Rates Of Malnutrition Research Articles

Burden of acute malnutrition in the conflict-affected urban communities of Tigray, Northern Ethiopia: a cross-sectional study

BackgroundMalnutrition impedes the growth, development, and survival of children. Conflict has severely affected the livelihoods of families and caused an alarming increase in food insecurity, population displacements, and extreme poverty in Tigray. Therefore, this study aimed to assess the prevalence and factors associated with acute malnutrition among 6- to 23-month-old children in the armed conflict-affected urban areas of Tigray.MethodsThe study population were randomly selected children aged 6 to 23 months. A cross-sectional study design was used. Data was collected from July 13 to 28, 2022 in Tigray region, Northern Ethiopia. A systematic random sampling technique was used to select the participants. Sociodemographic, lifestyle, anthropometric, and clinical variables were collected using a structured questionnaire. The data were analyzed using SPSS version 24 and presented using descriptive and analytical statistics. Binary logistic regression was used to identify independent predictors of acute malnutrition. All variables were declared statistically significant at a p-value of < 0.05.ResultsA total of 368 participants aged 6–23 months were included in the study. Half (50.5%) and around three-fourths (72.6%) of the participants were females and 12 to 23 months old children, respectively, with a mean (SD) age of 15.2 (5.1) months. The overall proxy global acute malnutrition rate was 44.3%, with 34.5% and 9.8% being moderate acute malnutrition and severe acute malnutrition, respectively. In the multivariable logistic regression model, three variables (consumption of legumes, maternal nutritional status, and household access to clean water) were identified as significant predictors of proxy global acute malnutrition. Children who didn’t eat legumes (AOR (95%CI): 2.39 (1.44, 3.97)), children of acutely malnourished mothers (AOR (95%CI): 1.60 (1.02, 2.51)), and children from households with insufficient water supply (AOR (95%CI): 1.99 (1.20, 3.31)) were significantly associated with an increased likelihood of acute malnutrition as compared with their counterparts.ConclusionsChildren from the armed conflict areas of Tigray are disproportionally impacted by acute malnutrition. Nearly half of the children were acutely malnourished, with one in ten suffering from the more serious severe acute malnutrition. Hence, urgent action is needed to prevent their permanent mental and physical deterioration and death by improving consumption of high protein foods, nutritional status of mothers, and access to clean water.

Impact of the School Food Environment on Dietary Choices and Body Mass Index Among Adolescents: A Case Study of Secondary Schools in Suakoko District, Bong County, Liberia

Adolescence is a critical period for developing lifelong dietary habits, and the school food environment plays a significant role in shaping these behaviors. With increasing rates of obesity and malnutrition among adolescents, understanding the influence of the school food environment is crucial, particularly in sub-Saharan Africa, where traditional diets are transitioning towards more processed, calorie-dense foods. This study aimed to assess the impact of the school food environment on dietary choices and body mass index (BMI) among adolescents in Suakoko District, Bong County, Liberia. A cross-sectional design was employed involving 275 students from 23 randomly selected public and private secondary schools. Data were collected using structured questionnaires, direct observations of the school food environment, and anthropometric measurements. Statistical analysis, including chi-square tests, was conducted to explore the relationships between school food environment, dietary choices, physical activity, and BMI. The results revealed that 64% of the students did not frequently choose fruits and vegetables, with food choices primarily influenced by availability and taste. A significant relationship was found between physical activity and nutritional status (p = 0.017), with regular physical activity being linked to a healthier BMI. However, no significant associations were found between school promotion of healthy eating, nutrition education, or the presence of school gardens, and students’ BMI. In conclusion, although schools play a vital role in shaping dietary habits, this study emphasizes the need for more effective interventions to improve access to nutritious foods and promote physical activity. Addressing the gaps in school infrastructure and enhancing nutrition education could contribute to better health outcomes for adolescents in Liberia.

THE ROLE OF NUTRITIONAL STATUS IN THE PERSISTENCE OF MEASLES IMMUNITY AMONG CHILDREN: A MULTIVARIATE ANALYSIS

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; The persistence of measles immunity in children is influenced by multiple factors, including nutritional status. This study aimed to assess the role of body mass index (BMI) as a proxy for nutritional status in the persistence of measles immunity, alongside other socio-demographic factors, in a pediatric population. &lt;strong&gt;Methods:&lt;/strong&gt; A multivariate logistic regression analysis was conducted on 200 children (2-15 years) attending the University Teaching Children's Hospital in Lusaka, Zambia. Immunity retention was measured through IgG serology. BMI represented nutritional status, and the analysis adjusted for key variables such as HIV status, breastfeeding history, sex, and education level. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to determine the association between nutritional status and immunity persistence. &lt;strong&gt;Results:&lt;/strong&gt; Children categorized as well-nourished had significantly lower odds of waning immunity (OR = 0.37, 95% CI = 0.16–0.83, p = 0.016). However, for children with over or under malnutrition, the association was not statistically significant (OR = 0.23, 95% CI = 0.03–1.62, p = 0.140). Additionally, HIV-positive status was associated with decreased immunity retention (OR = 0.28, 95% CI = 0.14–0.56, p &amp;lt; 0.001). Breastfeeding was positively associated with immunity persistence (OR = 3.34, 95% CI = 1.53–7.29, p = 0.003), while other socio-demographic factors such as sex and education level showed no significant effect. &lt;strong&gt;Conclusion:&lt;/strong&gt; Nutritional status, as measured by BMI, plays a significant role in the persistence of measles immunity among children, with over- and under-nourished children being associated with lower immunity retention. These findings suggest that nutritional interventions may be necessary to improve vaccine efficacy, particularly in populations with high rates of malnutrition or obesity. The results also highlight the need for further investigation into the mechanisms linking nutritional status to immune response and the development of targeted public health strategies to optimize measles immunization outcomes in children.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0722/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Nutrition and diet in children with orofacial clefts in Africa: a scoping review

Background and aimThe burden of orofacial clefts (OFCs) has declined globally except in sub-Saharan Africa, with a great disease burden in North Africa. Children with OFCs have a high risk of malnutrition, and African countries have some of the highest malnutrition rates. This scoping review assessed the status of research on OFCs and nutrition and feeding among children living in African countries.MethodsWe followed the Joanna Briggs Institute guidelines for conducting scoping reviews. We searched eleven databases for articles on malnutrition and feeding among children with OFCs living in African countries. No restriction was done by type of study or publication date. Books, book chapters, and reviews were excluded. Only publications in English language were included. We extracted information about the publication year, study design, setting, location, participants’ age, data collection methods, international collaboration, and funding. We classified articles into studies assessing (1) the impact of nutritional deficiencies during pregnancy on OFCs, (2) the impact of OFCs on malnutrition, (3) feeding problems in children with OFCs, and (4) the impact of nutritional status on OFCs repair outcomes. We calculated frequencies and used bar charts and a map.ResultsOut of 208 search results, 36 were duplicates, and 25 eventually fit the inclusion criteria, with 52% retrieved from Google Scholar. About 80% of the studies were from four countries: Nigeria, South Africa, Ghana, and Uganda; 72% were hospital-based and 52% were cross-sectional. The most frequent data collection method was clinical examination and questionnaires. Most studies focused on feeding problems in children with OFCs (44%) and the impact of OFCs on malnutrition (32%). International collaboration was observed in six studies, with one study showing South-South collaboration. Only two studies were funded.ConclusionsThere is a predominance of under-funded descriptive research not indexed by international databases. Minimal research has been directed to population-level OFC preventive programs in primary healthcare settings and assessing interventions supporting children with OFCs. A research agenda is needed to prioritize research needs and secure funds to support South-South collaboration to address the nutrition and feeding-related problems associated with OFCs.

The dual burden of malnutrition and its associated factors among mother-child pairs at the household level in Ethiopia: An urgent public health issue demanding sector-wide collaboration.

The coexistence of under-nutrition and over-nutrition in developing countries like Ethiopia results in the "mother-child pair double burden of malnutrition," with children experiencing either stunting, wasting or underweight while mothers face overweight or obesity. This poses a major public health challenge, prompting global health organizations to prioritize the issue and urge governments to act quickly. Despite this, there is a lack of research in Ethiopia on the double burden of malnutrition among mother-child pairs at the household level and the factors that worsen it. To assess the magnitude of double burden of malnutrition and its associated factors among mother-child pair at household level in East Ethiopia, 2022. A community-based cross-sectional study was conducted in East Ethiopia from April 15 to June 11, 2022. Multi-stage sampling was used, and data were collected through structured interviews. Child nutrition indicators were processed using WHO Anthro software. Binary logistic regression analysis was performed, calculating both crude and adjusted odds ratios to assess associations. Variables with a P value <0.05 in multivariable analysis were deemed statistically significant. The study revealed that coexisting malnutrition rates for (OM/SC), (OM/WC), and (OM/UC) were 8.5%, 7.0%, and 7.9% respectively. The double burden of malnutrition among mother-child pairs was found to be 12.3% [95% CI: 10.7, 13.7]. Marital status (divorced) [AOR = 1.80; 95% CI: 1.15, 2.82], child birth order (fourth or above) [AOD = 1.88; 95% CI:1.08, 3.26], number of under-five children in the household (five or more under-five children) [AOR = 1.58; 95% CI: 1.04, 2.39], poor maternal and child dietary diversity score [AOR = 2.76; 95% CI: 1.71, 4.45] and [AOR = 8.66; 95% CI: 4.85, 15.44], respectively, household food security status (food insecurity) [AOR = 3.68; 95% CI: 2.36, 5.75], and maternal stature (short stature) [AOR = 2.39; 95% CI: 1.65,3.45] were factors significantly associated with this burden. The study emphasized the double burden of malnutrition affecting both mothers and children, a major public health concern in the area. Early-life nutrition is vital in preventing childhood under nutrition and adult obesity, leading to this dual burden. Breaking the cycle of malnutrition across generations is crucial. Policy makers should prioritize improving child nutrition and maternal health, stressing early-life nutrition to address the mother-child double burden of malnutrition.

A retrospective cohort study on the association between nutritional status and prognosis in COVID-19 patients with severe and critical infection.

To evaluate the relationship between nutritional scoring systems, nutritional support methods, and the prognosis of severe and critically ill patients infected with the Omicron variant of coronavirus disease 2019 (COVID-19). Patients with confirmed Omicron variant severe and critical COVID-19, who were admitted to Chongqing Medical University First Hospital between December 2022 and January 2023, were enrolled into this retrospective study. Clinical data of patients who survived for 28 days were compared with those who died during the same period. Nutritional status was assessed using the 2002 Nutrition Risk Screening (NRS) tool and Prognostic Nutritional Index (PNI). Factors influencing patient mortality were identified by multivariate logistic regression, and the relationship between patient nutrition and mortality as the disease progressed was illustrated using Kaplan-Meier curves. The study was registered on the ChiCTR platform (No. ChiCTR2300067595). A total of 508 patients were included (349 survivors and 159 non-survivors). Significant differences were found in sex, age, NRS score, PNI score, albumin level, lymphocyte count, chronic comorbidities, mechanical ventilation, neutrophil count, procalcitonin, and platelet count between survivors and non-survivors. Multivariate analysis revealed that high NRS score (OR 3.87, 95% CI, 1.97, 7.63), fourth-level nutritional support (combined enteral and parenteral nutrition; OR 7.89, 95% CI, 1.32, 47.28), chronic comorbidities (OR 4.03, 95% CI, 1.91, 8.51), and mechanical ventilation (OR 6.03, 95% CI, 3, 12.13) were risk factors for mortality (OR > 1). The malnutrition rate among patients with NRS ≥ 3 was 41.93%. The median (interquartile range) PNI score was 38.20 (35.65, 41.25) for survivors versus 32.65 (29.65, 36.58) for non-survivors. The mortality rate was higher in patients with high nutritional risk within 28 days of hospitalization. The descending order for mortality rate in patients receiving different nutritional support was: dual parenteral and enteral nutrition, no nutritional intervention, single enteral nutrition, and single parenteral nutrition. A high proportion of severe and critically ill patients with COVID-19 experience malnutrition, and various factors are associated with their prognosis. High nutritional risk is significantly related to patient mortality. Early assessment using NRS or PNI is crucial for these patients, and personalized interventions should be implemented to improve overall nutritional status, maintain organ function, and enhance the body's antiviral defence.

The impact of a pediatric malnutrition telehealth clinic on anthropometric measurements in children aged 6-59 months in rural Guatemala.

Guatemala, a country with high rates of pediatric malnutrition, has significant challenges including food and potable water insecurity and a lack of health care providers. This study examined the impact of telehealth clinic attendance on pediatric malnutrition scores. A sample of 42 Guatemalan children aged 6-59 months with malnutrition were recruited to participate in eight clinic events, including two in-person and six telehealth clinics. Six telehealth clinics were held at 4- to 6-week intervals, bookended by an initial and concluding in-person event. Nonparametric tests were used to analyze changes between baseline and last visit z-scores for height, weight for length, mid-upper arm circumference (MUAC), and body mass index (BMI) and to examine the relationship between the number of telehealth visits and z-score measurements at baseline and last visit. The number of children with severe malnutrition at baseline by weight for length, BMI, and MUAC decreased by the last visit. A decrease occurred in the number of children with stunted height. Changes in z-scores for height, weight for length, BMI, and MUAC between study onset and last visit did not reach statistical significance. Statistically significant relationships existed between clinic attendance and baseline and last visit weight for height/length z-scores and baseline MUAC z-scores. Positive improvements in nutritional status occurred, especially among children with severe malnutrition. Children with severe malnutrition had significantly better telehealth attendance. Studies with larger sample sizes are needed. Study results indicate that telehealth may be a tool to battle global pediatric malnutrition.

The Relationship Between Knowledge Level and Attitudes of Mothers of Toddlers Towards Visits to Posyandu In Janti Village, Tarik District, Sidoarjo

One of the objectives of the Posyandu program is to reduce nutritional problems. The rate of malnutrition in Sidoarjo Regency is 3.8%, at the Tarik Health Center it is 0.13%, and in Janti Village, it reaches 5.13%. Malnutrition negatively impacts toddler growth. In 2023, the visit rate of toddlers to Posyandu in Janti Village was low, at only 32.1% of the total number of toddlers in the village, resulting in suboptimal monitoring of their growth. One factor influencing mothers' visits to Posyandu is their knowledge and attitude.This research is an analytical observational study with a cross-sectional design, aiming to analyze the relationship between the knowledge and attitudes of mothers of toddlers towards visits to Posyandu in Janti Village, Tarik District, Sidoarjo. The population consisted of 224 mothers of toddlers, with a sample of 70 respondents selected randomly through random sampling. Data were collected through questionnaires on the knowledge and attitudes of mothers towards Posyandu, as well as attendance records at Posyandu, and analyzed using Chi-Square and Fisher's Exact tests.Most respondents were aged 25-34 years (72.9%), had completed high school education (50.5%), and were housewives (62.6%). They generally possessed good knowledge about Posyandu (68.6%) or adequate knowledge (31.4%). Regarding visitation, 64.3% were active and 35.7% were inactive. This suggests that positive knowledge and attitudes towards Posyandu significantly influence visitation rates, supported by statistically significant results with a p-value of 0.001 (≤ 0.05).There exists a relationship between the level of knowledge and attitudes of mothers towards visits to Posyandu.

An evaluation of interventions within a Growth Through Nutrition project aimed at enhancing optimal nutrition and water, sanitation and hygiene (WASH) and nutrition practices among nutritionally most vulnerable households (MVHHs) in Ethiopia.

Despite a downward trend, Ethiopia still faces significant challenges with high rates of stunting and acute malnutrition in children. To tackle these issues, the Feed the Future Ethiopia Growth Through Nutrition Activity, a USAID-funded project aligned with Ethiopia's National Nutrition Program, was executed from 2016 to 2023. This initiative aimed to enhance nutrition for women and young children across six regions through multisectoral interventions. Annual surveys conducted in 2017, 2018, and 2020 evaluated the impact of livelihood support and Water, Sanitation, and Hygiene (WASH)-focused social behavior change communication (SBCC) on vulnerable households with children under two. The results showed significant improvements in child nutrition. Dietary diversity among children increased from 12% to 34% (p<0.001), and the percentage of children receiving a minimal acceptable diet rose from 12% to 30.7% (p<0.001). Women's dietary diversity also improved markedly, from 2% to 16% (p<0.001). Handwashing practices saw improvements, with the proportion of households having handwashing facilities rising from 14% to 31% (p<0.001), and the adherence to critical handwashing moments increased from 16% to 23%. However, challenges in water treatment and latrine use persisted, with less than 25% improvement. The findings suggest that integrating livelihood support with SBCC interventions can positively enhance nutritional outcomes. Continued focus on these strategies is recommended to further support vulnerable households.

Malnutrition in Guinea-Bissau: a country wide representative cross-sectional study

Abstract Background According to the WHO, malnutrition refers to deficiency, excess, or imbalance in a person’s intake of energy and/or nutrients. Children under five are especially vulnerable to malnutrition. The problem is widespread, but it is particularly prevalent in West African countries, where a prevalence of 30% stunting, 6.7% wasting and 2.4% overweight was described in 2022. In this study, we aimed to evaluate malnutrition in Guinea-Bissau (GB), a low-income country in West Africa. Methods We conducted a cross-sectional study between May and June 2023 on a representative sample of 1608 children aged 6 to 59 months, who had access to health care in all 11 regions of GB. Nutritional status was assessed by evaluating weight for height/length, weight for age, height/length for age, and hemoglobin concentration was determined using a portable hemoglobin analyzer. Furthermore, semi-structured questionnaires were applied to children’s parents, including questions on sociodemographic and behavioral factors, such as ethnicity, parental literacy, health care, and dietary patterns. Results 802 boys and 806 girls were included in the study, with a mean age of 26 months. Malnutrition rates were comparable to those described in other West African countries. We found wasting rates of 8,3%, stunting rates of 24,3%, low weight rates of 17,4%, and overweight rates of 2,4% among children under five. Importantly, 55.9% of the children had anemia: 23.6% had mild anemia, 31.1% had moderate anemia, and 1.2% had severe anemia. Statistical analyses are underway to investigate factors associated with malnutrition. Conclusions An important challenge in global health is combating malnutrition in all its forms. The identified prevalence of malnutrition in GB is high and emphasizes the importance of developing strategies and policies with local authorities so that the Sustainable Development Goals and Global Goals of Nutrition can be achieved and health outcomes improved. Key messages • Collaboration essential: researchers, policymakers, healthcare, and local authorities must unite for targeted malnutrition interventions. • Sustainable development in GB hinges on addressing malnutrition among its children through concerted efforts.

The effect of war and siege on children with diabetes admitted to ayder comprehensive specialized hospital in mekelle, tigray, ethiopia: a cross-sectional study

The armed conflict in Tigray, which spanned from November 2020 to November 2022, along with the accompanying siege, led to the near-total collapse of Tigray’s healthcare system. Type 1 Diabetes Mellitus, the most common chronic condition in children, requires significant lifestyle adjustments, including daily insulin injections, regular glucose monitoring, and dietary modifications; all of which are severely impacted by war and siege. This study compared Type 1 diabetes care for children at the Ayder Comprehensive Specialized Hospital, Tigray, during the conflict and siege period with that of the pre-war period. We conducted a retrospective cross-sectional survey, analyzing data from September 2019 to August 2020 (pre-war period) and comparing it with data from September 2021 to August 2022 (war and siege period). Descriptive statistics, including frequencies and percentages, were employed, and Pearson’s or Spearman’s correlation analyses were used to evaluate correlations where appropriate. We identified 143 pediatric patients admitted (56 during the pre-war period and 87 during the war and siege period), with a mean age of 109 months in both periods. During the war and siege, a higher proportion of diabetes admissions were due to diabetic ketoacidosis (DKA) (90%) compared to the pre-war period (75%). In the pre-war period, the most common trigger for DKA was infections (35%), while in the war and siege period, it shifted to malnutrition (47%), infections (46%), lack of access to healthcare facilities (31%), and running out of medicines (24%). Complications such as death, renal failure, cerebral edema, and shock were more prevalent during the war and siege periods. The case fatality rate was significantly higher during the war and siege (9%) compared to the pre-war period (0%), correlating strongly with the severity of DKA, the degree of hypokalemia, the presence of complications, and admission during the war and siege. Our study showed the negative impact of war and siege on diabetes care in children demonstrating a high rate of DKA admissions with increased severity, complications, malnutrition, and case fatality rates. People with diabetes especially type 1 deserve great attention during such a crisis as the lack of insulin could lead to severe complications including death.

Income and education disparities in childhood malnutrition: a multi-country decomposition analysis

IntroductionChildhood malnutrition is a complex issue with a range of contributing factors. The consequences of malnutrition are severe, particularly for children. This study aims to identify the factors contributing to inequality gaps in childhood malnutrition. Our study provides insights into modifiable elements to inform interventions targeted at distinct contexts and populations to improve child nutrition.MethodsThis study utilized data from the Demographic and Health Surveys (DHS) of 27 countries. First, the risk differences (RDs) between the prevalence of childhood malnutrition among the determinant variables, household income, and maternal education categories were calculated. The Blinder‒Oaxaca decomposition was subsequently used to determine the extent to which the difference in childhood malnutrition prevalence between low-income and high-income groups and maternal education levels results from the contributory effects of the explanatory variables: child and maternal individual-level compositional factors.ResultsWe examined data from 138,782 children in 27 countries from 2015 to 2020. The prevalence of childhood malnutrition (10.5%) varied across countries, ranging from 6.5% in Burundi to 29.5% in Timor Leste. On average, the prevalence of childhood malnutrition was 11.0% in low-income households and 10.7% among mothers without education. Some nations had pro-low-income (i.e., malnutrition concentrated among children from poor households) or pro-no-maternal education (i.e., malnutrition concentrated among children from mothers with no formal education) inequality in childhood malnutrition, but most did not. We found a complex interplay of compositional effects, such as the child’s age, maternal education, maternal health behavior, and place of residence, that influence the inequality in childhood malnutrition rates across 10 pro-low-income countries. In addition, we also found that a complex mix of compositional effects, such as the household wealth index, maternal health behavior, and maternal age, contribute to childhood malnutrition inequality between educated and uneducated mothers across the 7 pro-no maternal education countries.ConclusionThe prevalence of childhood malnutrition varies among low-income, high-income, and no maternal education-maternal education groups. This study highlights the need for a country-specific approach to addressing childhood malnutrition, with policies and interventions tailored to each country’s specific context.

Effect of the COVID-19 pandemic on malnutrition in socially vulnerable children in Brazil.

This article aims to evaluate the effect of the COVID-19 pandemic on malnutrition among children under two years of age enrolled in the Bolsa Família Program (BFP). Ecological study of interrupted time series (ITS), with low weight for age, stunting, and overweight as time-dependent variables of malnutrition, extracted monthly (Jan/2008 to June/2021) from the Food and Nutrition Surveillance System. The COVID-19 pandemic was the exposure, dichotomized into pre-pandemic and pandemic. In RStudio, the trend was obtained by Prais-Winsten regression, and the effect of the pandemic on the time-dependent variables was determined by SARIMA modeling, estimating the regression coefficients (RC) adjusted for trend and seasonality (α = 5%). The pandemic was associated with an increase in: i) low weight for age in the South (RC = 0.94; p < 0.001) and Southeast (RC = 1.97; p < 0.001); ii) height deficit in the Midwest (RC = 2.4; p = 0.01), South (RC = 2.15; p < 0.001) and Southeast (RC = 2.96; p < 0.001); and iii) and overweight in the North (RC = 1.51; p = 0.04), Midwest (RC = 2.29; p = 0.01), South (RC = 2.83; p < 0.001), and Southeast (RC = 0.72; p = 0.04). The pandemic increased underweight in the South and Southeast, and the double burden of malnutrition in the Midwest, South, and Southeast. In the Northeast and North, higher rates of malnutrition still persist.

PT Pertamina Patra Niaga Aviation Fuel Terminal (AFT) Syamsudin Noor Duta Duta Bahtera Program in Realizing Community-Based Sustainable Development Goals (SDG's) in Banjarbaru

Duta Bahtera Program implemented by PT Pertamina Patra Niaga Aviation Fuel Terminal (AFT) Syamsudin Noor, Banjarbaru, is an initiative to reduce malnutrition rates through a community-based approach. This program involves multiple stakeholders, such as integrated health post cadres, parents, health centres and nutritionists in training activities, providing additional food, and socializing good parenting patterns. This is descriptive qualitative research to examine the implementation of the Duta Bahtera Program by PT Pertamina Patra Niaga AFT Syamsudin Noor, Banjarbaru and its relation to the Sustainability Development Goals (SDGs). The results of Duta Bahtera program showed that the program contributes significantly to public health and can be used as a model for similar programs in other areas. With effective collaboration and empowerment, this program creates a strong foundation for a healthier future for children in Indonesia. Thus, the Duta Bahtera Program has a role in supporting the achievement of Sustainable Development Goals (SDGs), especially in eradicate poverty (SDG 2), improving health and well-being (SDG 3), and empowering communities and building multi-party collaboration (SDGs 17). This program also shows efforts to maintain a balance between environmental sustainability, economic growth and community welfare as a symbol of achieving the Triple Bottom Line SDGs.

Relationship Between Oral Hypofunction and Nutritional Status in Patients Treated With Maxillofacial Prostheses.

Introduction Patients who have jaw or tongue defects owing to head and neck cancer or congenital disease suffer from oral dysfunction such as speech, swallowing, and mastication. Although maxillofacial prostheses are applied to improve oral functions, their oral functions remain compromised compared to those of patients without jaw or tongue defects. On the other hand, it has been reported that oral hypofunction could lead to malnutrition in the general elderly. However, to date, no reports have evaluated the relationship between oral function and nutritional status in patients with maxillofacial prostheses. In this study, we comprehensively evaluated oral function according to the examination items for oral hypofunction. We assessed which functions were related to nutritional status in patients with jaw defects caused by tumors or congenital diseases who are candidates for maxillofacial prosthetic treatment. Methods Patients who underwent prosthetic treatment at the Department of Maxillofacial Prosthodontics, Aichi-Gakuin University Dental Hospital, between May 2021 and January 2024 and who were doing well were included in the study. Oral function was assessed with seven tests according to the criteria of the Japanese Society of Geriatric Dentistry, and nutritional status was evaluated using the Mini Nutritional Assessment Short-Form (MNA-SF). Patients were classified according to age and type of deficiency. Additionally, the presence or absence of oral hypofunction and malnutrition or risk of malnutrition were assessed. The impact of oral hypofunction tests and defect status on the risk of malnutrition was evaluated using a logistic regression model. Results Oral hypofunction and malnutrition or risk of malnutrition were more frequent in the elderly group by age. Regarding the type of defect, the rate of oral hypofunction and malnutrition or risk of malnutrition was highest in the tongue defect group. Results of the logistic regression analysis indicated that nutritional status was associated with tongue deficiency, tongue-lip motor function, tongue pressure, and swallowing function. Conclusion The nutritional status of maxillofacial prosthetic wearers was associated with oral hypofunction. Particularly, malnutrition and risk of malnutrition were increased with tongue defects and deficiencies in tongue-lip motor function, tongue pressure, and swallowing.

Advances in food fortification: Ensuring a healthier humanity, types, and analytical methods

Food fortification is the practice of improving food products' nutritional value by adding necessary vitamins and minerals. This practice is typically implemented to address widespread deficiencies of these nutrients in the population and improve public health. Fortification can be achieved through various methods, including adding specific micronutrients to staple foods such as flour, oil, or salt, as well as through the addition of micronutrients to processed or packaged foods. The benefits of food fortification include reduced rates of malnutrition and related health problems, improved overall health and cognitive development, and increased productivity. Despite these benefits, there are also potential challenges to the implementation of food fortification programs, including the need for accurate monitoring and assessment to ensure the appropriate use of fortificants and to prevent over-fortification. Despite these challenges, food fortification remains a promising strategy for improving public health and reducing the burden of micronutrient deficiencies globally.

Frailty as a sequela of burn injury: a post hoc analysis of the “RE-ENERGIZE” multicenter randomized-controlled trial and the National Health Interview Survey

BackgroundWith advancements in burn treatment and intensive care leading to decreased mortality rates, a growing cohort of burn survivors is emerging. These individuals may be susceptible to frailty, characterized by reduced physiological reserve and increased vulnerability to stressors commonly associated with aging, which significantly complicates their recovery process. To date, no study has investigated burns as a potential risk factor for frailty. This study aimed to determine the short-term prevalence of frailty among burn survivors’ months after injury and compare it with that of the general population.MethodsA post hoc analysis was conducted on the Randomized Trial of Enteral Glutamine to Minimize the Effects of Burn Injury (RE-ENERGIZE) trial, an international randomized-controlled trial involving 1200 burn injury patients with partial- or full-thickness burns. Participants who did not complete the 36-Item Short Form Health Survey (SF-36) questionnaire were excluded. Data for the general population were obtained from the 2022 National Health Interview Survey (NHIS). Frailty was assessed using the FRAIL (Fatigue, Resistance, Ambulation, Illness, Loss of weight) scale. Due to lack of data on loss of weight, for the purposes of this study, malnutrition was used as the fifth variable. Illness and malnutrition were based on admission data, while fatigue, resistance, and ambulation were determined from post-discharge responses to the SF-36. The burn cohort and general population groups were matched using propensity score matching and compared in terms of frailty status. Within the burn group, patients were divided into different subgroups based on their frailty status, and the differences in their (instrumental) activities of daily living (iADL and ADL) were compared. A multivariable analysis was performed within the burn cohort to identify factors predisposing to frailty as well as compromised iADL and ADL.ResultsOut of the 1200 burn patients involved in the study, 600 completed the required questionnaires [follow-up time: (5.5 ± 2.3) months] and were matched to 1200 adults from the general population in the U.S. In comparison to the general population, burn patients exhibited a significantly higher likelihood of being pre-frail (42.3% vs. 19.8%, P < 0.0001), or frail (13.0% vs. 1.0%, P < 0.0001). When focusing on specific components, burn patients were more prone to experiencing fatigue (25.8% vs. 13.5%, P < 0.0001), limited resistance (34.0% vs. 2.7%, P < 0.0001), and restricted ambulation (41.8% vs. 3.8%, P < 0.0001). Conversely, the incidence rate of illness was observed to be higher in the general population (1.2% vs. 2.8%, P = 0.03), while no significant difference was detected regarding malnutrition (2.3% vs. 2.6%, P = 0.75). Furthermore, in comparison with robust burn patients, it was significantly more likely for pre-frail and frail patients to disclose compromise in ADL and iADL. The frail cohort reported the most pronounced limitation.ConclusionsOur findings suggest a higher incidence of post-discharge frailty among burn survivors in the short-term following injury. Burn survivors experience compromised fatigue, resistance, and ambulation, while rates of illness and malnutrition were lower or unchanged, respectively. These results underscore the critical need for early identification of frailty after a burn injury, with timely and comprehensive involvement of a multidisciplinary team including burn and pain specialists, community physicians, physiotherapists, nutritionists, and social workers. This collaborative effort can ensure holistic care to address and mitigate frailty in this patient population.

The state of decentralization of the healthcare system and nutrition programs in the Lao People’s Democratic Republic: an organizational study

BackgroundThe Lao People’s Democratic Republic (Lao PDR), a lower-middle income country, has a higher malnutrition rate than other Southeast Asian countries. The decentralization of healthcare is a determinant of the effectiveness of programs to reduce malnutrition, but no study has focused on this factor in this country. This organizational study explores the state of decentralization of the healthcare system in Lao PDR that underlies the nutrition programs in the country.MethodsA qualitative study, which is based on a neo-institutional theory conceptual framework, explored factors related to dominant structure (laws, regulations, resources) and interpretative schemes (dominant ideas and beliefs) that characterize the nutrition services provided in the Lao healthcare system. Twenty-four semistructured interviews were performed with representatives of healthcare institutions involved in nutrition programs at different government levels, external donors and civil society organizations. The interviews were completed with relevant documents. The analysis focused on the convergence of interpretative schemes of the organizations concerned and the coherence between the structure underpinning the nutrition programs and the interpretative schemes.ResultsServices deployed to reduce malnutrition in the Lao PDR remain largely centralized, despite factors specific to the country that led it to promote decentralization of its services. The convergence of interpretive schemes and the coherence between the observed structure and the interpretative schemes of actors at all governance levels ensure the stability of this state of decentralization, which has persisted for almost 50 years.ConclusionNutrition programs in the Laos PDR are largely under the responsibility of the central government. The transformations in the healthcare system, notably with the use of new information technologies and the fact that the provinces are populated by a growing number of professionals trained in nutrition in addition to factors that push the system to be decentralized, such as ethnic diversity, the increasing availability of human resources in provinces, and the use of communication technologies, are not strong enough to change the balance of power between governance levels. The deconcentration that characterizes decentralization is therefore likely to continue for the foreseeable future.

Minimum dietary diversity is associated with lower risk of childhood underweight: Evidence from the 2019/2021 National Family Health Survey of India

A lack of consumption of a diversified diet is associated with poor physical and cognitive development in children. Evidence on the relationship between minimum dietary diversity (MDD) and childhood malnutrition remains inconclusive in India. We hypothesized that children aged 6 to 23 months on a diversified diet (five out of eight defined foods and beverages) are less likely to be malnourished (stunting, wasting, and underweight) compared to their counterparts who are not on a diversified diet. This cross-sectional study was based on the 2019-2021 National Family Health Survey of India, comprising a weighted sample of 57,714 children aged 6 to 23 months. Multilevel logistic regression was conducted for data analysis. The results showed a significant protective effect of dietary diversity on underweight (odds ratios [OR] = 0.91; 95% confidence intervals [CI]: 0.86-0.96). In addition, children who did not consume eggs (OR = 1.09; 95% CI; 1.03-1.15), dairy products (OR = 1.22; 95% CI: 1.17-1.27), or fruits and vegetables (OR = 1.11; 95% CI: 1.06-1.17) were more likely to be underweight than children who did. Children who did not consume dairy products, fruits, and vegetables were also more likely to be stunted and wasted. However, we did not find significant associations of MDD with wasting and stunting. Nutritional interventions promoting daily consumption of dairy products, eggs, fruit, and vegetables are recommended to address the growing problem of childhood malnutrition in India. Regions with higher rates of malnutrition and those lacking MDD, such as Uttar Pradesh and Rajasthan, should be prioritized.

Investigation of situation for development of infection, nutritional and length of hospital stay in elderly hospitalized in a palliative clinic

Aim: In our study, we aimed to evaluate patients' nutritional status, compare frequently used nutritional scales with each other and with the duration of hospitalization, and measure the effect of nutritional status on infection and mortality who are in the elderly. Materials and Methods: Nutritional Risk Screening-2002, Mini Nutritional Assessment, and Geriatric Nutritional Risk Index were used. Patients were monitored for infection and mortality throughout the hospitalization period. Results: The prevalence of malnutrition was found 98.6% with Mini Nutritional Assessment, 97.3% with Nutritional Risk Screening-2002, and 87.1% with Geriatric Nutritional Risk Index. A high correlation was found between the Geriatric Nutritional Risk Index and albumin, body mass index, arm, and calf circumference. Conclusion: The malnutrition rate is quite high in patients who need palliative care. The Geriatric Nutritional Risk Index, compared to Nutritional Risk Screening-2002 and Mini Nutritional Assessment, is an effective and user-friendly scale that contains objective variables in bed-dependent patients for nutrition.