Malnutrition In Under-five Children Research Articles

Directed acyclic graph helps to understand the causality of malnutrition in under-five children born small for gestational age

Directed acyclic graph helps to understand the causality of malnutrition in under-five children born small for gestational age

Study on Weight Gain Efforts through Indigenous Technical Knowledge

Introduction: In India, under-five child malnutrition is a serious public health issue. This is demonstrated by the fact that India has one of the highest rates of underweight children worldwide. Aims: The study was carried out to assess the spatial distribution of nutritional status of children of 1-5 years through weight-for-age, height-for-age, weight-for-height data collected by the KVK. Preschoolers' dietary health was regressed on several sociodemographic factors after eliminating the effect of age. The information reveals that children's nutritional condition varies geographically and by gender in India. Methodology: A study was conducted in district Seoni of Madhya Pradesh to eliminate malnutrition via using indigenous technical knowledge (ITK). The trials were conducted in three following years viz 2020 to 2023. Primarily the training was conducted of mothers along with Anganwadi workers regarding the addition of sweet rice to kids from 1-5 years age group. Results: There was twice-daily portions of sweet rice, was prepared by using Jaggery by adding water, desi ghee, and roasted rice dry fruits added to it and then it cooked for 15-30 min and given for 45 days. The average body weight gain after evaluation and personal conversations of mothers was recorded as 9.91 kg and the proportion change against farmers practice was 13.48. Conclusion: The study concluded that rice prevalent areas and rice-based food habits for mothers and children should be adopted the sweet rice (ITK) the recommended practice against farmers’ practice.

Determinants of Severe Acute Malnutrition in under-five children in Dibrugarh District, Assam

Background: Malnutrition is a major public health problem and leading determinant of morbidity and mortality in under-five children in India. Aim & Objective: To assess determinants of Severe Acute Malnutrition (SAM) in under-five children of Dibrugarh district, to assess knowledge and practice of Infant, Young Child Feeding Practices (IYCF) and to assess the knowledge and practice of identification of SAM of Anganwadi workers. Settings and Design: Dibrugarh district, Assam. Mixed method study. Methods and Material: It was a case-control study that interviewed mothers of children between 6-59 months between June 2021 to May 2022. Using a pre-tested semi-structured questionnaire Interviews of a total of 164 under-five children’s mothers (82 cases and 82 controls)] were done. Qualitative data was also collected by in-depth interviews of Anganwadi workers (AWWs). Statistical analysis used: SPSS version 25.0. Chi-Square test, unadjusted OR for Bivariate analysis and adjusted odds ratio using Multiple logistic regression was calculated. Results: Determinants of severe acute malnutrition were joint family (AOR 3.08, 95% CI 1.02-9.31, p= 0.046); birth weight less than 2.5 kg (AOR 20.6, 95% CI 4.50-94.03, p=<0.0001); mothers with less than 4 antenatal check-ups (AOR 5.13, 95% CI 1.28-29.47, p=0.021); partial immunization (AOR 9.2, 95%CI 1.83-46.59, p=0.007); and irregular utilization of ICDS services (AOR 27.36, 95%CI 5.73-130.66, p=<0.0001). Problems faced by AWWs during service delivery were communication barriers, community resistance during home visits, and increased workload during COVID-19. Conclusions: IYCF practices need to be promoted with screening and growth monitoring for early detection and timely referral of malnutrition along referred back and linkages of services so that home-based and community-based management can be done to prevent severe acute malnutrition.

Effects of complementary food formulated from millet, soybean, and grasshopper on hematological parameters of malnourished weanling albino rats

Background: Malnutrition in under-five children remains an issue of public health, especially in low and middle-income countries, and is associated with inadequate child development and poor survival. Recent public health intervention strategies for malnourished children allow for localized targeted supplementation with locally available materials to replace the imported Ready-to-Use-Supplementary-Food (RUSF) for the target group. Aims: The aim of the study was to develop a local supplementary food and determine its effects on hematological parameters of weanling rats. Material and Methods: The experimental study involved thirty weanling albino rats, grouped into groups A, B, and C, each consisting of ten rats. All the groups were acclimatized for fourteen days, thereafter, groups A and B were induced with moderate acute malnutrition (MAM) by feeding with only corn starch for fourteen days. Weight, tail length, and hematological parameters (hemoglobin level, white blood cell count) of all the weanling albino rats were determined and recorded as baseline values on the fourteenth day. Therapeutic food made from millet, soybean, and grasshopper blends was produced and fed to group A as the intervention, Group B was fed with corn starch only and group C was fed on normal rat pellets for twenty-eight days. Weight, tail length, and hematological parameters were determined and recorded at the end of the intervention. Results: Experimental group A had the lowest packed cell volume (PCV) value with a difference of 2.20 ± 0.56 %, the lowest hemoglobin (Hb) level with a difference of 0.58 ± 0.02 g/dL, the control group had the highest PCV, Hb, and RBC with values of 4.10 ± 0.5 %, 1.58 ± 0.21 g/dL, and 0.9 ± 0.05 x 106 µ/L respectively. Conclusions: With the evidence provided by the parameters assessed in the study, it can be concluded that the developed therapeutic food is efficacious in the treatment of malnutrition especially in weanling albino rats. Keywords: Moderate Acute Malnutrition (MAM), Ready-to-Use-Supplementary-Food (RUSF) Malnutrition, Complementary feeding, Animal studies.

Environmental enteropathy and its association with water sanitation and hygiene in slum areas of Jimma Town Ethiopia.

Environmental Enteropathy is an inflammatory condition of the gut that leads to intestinal barrier dysfunction. It is a common problem in resource-limited countries and results from exposure to larger quantities of fecal bacteria to poor personal hygiene and environmental sanitation. Due to poor intestinal permeability, there is a problem with absorption of nutrients, which in turn leads to growth faltering, poor cognitive development, and oral-vaccine failure. The aim of this study was to identify the children with an elevated lactulose to mannitol ratio (indicative of possible environmental enteropathy) and its association with water sanitation and hygiene in slum areas of Jimma Town so as to mitigate the problem of malnutrition in under-five children. A community-based cross-sectional study was carried out from January to April 2021. A Lactulose mannitol test was performed to determine the prevalence of elevated lactulose to mannitol ratio (possibly environmental enteropathy) in children aged 12 to 59 months. A pretested questionnaire was used to collect data on water sanitation and hygiene (WASH) indicators and sociodemographic characteristics. A multivariable logistic regression analysis was used to isolate independent predictors for possible environmental enteropathy. All tests were two-sided and statistical significance was declared at P<0.05. The results of this study showed that 19.3% (95%CI: 14.8-23.7) of children had an increased lactulose to mannitol ratio (>0.15). On multivariable logistic regression analysis, the variables drinking water from unimproved water sources (AOR 3.741; 95%CI: 0.914-15.310,p = 0.048), unsafe coverage of water storage (AOR 0.363; 95%CI: 0.169-0.777, P = 0.009), public latrine utilization (AOR 0.139 95%CI: 0.024-0.816, P = 0.029),and hand washing less than 3 critical time of hand washing practices (AOR 4.369;95%CI: 1.411-13.524,P = 0.011) were significantly associated with an increased in lactulose mannitol ratio (possible indicative of intestinal permeability/environmental enteropathy). This study showed that one fifth of under-five children in Jimma Town had an elevated lactulose to mannitol ratio (possibly environmental enteropathy). The WASH sectors and other governmental organizations should give emphasis to areas with poor water sanitation and hygiene to mitigate the problem of environmental enteropathy and related consequences like growth faltering, poor cognitive development, and oral-vaccine failure in the study area.

A hybrid ensemble approach to accelerate the classification accuracy for predicting malnutrition among under-five children in sub-Saharan African countries

BackgroundThe proper intake of nutrients is essential to the growth and maturation of youngsters. In sub-Saharan Africa, 1 in 7 children dies before age 5 y, and more than a third of these deaths are attributed to malnutrition. The main purpose of this study was to develop a majority voting–based hybrid ensemble (MVBHE) learning model to accelerate the prediction accuracy of malnutrition data of under-five children in sub-Saharan Africa. MethodsThis study used available under-five nutritional secondary data from the Demographic and Health Surveys performed in sub-Saharan African countries. The research used bagging, boosting, and voting algorithms, such as random forest, decision tree, eXtreme Gradient Boosting, and k-nearest neighbors machine learning methods, to generate the MVBHE model. ResultsWe evaluated the model performances in contrast to each other using different measures, including accuracy, precision, recall, and the F1 score. The results of the experiment showed that the MVBHE model (96%) was better at predicting malnutrition than the random forest (81%), decision tree (60%), eXtreme Gradient Boosting (79%), and k-nearest neighbors (74%). ConclusionsThe random forest algorithm demonstrated the highest prediction accuracy (81%) compared with the decision tree, eXtreme Gradient Boosting, and k-nearest neighbors algorithms. The accuracy was then enhanced to 96% using the MVBHE model. The MVBHE model is recommended by the present study as the best way to predict malnutrition in under-five children.

Malnutrition in Ethiopia: pattern analysis and associated factors among under-five children

PurposeThis study aims to examine the differences within individuals and clusters in nutritional status and identify socioeconomic factors in the nutritional status of under-five children in Ethiopia.Design/methodology/approachA weighted sub-sample of 5,270 under-five children was drawn from the under-five children data set of the Ethiopian 2019 Mini Demographic and Health Survey. Multilevel modeling was used to look at the association between the nutritional status of children with predictors.FindingsThe proportion of stunting, underweight and wasting among under-five children were 39.3%, 28.6% and 16.3%, respectively. The observed Global Moran Index’s value for child malnutrition (stunting, wasting and underweight) prevalence in Ethiopia were I = 0.204 for stunting, I = 0.152 for wasting and I = 0.195 for underweight at p = 0.000 was statistically significant indicating that spatial variability of malnutrition of under-five children across survey clusters and regions was observed. Moreover, the result of heterogeneity between clusters obtained for stunting, underweight and wasting was significant providing evidence of variation among regional clusters concerning the status of nutrition of under-five children. Child’s age in months, breastfeeding, family educational level, wealth index, place of residence, media access and region were highly significantly associated with childhood malnutrition. The inclusion of the explanatory variables has shown a significant impact on the variation in malnutrition among regions.Practical implicationsEnhance education, expanding the activities regarding nutritional and health services using media, health extension workers, and health institutions.Originality/valueThe study provides the malnutrition situation status of Ethiopian country when the survey carried out.

Comparison of Different Nutritional Screening Approaches and the Determinants of Malnutrition in Under-Five Children in a Marginalized District of Punjab Province, Pakistan.

Objectives: This research measures the occurrence of malnutrition amongst under-five children in the Rahimyar Khan district of Southern Punjab in Pakistan. Employing different anthropometric measurement approaches such as (1) conventional indices (HAZ, WAZ, and WHZ), (2) CIAF, (3) BMI-for-age, and (4) MUAC, we compare their estimated results and examine the relationship between socioeconomic determinants and different anthropometric indicators. Methods: The study employs a proportional purposive random sampling method to collect data from 384 rural households in the community-based study using a self-administered survey and following the Lady Health Workers (LHWs) registered records. The nutritional status of 517 under-five children is measured with references to WHO (2009) child growth standards. Furthermore, the investigation used the model of binary logistic regression to measure the impact of socioeconomic factors on child malnutrition. Results: Compared with other approaches, the CIAF identifies more malnourished children (63%). The results of binary logistic regression illustrate that all the explanatory variables indicate a more significant empirical association with CIAF than conventional indices, BMI-for-age, and MUAC. Conclusion: CIAF is a more reliable tool for assessing child nutrition because it not only demonstrates more accurate estimates of malnutrition but also recognizes children with multiple anthropometric failures.

Prevalence and Risk Factors of Intestinal Parasitic Infection in Under-Five Children With Malnutrition: A Hospital Based Cross-Sectional Study.

ABSTRACTBackground:Intestinal parasitic infections (IPIs) and malnutrition in under-five children contribute substantially to developing countries’ childhood morbidity and mortality. This study assessed the prevalence and profile of IPI in under-five children and compared them with nutritional status and other socioeconomic factors.Methods:Anthropometric indices were used for checking the nutritional status of under-five children. Malnutrition was graded into four grades (I–IV) based on the Indian Academy of Pediatrics advocated Weight-for-Age criteria. Children whose Height-for-Age and Weight-for-Height were <−2, standard deviations were regarded as stunted and wasted, respectively. Stool samples were examined by direct wet mount (normal saline and iodine) and formol-ethyl acetate concentration technique to detect parasitic cyst and ova. Stool smears were made directly from the specimen and after concentration and stained by kinyoun’s stain. Subsequently, the association of undernutrition was assessed with intestinal IPI using the Chi-square test.Results:The overall prevalence of Grade I, II, III, and IV malnutrition was 52%, 31.7%, 12.2%, and 4.1% while stunting and wasting IPIs were present in 60.2% and 36.6%, respectively. IPIs were present in 47.2%, and 11.4% showed polyparasitism. Soil-transmitted helminths were found to be the commonest (Ascaris lumbricoides: 21.1%; Trichuris trichiura: 13.0%; and hookworms: 8.1%) followed by the intestinal protozoa (Enterobius vermicularis: 7.3, Giardia lamblia: 6.5, and Cryptosporidium spp.: 2.4%). Increasing age upto 5 years, improper excreta disposal, low level of maternal education, and a higher number of childrenin the family were predictors of IPIs. The prevalence of IPI was significantly associated with Grade II and III undernutrition, stunting, and wasting. Individually, Ascaris and hookworms contributed significantly to stunting and cryptosporidium spp. to wasting.Conclusion:Prevalence of IPI in malnourished under-five children is high. Joint nutritional interventional strategies, early diagnosis/treatment of under-five children, and increased awareness among masses are imperative to break the vicious cycle of malnutrition and parasitic diseases.

Effectiveness and tolerability of standardized milk based, standardized non-milk based and hospital-based formulations in the management of moderate acute malnutrition in under-five children: A randomized clinical trial

Introduction : Moderate acute malnutrition (MAM) is a leading cause of under-five morbidity and mortality globally. Supplementary feeding is a strategy recommended by WHO for managing the condition.Objective: To evaluate the effectiveness and tolerability of standardized milk-based formulation (SMBF), standardized non-milk based formulation (SNMBF) and hospital-based formulation (HBF) in under-fives with MAM.Method: This was an open label randomized clinical trial in which eligible children aged 6 – 59 months with MAM were assigned to receive the SMBF, SNMBF or HBF at 50% of their daily caloric requirement with their regular family diet for four months. Their baseline characteristics and anthropometric indices were noted. They were followed up on two weekly basis during which further assessments were performed. The analysis for effectiveness and tolerability of the formulations were based on “per protocol”.Results: A total of 687 children were screened and 188 enrolled. Seventy children received SMBF, 63 received SNMBF while 55 received HBF. There were 54/70 (77.1%), 57/64 (89.1%) and 46/55 (83.6%) evaluable participants in the SMBF, SNMBF and HBF group respectively. Recovery from MAM was 43/54 (79.6%), 40/57 (70.2%) and 32/46 (69.6%) in the SMBF, SNMBF and HBF group respectively. Normal nutritional status was attained by 13 (24.0%), 10 (17.6%) and 5 (10.9%) children in the SMBF, SNMBF and HBF group respectively. Diarrhea and skin rashes were the main features of poor tolerability.Conclusions: The formulations were effective in managing MAM in childhood but the SMBF was the most effective. Diarrhea and skin rashes were the main features of poor tolerability.

Determinants of malnutrition of under-five children among rural households in the southwest, Nigeria

Malnutrition has been attributed to many deaths among under-five children in most of the developing countries including Nigeria. Understanding the determinants of malnutrition can provide insights in designing interventions for reducing the high rates of child malnutrition. This study focused on what determines the malnutrition of under-five children among rural households in the southwest, Nigeria. A multistage sampling technique was employed to select 395 households that had 487 under-five children. Data were collected on child’s, mother’s, household’s and community characteristics using a pre-tested structured questionnaire. Information on the child’s nutrition status was obtained using Mid Upper Arm Circumference (MUAC) tape. The data were analyzed using descriptive statistics and logit model with STATA 14 statistical package. The results revealed that the average age of under-five children was about 25 months and over 50% of them are girls with a malnutrition rate of 44.0%. The child’s sex, the child’s birth interval, cultivated farm size, mother’s education, water source, and distance to nearest health center significantly determined the child’s malnutrition in rural areas of southwest Nigeria. Given the findings of this research, it is suggested that; mothers should be advised to use contraceptives for child spacing; farmers should be enlightened on the need to implement modern farming practices that lead to optimum yield per land cultivated rather than increasing the size of cultivated farmland; there should be an improvement on women’s education as well as a potable water source; and health care facilities close to respondents’ residence should be provided.

Oxidative Stress, Mitochondrial Dysfunction, and Premature Ageing in Severe Acute Malnutrition in Under-Five Children.

To assess oxidative stress, mitochondrial dysfunction, and premature ageing in children with severe acute malnutrition (SAM). This cross-sectional study was conducted in children (1 mo-5 y) with SAM (defined as per WHO criteria) presenting to Pediatrics inpatient department. Oxidative stress, mitochondrial dysfunction, and premature ageing were assessed by measuring and comparing total antioxidant status (TAOS), mitochondrial DNA (mtDNA) content, and telomere length (TL), respectively in 40 under-five children with SAM and 40 age- and sex-matched non-malnourished controls. Oxidative stress was significantly increased in children with SAM, reflected by lower median (IQR) TAOS in cases as compared to controls [10.78 (9.08, 12.3) vs. 16.63 (15.20, 18.03) mM Trolox, p < 0.001]. Median (IQR) mtDNA content was significantly increased in children with SAM [188.7 (105.2, 398.9) vs. 116.2 (67.2, 154.6), p < 0.001]. There was no significant difference in telomere length between cases and controls [1184.5 (894, 1408) vs.1082.6 (823.3, 1479), p = 0.747]. Children with SAM had significantly increased oxidative stress that possibly caused mitochondrial dysfunction but no premature ageing.

The Relationship between Exclusive Breastfeeding and Diarrhea in Under Six Months Infants in 2017 (Analysis of Indonesian Health Demography Data Survey 2017)

Background: Diarrhea is the main cause of malnutrition in underfive children. One of the efforts to prevent diarrhea in infants is exclusive breastfeeding. Exclusive breastfeeding is infant that receives only breast milk without any additional consumption from 0 to 6 months. Under six months infant who are not exclusively breastfed have a higher risk of developing diarrhea than those who are exclusively breastfed.Methods: This study aims to determine the relationship between exclusive breastfeeding and the incidence of diarrhea in under six months infants in Indonesia. This study analyze secondary data from the 2017 Indonesian Demographic and Health Survey. The sample in this study consist of all live infants aged 0-6 months born to women aged 15-49 years in Indonesia who were successfully interviewed and had a complete answer (no answer missing). After weighting, 1898 samples were obtained.Result: The result found that the proportion of diarrhea incidence in Indonesia is 9.1%. Meanwhile of all infants, 36% were not exclusively breastfed. The results showed that there was a significant relationship between infants who were not exclusively breastfed and diarrhea incidence in Indonesia after adjusted by mother's education level, maternal employment status, mother’s economic level, area of residence, and latrine ownership (PR = 2.12, 95% CI = 1.46-3.07).Conclusion : Infants who were not exclusively breastfed increase the risk for diarrhea. Therefore it is necessary to have a program to increase the coverage of exclusive breastfeeding. The program can take the form of counseling by health workers in health services.

Socio-Economic Disparities in Under-Five Child Malnutrition in Nigeria

INTRODUCTION: Recent attention over the health, wellbeing and nutritional intake of children below five years of age has grown tremendously. This is mainly because these years are crucial to a child&amp;rsquo;s survival, growth and development; and if not handled properly could unfavorably affect the well-being status and efficiency of the child in later adult life. The study focused on malnutrition of children under the age of five in relation to their socio-economic status. It was measured by stunting, wasting and underweight. &#x0D; &#x0D; METHODOLOGY: Data from the Living Standards Measurement Study (LSMS)/General Household Survey (GHS) 2015/2016 Nigeria was used for analysis. Malnutrition was measured using the three anthropometric measures which are expressed in terms of Z-scores namely: Stunting: height-for-age (HAZ), Wasting: weight-for-height (WHZ) and Underweight: weight-for-age (WAZ). The socioeconomic disparities in malnutrition were checked according to gender, place of residence and geo-political zones in Nigeria. While the concentration index and curves were used to check for the magnitude of inequality in malnutrition ascribable to the socio-economic status.&#x0D; &#x0D; RESULTS: The percentage of children stunted was the highest with 37.8 percent, followed by the percentage of children underweight to be 20.25 and children wasted was 9.63 percent. The percentage of stunting, wasting and underweight were considerably greater in male children compare to the female children. Stunting and underweight were responsive to the household socioeconomic status. A higher percentage of children below five years of age who were stunted, wasted and underweight lived in the rural areas of Nigeria compare to the children living in the urban areas. The rate of stunting was highest in the North West with a 52.91 percent, followed by North East with 43 percent, and lowest in the South South with 20.67 percent. The concentration indices analysis revealed that stunting, wasting and underweight all had negative signs signifying concentration among the poor household children. Finally, as one moves up the ladder of the socioeconomic status, a significant fall in the rate of stunting is witnessed. Therefore, increasing the income of the poorest in a society is a sound strategy to curb the high rates of stunting in the socio-economically deprived segments of the country.

Assessment of Nutritional Status of Underfive Children in a Low Socio-Economic Urban Community of Guntur city in AP State

Introduction: Under nutrition profoundly affects children’s survival, growth and development. Variousclassifications of malnutrition in children use different cut off points for malnutrition making it difficultto compare data. The Composite Index of Anthropometric Failure (CIAF) is an alternative classificationsystem which incorporates stunting, wasting and underweight. Objective: To identify malnutrition inunderfive children in a low socio-economic urban area of Guntur city. Methods: This cross-sectional studywas carried out during 2017 and 2018 at Israilpet in Guntur city of Andhra Pradesh. Weights and heightswere measured for 740 underfive children (367 boys and 373 girls) according to WHO guidelines. The datacollected was entered into MS Office Excel and analysed data is presented in the form of tables. Importantfindings are subjected to statistical tests at 5% Level of Significance. Results: Using WHO standards, 4.1%boys and 1.9 % girls are lesser than 3 standard deviations from the median and therefore can be consideredseverely malnourished. 10.4 % boys and 8.8% girls were moderately malnourished. Only 1 girl was morethan +3 SDs and is obese. The infant age group has the highest prevalence of malnutrition (33.7%). Stuntingis overall 10.0 % while wasting is 39.6%. Anthropometric failure taking into consideration all three aspectsof malnutrition i.e. wasting, stunting and underweight is 53.9% (boys 54.2% and girls 53.7%) Discussion:The response to child under nutrition in India has been limited to food supplementation not taking intoconsideration the multidimensional nature of malnutrition. Stunting is a significant form of under-nutritionbut goes largely unrecognized. CIAF could recognize more undernourished children than the z score-basedclassification. Conclusion: Using low weight-for-age as the only criterion may underestimate the trueprevalence of under nutrition. It is also seen that under nutrition in the first year of life is significantly higherboth in boys and girls.

Malnutrition and Socio-economic Factors in HIV Infected and Uninfected Under 5 Children in Zambia

Abstract Malnutrition contributes to more than one third of all child deaths, although hardly listed as the direct cause. In sub-Saharan Africa, malnutrition accounts for about 2% of deaths and 3% of Disability adjusted life years (DALYs) among under-5 children. In Zambia, 35% of under-5 children are stunted, 4% wasted, 12% underweight and 5% overweight. Malnutrition and HIV interact in complex ways that increase vulnerability to and worsen each condition therefore we sought to determine factors associated with malnutrition among under 5 children in Zambia. Using Stata version 14.2, we extracted and analysed sample data of 159 children aged 0-59 months from the 2016 ZAMPHIA population-based survey, that used a two-stage cluster sampling design. We used Generalised Linear Models to measure socio-economic factors associated with malnutrition. P-value of less than 0.05 was set as level of statistical significance. Factors associated with malnutrition included gender, child's HIV status and wealth index which showed an association with stunting, wasting and being underweight. The 16 (10%) under-5 children living with HIV were significantly more affected by stunting (38% vs 33%), wasting (19% vs 11%) and underweight prevalence (38% vs 10%) than the remaining 143 who were HIV negative. Our sample prevalence was similar to national stunting (33% vs 35%) and underweight prevalence (13% vs 12%) but had three times higher wasting prevalence (12% vs 4%). A high prevalence of malnutrition was found in HIV positive compared to negative under 5 children, wealth index showing an association with malnutrition. Eliminating malnutrition is key to attaining SDG 3 which is to end preventable deaths of newborns and children under 5 years of age. Key messages All types of malnutrition had a higher prevalence in HIV infected than uninfected under five children in Zambia. Wealth index is a socio-economic factor that is associated to all types of malnutrition in under-five children in Zambia.

The double burden of malnutrition in under-five children at national and individual levels: observed and expected prevalence in ninety-three low- and middle-income countries.

ObjectiveTo assess whether the observed prevalence of the double burden of malnutrition (DBM) would be higher than expected on the basis of chance, through analyses at national, wealth quintile and individual child levels.DesignWe selected nationally representative surveys from low- and middle-income countries (LMIC) carried out since 2005 with anthropometric measures on children under 5 years of age. Household wealth was assessed through asset indices. The expected prevalence of DBM was estimated by multiplying the prevalence of stunting (low height/length for age) and overweight (high weight for height/length). The WHO recommended cut-offs (20% for stunting and 10% for overweight) that were used to define DBM at national level. DBM at individual level was defined as co-occurrence of stunting and overweight in the same child.SettingNationally representative surveys from ninety-three LMIC.ParticipantsA total of 825 633 children were studied.ResultsDBM at national level was observed in five countries, whereas it would be expected to occur in eleven countries. Six countries did not present evidence of DBM at national level but did so in at least one wealth quintile. At individual level, thirty countries (32·3%) showed higher prevalence of DBM than would be expected, but most differences were small except for Syria, Azerbaijan, Albania and Egypt.ConclusionsThe observed number of countries or socio-economic subgroups within countries with the DBM using recommended thresholds was below what would be expected by chance. However, individual-level analyses showed that one-third of countries presented higher prevalence of DBM than would be expected.

Determinants of Malnutrition in Under-five Children in Angola, Malawi and Senegal

Introduction: Malnutrition is one of the leading causes of under-five mortality globally. With the estimated target of reducing mortality in this age group by 2030, understanding and determining the factors contributing to child mortality are critical. Methods: The current study used Demographic Health Survey (DHS) data from Angola (2016), Malawi (2016) and Senegal (2016). The DHS data for under-five children from these three countries were then combined in this study to create a pooled sample. This method allows for a comparison and generalization of the results across countries and has also been used in previous studies. The dependent variables (severely nourished, moderately nourished and nourished) were developed by using calculated Weight-for-age Z-scores (WAZ) from DHS data. The exploratory analysis was conducted by performing a gamma measure and chi-square test of independence to evaluate the association between malnutrition status and covariates. Results &amp; Discussion: Based on the generalized linear mixed model, the type of residence, sex of the child, age of the child, mother’s level of education, birth interval, wealth index and the birth order are correlated to malnutrition in Angola, Malawi and Senegal. Children who are from rural communities, poor households, with a mother having attained primary education, are female and are between the age of 24 and 59 months are associated with malnutrition. The results of the study suggest that children from these three countries who reside with mothers who have attained only primary education are at the highest risk of being affected by malnutrition. Conclusion: The results show the necessity of collaboration among the three countries in order to achieve the Sustainable Development Goal (SDG) target.

Prevalence and Determinants of Malnutrition in under Five Children in Selected Health Facilities in Egume, Kogi State, Nigeria

Aims: This study was conducted to determine the prevalence and determinants of malnutrition in under five children in selected health facilities in Egume, Dekina LGA, Kogi State.&#x0D; Study Design: This was a cross-sectional descriptive study with historic data that assessed the Prevalence and determinants of malnutrition of under-five children in selected health facilities in Egume Dekina Local Government Area, Kogi State.&#x0D; Study Area: The study was conducted at General Hospital and St. Luke clinic in Egume, Dekina LGA, Kogi State.&#x0D; Methodology: The study focused on Mothers and their under five children who were treated as in- or out- patients at the General Hospital and St. luke clinic Egume within the past five years, Interview was conducted with the aid of a validated, questionnaire, after obtaining informed consent from mothers and ethical clearance from the Health Research Ethics Committee, Kogi State Ministry of Health. Data was obtained through reviews of available health records. Anthropometric measurement was carried out following standard procedures.&#x0D; Results: The study showed that 21.3%, 25.6%, 47.4% and 5.7% of the sampled children were mildly undernourished, moderately undernourished, severely undernourished and healthy respectively.&#x0D; Conclusion: The present study further revealed that a child’s age and gender, mother’s education and nutrition and other health variables such as clean water and toilet are determinants of child malnutrition.

Prevalence and Profile of Malnutrition in Under-Five Children with Congenital Heart Diseases in Cairo University Pediatric Hospitals

Background: Malnutrition among children with Congenital Heart Disease (CHD) is considered a major public health problem causing significant impact on children morbidity and mortality. Objectives: The study aimed to assess the prevalence and epidemiological pattern of malnutrition among under-five Egyptian children with CHD. Methods: A cross sectional analytical study design included 300 children, having uncomplicated CHD. Hemoglobin level, serum iron and total iron binding capacity were recorded. Additionally, Anthropometric measurements were assessed and Z scores were calculated for weight for age (WAZ), weight for height (WHZ), and height for age (HAZ) have been calculated. Malnutrition was defined as weight, height, and weight/height Z score <–2. Results: Generally, prevalence of malnutrition among the studied sample of CHD children was 47%. Forty–four percent of the studied population were underweight, 29.7% were stunted, while wasting was only 6.7%. Malnutrition was significantly higher among those with low income compared to their expenditure (P = 0.038) and was significantly lower in those breastfed on regular intervals compared to those fed on demand (P = 0.002). Additionally, malnutrition was significantly higher in those receiving complementary feeding compared to those breastfed or bottle fed only (P value 0.03).Conclusion: Malnutrition is an obvious complicating problem in children with CHD, associated with existence of anemia, breastfeeding on demand and early- starting of complementary feeding.