was given, including the 24 hour recall. The analysis was complemented by participant observation. 83% of Mazahua mothers were overweight or obese. The nutritional status of preschool children with obese mothers had a higher percentage of malnutrition (76%).In regards to the gender variable, it was found that 54% of children with obese mothers were short in body height. When relating the educational level of the mother, this variable was statistically significant (p=0.015), where illiteracy is more related to child malnutrition of mothers who have standard weight or less. Finally, Mazahua households with obese and non-obese mothers do not show significant differences based on their dietary and nutritional characteristics. The high prevalence of households integrated by malnourished preschoolers with obese mothers is another symptom of poverty in indigenous areas in Mexico, where low Human Development Indexes prevail.

Effects of deworming on malnourished preschool children in India: an open-labelled, cluster-randomized trial.

BackgroundMore than a third of the world's children are infected with intestinal nematodes. Current control approaches emphasise treatment of school age children, and there is a lack of information on the effects of deworming preschool children.MethodologyWe studied the effects on the heights and weights of 3,935 children, initially 1 to 5 years of age, of five rounds of anthelmintic treatment (400 mg albendazole) administered every 6 months over 2 years. The children lived in 50 areas, each defined by precise government boundaries as urban slums, in Lucknow, North India. All children were offered vitamin A every 6 months, and children in 25 randomly assigned slum areas also received 6-monthly albendazole. Treatments were delivered by the State Integrated Child Development Scheme (ICDS), and height and weight were monitored at baseline and every 6 months for 24 months (trial registration number NCT00396500). p Value calculations are based only on the 50 area-specific mean values, as randomization was by area.FindingsThe ICDS infrastructure proved able to deliver the interventions. 95% (3,712/3,912) of those alive at the end of the study had received all five interventions and had been measured during all four follow-up surveys, and 99% (3,855/3,912) were measured at the last of these surveys. At this final follow up, the albendazole-treated arm exhibited a similar height gain but a 35 (SE 5) % greater weight gain, equivalent to an extra 1 (SE 0.15) kg over 2 years (99% CI 0.6–1.4 kg, p = 10−11).ConclusionsIn such urban slums in the 1990s, five 6-monthly rounds of single dose anthelmintic treatment of malnourished, poor children initially aged 1–5 years results in substantial weight gain. The ICDS system could provide a sustainable, inexpensive approach to the delivery of anthelmintics or micronutrient supplements to such populations. As, however, we do not know the control parasite burden, these results are difficult to generalize.Trial RegistrationClinicalTrials.gov NCT00396500

Evaluation of a nutrition supplementation programme in the Northern Cape Province of South Africa.

This study aimed at assessing the effectiveness regarding implementation and impact of a take-home nutrition supplementation programme, the Protein Energy Malnutrition (PEM) Scheme, that targets malnourished pre-school children and pregnant and lactating women in the Northern Cape Province of South Africa. In assessing implementation of the PEM Scheme, a cross-sectional descriptive study was undertaken over a 6-month period in the six regions of the Northern Cape Province. Interviews were conducted with programme managers and health personnel at clinics who were responsible for implementing the PEM Scheme. In assessing the impact of the PEM Scheme on growth, a retrospective review was done of the clinic records (including anthropometric data) of children enrolled in the PEM Scheme over a 1-year period. About 76% of the budget allocated to the PEM Scheme had been utilised over the 1-year period. The budget for the following financial year was based solely on food supplements purchased in the previous year. Coverage of malnourished pre-school children and eligible pregnant and lactating women for enrolment was estimated to be 50% and 60%, respectively. Eighty-five per cent of health facilities in the province participated in the PEM Scheme. Some of the main problems identified included: lack of training, inappropriate targeting of certain groups, incorrect application especially of discharge criteria for pregnant and lactating women, inadequate assessment for nutrition-related disease, inadequate nutrition counselling and no standardised monitoring. Of the 319 children enrolled over a year, the mean age was 16.2 (standard deviation 16.2) months, 41% had been low-birth-weight and 18% had been diagnosed with tuberculosis. Ten per cent of the children with a weight-for-age Z-score of <-2 moved into the normal Z-score range after being on the PEM Scheme for a mean duration of 8 months. There was an overall improvement in the weight-for-age Z-scores of 25% of the sample, with a significant difference between the mean weight-for-age Z-scores at enrolment and follow-up This was mainly related to significant improvement in the mean weight-for-age Z-scores of children <2 years. Numerous problems with the PEM Scheme have been identified which could have limited its impact. Recommendations are proposed for improving the effectiveness and impact of the PEM Scheme in the province.

Vitamin A Supplementation but Not Deworming Improves Growth of Malnourished Preschool Children in Eastern Zaire

A randomized controlled trial was conducted in eastern Zaire to assess the effects of high dose vitamin A supplementation and regular deparasitation on the growth of 358 moderately malnourished preschool children, discharged from the hospital. The treatment groups received either vitamin A (60 mg of oily solution of retinyl palmitate, 30 mg if aged <12 mo) every 6 mo or mebendazole (500 mg) every 3 mo; the control group received no supplementation. Anthropometric data were gathered at baseline and after 6 and 12 mo of follow-up. Serum retinol concentrations were measured at baseline and after 3 mo. The three groups did not differ in sociodemographic indicators, age and sex composition, nutritional status and serum retinol concentrations at baseline. In children who were vitamin A deficient at baseline, adjusted mean weight and mid-upper arm circumference (MUAC) increments were higher in the vitamin A–supplemented group than in the control group [annual increment in weight and MUAC in vitamin A vs. control group: 2.088 vs. 1.179 kg (P = 0.029) and 2.24 vs. 0.95 cm (P = 0.012), respectively], whereas growth increment did not differ between the dewormed group and the control group. In children who were not vitiamin A deficient at baseline, growth increment did not differ between the vitamin A–supplemented and control groups, whereas weight gain was lower in the dewormed group than in the control group. Vitamin A–supplemented boys gained more weight and height than control boys, whereas vitamin A–supplemented girls gained less height than control girls. Dewormed boys and girls gained less weight than control boys and girls. Programs to improve vitamin A status by high dose vitamin A supplementation may improve growth of preschool children who are vitamin A deficient, whereas deworming does not.

Evaluation of rose bengal staining test and rapid dark-adaptation test for the field assessment of vitamin A status of preschool children in Southern Brazil

The objective of this study was to evaluate two of several methods presently available for assessing vitamin A status of marginally malnourished preschool children of socioeconomically deprived families in Southern Brazil. The rose bengal staining test and rapid dark-adaptation test were evaluated by comparing their results with conventional methods that require estimation of dietary intake of vitamin A equivalents and determination of plasma levels of retinol before and after an oral supplementation of 200 000 IU vitamin A. Results indicate that neither test evaluated is useful by itself. There was no significant correlation between the results of the rose bengal staining test and the plasma levels of retinol. Also, no significant correlation was observed between the rapid dark-adaptation time and the vitamin A status of the preschool children as determined by plasma-retinol levels before and after vitamin A supplementation.

Relationships between Ascaris infection and growth of malnourished preschool children in Kenya

A longitudinal study in Ascaris-infected and noninfected children was conducted in two Kenyan villages. Anthropometric, clinical, and stool exams were performed three times at 14-week intervals. All children received an anthelmintic drug (levamisole) at the second examination. In the 14 weeks before deworming, children with Ascaris (n = 61) did not differ from controls (n = 125) in percentage expected weight gain. In the 14 weeks after deworming, previously infected children showed higher percentage expected weight gain than controls. Before deworming, there was a statistically significant (P less than 0.0005) decrease in triceps skinfold thickness in Ascaris-infected children versus controls. After deworming, skinfold increased significantly (P less than 0.0005) in previously infected children versus controls. Multiple regression analysis showed that Ascaris infection was by far the most important variable of those studied explaining decrease in skinfold thickness before and increase after deworming. It appears that even light Ascaris infections might adversely influence nutritional status, and deworming might enhance growth.

INTRACELLULAR COMPOSITION AND HOMEOSTATIC MECHANISMS IN SEVERE CHRONIC INFANTILE MALNUTRITION

Data obtained in a study of chemical composition of tissues in malnourished pre-school children are reported. In most cases, muscle and skin show an increase in total content of water, sodium and chloride. These changes are less striking but persist during "dehydration" judged on clinical grounds. The content of potassium in muscle was slightly to moderately decreased particularly in clinically edematous children. Edematous patients also had a markedly decreased intracellular concentration of potassium. In general, no correlation between intracellular concentration of sodium and potassium was found in muscle. Muscle obtained shortly before death or immediately after death frequently showed a marked shift of water and sodium into the intracellular compartment. A low ratio of concentration of potassium to noncollagenous nitrogen as compared to normals generally was observed. The skins of subjects without clinically demonstrable edema had comparable amounts of water but less fat per unit of dry fat-free solids than those of children with pitting edema. No particular correlation was found between overhydration and increase in content of the ("excess") chloride of the non-extracellular phase.