Malnutrition In Under-five Children Research Articles

Magnitude of malnutrition among underfive children in urban slums of commercial capital of India and its multifactorial causation: A community-based study.

Context:Malnutrition in children is common globally and may result in both short- and long-term irreversible negative health outcomes. It is not a simple disease with single causative factor but it is a disease with multifactorial causation.Aims:1) To estimate prevalence of malnutrition in underfive children using “Z” score. 2) To evaluate the role of epidemiological and maternal factors on the nutritional status of children.Settings and Design:Community-based cross-sectional study.Methods and Materials:Randomly 10 slums were selected and under five-year-old children and their mothers from urban slums were examined and interviewed.Statistical Analysis:Data was analyzed with SPSS ver 20 and appropriate tests were applied.Results:Four-hundred children were examined. According to Z score classification, 39.8%, 36.5%, and 24.8% of children are underweight, stunted, and wasted, respectively. Family size (P = 0.02, χ2 = 7.7), initiation of breastfeeding (P = 0.009, χ2 = 6.8), maternal education (P = 0.001, χ2 = 13.9), underweight mothers (P = 0.05, χ2 = 4.8), and maternal dietary intake (P = 0.03, χ2 = 6.5) are significantly associated with underweight children. Similarly, stunted children show strong association with increasing age of child (P = 0.001, χ2 = 18.1), birth weight (P = 0.006, χ2 = 7.6), and not seeking medical opinion (P = 0.03, χ2 = 7.0). Primary immunization (P = 0.05, χ2 = 3.5), maternal education (P = 0.002, χ2 = 12.4), employed mothers (P = 0.02, χ2 = 4.9), and underweight mothers (P = 0.05, χ2 = 5.3) are associated with wasting in children.Conclusions:This study reveals very high prevalence of malnutrition status among underfive children of urban slums of commercial capital of India. Various maternal and epidemiological factors affect child nutritional status.

Prevalence of Malnutrition in Under-Five Children of Mittapalem Village in Rayalaseema Region

Prevalence of Malnutrition in Under-Five Children of Mittapalem Village in Rayalaseema Region

Association Between Economic Inequality and Under-Five Child Malnutrition: Evidence from Bangladesh Demographic and Health Survey

Under-five child malnutrition is an important phenomenon in developing countries like Bangladesh. Historically certain privileged groups have been benefited by the improvements in economic conditions inflicting health care inequality among the population. This study attempts to examine the association between economic inequality of households and adverse under-five child malnutrition using information from 4,976 children aged 0 to 59 months of Bangladesh Demographic and Health Survey, 2014 data. A child is said to be an adversely malnourished if the growth rate is badly stunted i.e., if z-score of the measure height-for-age of a child is more than the two standard deviations under the median. Multivariate logistic regression is used to estimate the household’s economic effect on the rate of adverse growth-stunting of children. The estimation results show that children from the poorest group are about four times more likely to experience malnutrition than the children from the richest group (OR = 4.32; 95% CI: 3.83, 5.07). The effects of economic status on childhood under-nutrition are also significant when the analysis is adjusted for child’s age, gender, multiple birth status, antenatal care, skilled birth assistance, birth order number (OR=3.43; 95% CI: 3.04, 3.87); mother’s BMI, mother’s education level (OR=3.05; 95% CI: 2.71, 3.48); residence type, and geographic region (OR = 3.14; 95% CI: 2.74, 3.63). Hence, this study suggests that there is a statistically significant association between the household economic inequality and the growth rate stunting of children. Reduction of poverty and making social security services as well as maternal medical supports more available to the poor people are necessary to improve the overall under-five childhood malnutrition condition in Bangladesh.
 Dhaka Univ. J. Sci. 66(1): 73-78, 2018 (January)

Application of proportional odds model in identifying contributing factor of under-five child malnutrition in Bangladesh: A case study in Tangail district

Background: Children malnutrition is one of the major public health-related concerns in all over the world, especially in developing countries like Bangladesh. Several socioeconomic and demographic factors are responsible for this situation. Aims: The purpose of this research was to identify the contributing factors of malnutrition in Tangail district using primary data collected from rural Tangail. Materials and Methods: The sample was collected using the cluster sampling techniques. Villages were considered as a cluster, and the sample from cluster are selected using probability proportional to size method. In our study, we have categorized the child nutritional status as, “severely malnourished,” “moderately malnourished,” and “nourished” based on Weight-for-age z-score. Bivariate analysis was conducted by examining the gamma measurement for ordinal variables and to check the association between child nutrition status and selected individual variables; we have used the contingency table and Chi-square test. Statistical Analysis: Both univariate, bivariate, and multivariate analysis was conducted to meet the objectives of the study. The proportional odds model was selected to understand the stable effects of covariates influencing the child malnutrition. Results: Bivariate analysis shows significant (P

Contributing Factors to Under-Five Child Malnutrition in Rural Bangladesh

Contributing Factors to Under-Five Child Malnutrition in Rural Bangladesh

Risk factors for severe acute malnutrition in under-five children attending nutritional rehabilitation centre of tertiary teaching hospital in Karnataka: a case control study

Background: To determine and analyse the risk factors leading to severe acute malnutrition (SAM) in children under 5 years of age attending nutritional rehabilitation centre of our hospital.Methods: This questionnaire based case control study was conducted from January 2016 to December 2016 on SAM children. For comparison children attending outpatient department without any evidence of malnutrition were included. These SAM children were admitted to the nutritional rehabilitation centre of Cheluvamba Hospital attached to Mysore Medical College and Research Institute, Mysore, Karnataka.Results: A total of 103 SAM cases were compared with 100 controls. The sociodemographic risk factors were age less than 2 yrs, more family members (55.3% had 5 to 8 members), Birth spacing less than 2 years (39.8%), open air defecation (37.9%) and living in kucha house (32%). The dietary risk factors which were statistically significant were poor appetite (33%), prelacteal feed (19.4%), lack of exclusive breast feeding (42.7%), discontinuing breast feed before 2 years (74.8%), receiving complementary feed before 6 months (67%), bottle feeding (32%), calorie deficit (79.6%), protein deficit (66%) and feeding difficulty (17.5%).Conclusions: The social risk factors identified in this study were large family size, low income, more number of siblings and living standards like type of house, open air defecation. The nutritional risk factors were giving prelacteal feed, not giving exclusive breast feeding until 6 months, starting complementary feed before 6 months and giving food low in calories and protein.

Burden of Severe Acute Malnutrition in under-five Children (2-59 Months) Admitted in a Tertiary Care Hospital of Delhi.

The aim of the present study is to assess the burden of severe acute malnutrition (SAM) and other malnutrition in a tertiary care hospital in Delhi. All patients aged 2-59 months admitted from August 2012 to July 2014 were screened for malnutrition by anthropometry using standard techniques, and SAM was diagnosed as per guidelines [1, 2]. During the study period, 4520 children of age 2-59 months were admitted and complete data of 4354 children were available, which were analysed. Of these, 50.4% were underweight, 44.6% were stunted, 33.5% were wasted, 0.76% had oedematous malnutrition and 18.3% had SAM. Of all patients with SAM, 80% were <24 months old, with 54.1% males and 45.9% females. Moderate acute malnutrition was present in 21.4%. Associated co-morbidities were diarrhoea or respiratory infection or both. Hospitals of Delhi have a high load of complicated SAM and need adequate infrastructure and facilities for management of these children.

The association between malaria and malnutrition among under-five children in Shashogo District, Southern Ethiopia: a case-control study

BackgroundRecent studies have presented conflicting findings about whether malaria is associated with an increased or decreased risk of malnutrition. Therefore, assessing the relationship between these two disastrous diseases in the most vulnerable groups, such as in children aged below 5 years (under-five children), may lead to the discovery of new low-cost and effective aides to current methods of malnutrition prevention in malaria-endemic areas. Therefore, this study was conducted to assess the relationship between malaria and malnutrition among under five children in an area with a high degree of malaria transmission.MethodsThe study involved comparing malnourished children aged 6–59 months and nourished children of the same age for their past exposure to malaria, in Shashogo District, Southern Ethiopia. A validated structured questionnaire was used to collect home to home socioeconomic data and anthropometric instruments for clinical data. The collected data were analysed using descriptive and inferential statistics by means of EpiData entry software and STATA data analysis software.ResultsA total of 356 (89 malnourished and 267 nourished) under-five children participated in the study. Previous exposure to Plasmodium infection was found to be a predictor for the manifestation of malnutrition in under-five children (P = 0.02 [OR = 1.87, CI = 1.115–3.138]). Children from a household with a monthly income of less than USD 15 were 4.5 more likely to be malnourished as compared to the other children (P = 0.001 [OR = 0.422, CI = 0.181–0.978]).ConclusionThis study found that exposure to Plasmodium has a significant impact on the nutritional status of children. In addition, socio-demographic factors, such as family income, may play a role in determining whether children are malnourished or not and may lead to increased morbidity due to malnourishment in children living in malaria-endemic areas. Therefore, malnutrition control interventions should be consolidated with malaria prevention strategies particularly in high malaria transmission areas.

Risk factors for severe acute malnutrition in under-five children: a case-control study in a rural part of India

ObjectivesThe present study was planned to identify some of the risk factors of severe acute malnutrition (SAM) in under-five children in a rural part of India. Study designCase-control study. MethodsThe study was carried out in rural areas of Yavatmal district. A total of 737 cases (under-five SAM children) and an equal number of normal controls were included in the study. Data were collected using a structured questionnaire. Binary logistic regression was used for multivariate analysis using a hierarchical model. ResultsThe odds of a child being in the SAM category increased significantly if the family: was below the poverty line, have a kuccha house, have more children in the family, have less rooms in the house, have a working mother, has a mother with a lower level of education, have an unemployed father, did not use any water purification measure, did not always ensure parents washed their hands before feeding a child, did not wash hands with soap and water after defecation, have a father with any addictive habit like tobacco or alcohol consumption, have a maternal height <145 cm, have a maternal weight <45 kg, have a lower age at marriage for mothers, had an institutional delivery, have the same food utilized more than once in a day, have no age-appropriate vaccination, give prelacteal feeds, have a lower frequency of breast feeding, do not use semisolid food during the weaning period, exclusively breast feed for less than four months or more than six months, had low birth weight, have five or more episodes of illness in the previous year, have ≤3 feeds per day apart from breast milk, and not initiation of breast feeding within 30 min of birth. ConclusionRisk factors identified in the present study can be addressed through health system interventions. The strongest association was observed with child feeding practices; thus, more emphasis is required in nutritional education and counselling in strategies to fight undernutrition.

Trends in socioeconomic inequalities in child malnutrition in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2000–2011

BackgroundChild malnutrition is not only a major contributor to child mortality and morbidity, but it can also determine socioeconomic status in adult life. The rate of under-five child malnutrition in Vietnam has significantly decreased, but associated inequality issues still need attention.ObjectiveThis study aims to explore trends, contributing factors, and changes in inequalities for under-five child malnutrition in Vietnam between 2000 and 2011.DesignData were drawn from the Viet Nam Multiple Indicator Cluster Survey for the years 2000 and 2011. The dependent variables used for the study were stunting, underweight, and wasting of under-five children. The concentration index was calculated to see the magnitude of child malnutrition, and the inequality was decomposed to understand the contributions of determinants to child malnutrition. The total differential decomposition was used to identify and explore factors contributing to changes in child malnutrition inequalities.ResultsInequality in child malnutrition increased between 2000 and 2011, even though the overall rate declined. Most of the inequality in malnutrition was due to ethnicity and socioeconomic status. The total differential decomposition showed that the biggest and second biggest contributors to the changes in underweight inequalities were age and socioeconomic status, respectively. Socioeconomic status was the largest contributor to inequalities in stunting.ConclusionsAlthough the overall level of child malnutrition was improved in Vietnam, there were significant differences in under-five child malnutrition that favored those who were more advantaged in socioeconomic terms. The impact of socioeconomic inequalities in child malnutrition has increased over time. Multifaceted approaches, connecting several relevant ministries and sectors, may be necessary to reduce inequalities in childhood malnutrition.

Malnutrition in under-five children

Malnutrition in under-five children

Inequities in under-five child nutritional status in South Africa: What progress has been made?

Despite the emphasis given to poverty reduction in policy statements and a substantial increase in social spending, money-metric poverty has shown little improvement since South Africa's transition to democracy in 1994. Alternative approaches to measuring well-being and inequality may show a more positive trend. This article uses the 2008 National Income Dynamics Study to assess the magnitude of inequalities in under-five child malnutrition ascribable to economic status. The article compares these results with those of Zere and McIntyre, who analysed similar data collected in 1993. In both cases, household income, proxied by per-capita household expenditure, was used as the indicator of socio-economic status. Children's heights and weights have increased since 1993 and being stunted or underweight has become less common. Furthermore, pro-rich inequalities in stunting and being underweight have significantly declined since the end of apartheid. This suggests that pro-poor improvements in child welfare have taken place. Policies that may have contributed to this include the Child Support Grant, introduced in 1998, and improvements in healthcare and the education of women.

Risk factors for malnutrition in under-five children: one year after the Yogyakarta earthquake

Background Malnutrition in children under the age of five remains a major health problem, since half of mortality cases in this age group involve malnutrition. The 2006 earthquake caused destruction of physical, biological and socio-economic environments, potentially leading to malnutrition in Yogyakarta children.Objective To identify the prevalence and risk factors of malnutrition in Yogyakarta children under five years of age, one year after the 2006 earthquake.Methods We conducted a cross-sectional study among children aged 0 to 60 months in the Bambanglipuro Subdistrict, Bantul Regency, Yogyakarta from September to October 2007. Nutritional status was determined using weight for height Z-scores, according to the WHO 2006 Child Growth Standards.Results Out of 666 subjects, we found severe malnutrition, undernutrition, normal weight, and overweight status in 1.7%, 4.8%, 88.6% and 4.8%, respectively. By multivariate analysis, risk factors for malnutrition were not having been weighed during the previous three months (OR 0.35; 95% CI 0.1 to 0.8) and having acute respiratory infection in the previous two weeks (OR 1.99; 95% CI 1.1 to 3.8)Conclusion One year following the 2006 earthquake, acute respiratory infection in the previous two weeks and unmonitored growth in the previous three months were risk factors for malnutrition in children under five years.

Malnutrition of Under-Five Children: Evidence from Bangladesh

Objective: The objectives of this study are to describe the differentials and associated risk factors of malnutrition among under-five children in Bangladesh. Material &amp; Methods: The data extracted from Bangladesh Demographic and Health Survey (BDHS)-2007. Basic anthropometric variables were used for finding prevalence of anthropometric indices (stunting, wasting and under weight) to assess child’s nutritional statuses. Chi- Square test and Logistic Regression technique were used to find out the significant factors associated with child’s nutritional status. Results: The study results showed the high prevalence of stunting and underweight, for instance 42% and 40% of under-five children were stunted and underweighted respectively. The analyses of the study also revealed that household economic status, mother’s education, father’s education, mother’s antenatal visit (s), mother’s age at birth and mother’s BMI are the most significant factor /determinant s of child’s malnutrition. Conclusion: The magnitude of the Child’s malnutrition still is of great concern in Bangladesh. Significant association between maternal related factors and child’s nutritional status has been found in this study. For improving the nutritional status of children or for getting healthy babies the intervention program(s) must connect not only children but also newly mothers and prospective mothers. Key Words: Anthropometric measurement; Malnutrition; Stunting; Underweight; Wasting DOI: http://dx.doi.org/10.3126/ajms.v2i2.3662 Asian Journal of Medical Sciences 2 (2011) 113-119

Association between paternal smoking and nutritional status of under‐five children attending Diarrhoeal Hospital, Dhaka, Bangladesh

The study aimed at determining whether there is an association between paternal smoking and nutritional status of children aged 0-59 months. Furthermore, the study looked at the presence of any nutritional differentials within different socio-economic groups. Secondary analysis of data on children aged 0-59 months enrolled in the Hospital Surveillance System of International Centre for Diarrhoeal Disease Research, Dhaka Hospital, Bangladesh, during 1996-2006. Among 13,555 under-five children, fathers of 49% were smokers. In multivariate logistic regression models adjusting for potential confounders, fathers' smoking was significantly associated with increased risk of moderate underweight (OR 1.16, 95% CI 1.08-1.25), severe underweight (OR 1.15, 95% CI 1.06-1.26), moderate stunting (OR 1.15, 95% CI 1.06-1.23) and severe stunting (OR 1.13, 95% CI 1.03-1.25). In middle and lower socio-economic strata, risk of moderate and severe child malnutrition was found to be significantly increased in the group where the father was a smoker. Results indicate that there is an association between fathers' smoking and malnutrition of under-five children particularly in lower socio-economic group. A possible mechanism - if this association is causal - may be through a negative effect on family economy.

Using extended concentration and achievement indices to study socioeconomic inequality in chronic childhood malnutrition: the case of Nigeria

ObjectivesTo assess and quantify the magnitude of inequalities in under-five child malnutrition, particularly those ascribable to socio-economic statusMethodsData on 4187 under-five children were derived from the Nigeria 2003 Demographic and Health Survey. Household asset index was used as the main indicator of socio-economic status. Socio-economic inequality in chronic childhood malnutrition was measured using the "extended" illness concentration and achievement indices.ResultsThere are considerable pro-rich inequalities in the distribution of stunting. South-east and south-west regions had low average levels of childhood malnutrition, but the inequalities between the poor and the better-off were very large. By contrast, North-east and North-west had fairly small gaps between the poor and the better-off on childhood malnutrition, but the average values of the childhood malnutrition was extremely high.ConclusionThere are significant differences in under-five child malnutrition that favour the better-off of society as a whole and all geopolitical regions. Like other studies have reported, reliance on global averages alone can be misleading. Thus there is a need for evaluating policies not only in terms of improvements in averages, but also improvements in distribution.

THE ROLE OF NUTRITIONAL INFORMATION IN ADDRESSING UNDER-FIVE CHILD MALNUTRITION IN TANZANIA

The paper discusses the role of nutritional information for addressing under-five child malnutrition in Tanzania. The paper is based on a master's dissertation whose objective was to determine the sources of nutritional information used to provide nutritional information to mothers in Maternal and Child Health (MCH) clinics, to investigate variables that determine accessibility and use of nutritional information and the sources of information routinely consulted by mothers when seeking nutritional information. Questionnaires and interview guides were used to collect data from 150 mother-child pairs and 25 health workers randomly selected from selected MCH clinics around Morogoro Urban District. The study found that although the MCH health and nutrition education sessions are an important aspect in disseminating nutritional information to mothers, these sessions were seldom conducted and the attendance of mothers to these sessions was poor. Radio and oral communication from friends and colleagues were the most commonly used sources of information and education is the most important variable that determines use and access to nutritional information. The study concludes that access to reliable nutritional information is an important aspect in addressing child malnutrition and therefore efforts should be made to ensure that mothers have access to adequate and reliable nutritional information through establishment of information units within the MCH clinic and paying more attention to less educated women when providing information. University of Dar es Salaam Library Journal Vol.5(2) 2003: 82-92

Inequities in under-five child malnutrition in South Africa.

ObjectivesTo assess and quantify the magnitude of inequalities in under-five child malnutrition, particularly those ascribable to socio-economic status and to consider the policy implications of these findings.MethodsData on 3765 under-five children were derived from the Living Standards and Development Survey. Household income, proxied by per capita household expenditure, was used as the main indicator of socio-economic status. Socio-economic inequality in malnutrition (stunting, underweight and wasting) was measured using the illness concentration index. The concentration index was calculated for the whole sample, as well as for different population groups, areas of residence (rural, urban and metropolitan) and for each province.ResultsStunting was found to be the most prevalent form of malnutrition in South Africa. Consistent with expectation, the rate of stunting is observed to be the highest in the Eastern Cape and the Northern Province – provinces with the highest concentration of poverty. There are considerable pro-rich inequalities in the distribution of stunting and underweight. However, wasting does not manifest gradients related to socio-economic position. Among White children, no inequities are observed in all three forms of malnutrition. The highest pro-rich inequalities in stunting and underweight are found among Coloured children and metropolitan areas. There is a tendency for high pro-rich concentration indices in those provinces with relatively lower rates of stunting and underweight (Gauteng and the Western Cape).ConclusionThere are significant differences in under-five child malnutrition (stunting and underweight) that favour the richest of society. These are unnecessary, avoidable and unjust. It is demonstrated that addressing such socio-economic gradients in ill-health, which perpetuate inequalities in the future adult population requires a sound evidence base. Reliance on global averages alone can be misleading. Thus there is a need for evaluating policies not only in terms of improvements in averages, but also improvements in distribution. Furthermore, addressing problems of stunting and underweight, which are found to be responsive to improvements in household income status, requires initiatives that transcend the medical arena.

Epidemiology of undernutrition.

The present study was undertaken to find out the magnitude of the problem of under nutrition among the children under 5 years of age and also to identify the important factors influencing the nutritional status of the children. 30 cluster sampling technique had been applied in the study. A total of 600 children below five years of age were covered. Twenty under five children from each cluster were chosen for the study which was carried out during January to February '97. As per IAP criteria a total of 60.29% children were undernourished and 3.92% were severely undernourished. According to NCHS standard 46.57% & 6.86% children had weight below-2SD and -3SD respectively. A statistically significant relationship was found between the different age groups and nutritional status of under 5 children. Severe degree of malnutrition had highest prevalence under two years of age. The influence of variables like age, sex, religion, literacy status of parents and morbidity of the children were significantly associated with malnutrition. Practice of exclusive breast feeding, introduction of timely complementary feeding, education for maintaining personal hygiene, proper implementation of UIP immunization, periodic deworming, standard case management of diarrhoea and ARI as well as continuation of feeding during illness may reduce malnutrition of under-five children.