Prevalence Of Chronic Malnutrition Research Articles

Nutritional Challenges among African Refugee and Internally Displaced Children: A Comprehensive Scoping Review.

Children's nutrition in Africa, especially among those displaced by conflicts, is a critical global health concern. Adequate nutrition is pivotal for children's well-being and development, yet those affected by displacement confront distinctive challenges. This scoping review seeks to enhance our current knowledge, filling gaps in understanding nutritional and associated health risks within this vulnerable population. We conducted a scoping review of the literature on the nutritional status and associated health outcomes of this vulnerable population with the goal of informing targeted interventions, policy development, and future research efforts to enhance the well-being of African refugee and internally displaced children. This scoping review adopted Arksey and O'Malley (2005)'s methodology and considered studies published between 2000 and 2021. Twenty-three published articles met the inclusion criteria. These articles highlighted a wide variation in the levels of malnutrition among African refugee/internally displaced (IDP) children, with the prevalence of chronic malnutrition (stunting) and acute malnutrition (wasting) ranging from 18.8 to 52.1% and 0.04 to 29.3%, respectively. Chronic malnutrition was of 'high' or 'very high' severity (according to recent WHO classifications) in 80% of studies, while acute malnutrition was of 'high' or 'very high' severity in 50% of studies. In addition, anemia prevalence was higher than the 40% level considered to indicate a severe public health problem in 80% of the studies reviewed. In many settings, acute, chronic, and micronutrient malnutrition are at levels of great concern. Many countries hosting large, displaced populations are not represented in the literature, and research among older children is also lacking. Qualitative and intervention-focused research are urgently needed.

Progress in the fight against malnutrition in Mozambique: A review of policies, action plans, and nutritional intervention programs

Malnutrition is a public health problem in Mozambique, where 37% of children under five suffer from chronic malnutrition and 4% from acute malnutrition. Since national independence in 1975, action plans have been implemented to reverse this situation. Objective: To analyze the progress made in the fight against malnutrition through the policies, action plans and programmes implemented in the country since independence. Methodology: Documentary study, whose main data sources consisted of Demographic and Health Survey reports, Family Budget Surveys, SMART Surveys, Integrated Classification of Food Security Stages reports, information from FAO databases, as well as other studies on the nutritional situation in the country. The WHO and UNICEF classifications were used to describe the prevalence rates of malnutrition. Results: Except for acute malnutrition, which reduced from high to low between 1997-2023, the prevalence of chronic malnutrition had no statistically significant reductions and remains very high. Factors such as food insecurity, high illiteracy rates, armed conflict in northern Mozambique, poverty, unequal distribution of basic resources between provinces, weak monitoring and evaluation systems in the action plans implemented, poor investment in agriculture, covid-19, as well as the effect of climate change, which constantly affects the country, are the main causes. Conclusion: Despite efforts, malnutrition continues not to show significant reductions, which calls for further study and improvement of policies, as well as the control of risk factors.

Evaluation of malnutrition and screening tools in hospitalized children

Detecting malnutrition and its related risk factors are crucial, in hospitalized children. Anthropometric z scores are used to assess malnutrition. Screening tools also aim to detect the presence of malnutrition and the developing risk of malnutrition in hospitalized children to determine who may benefit from nutritional support. Therefore, the aims of the study are to detect malnutrition and its related demographic and clinical risk factors in hospitalized children and determining the sensitivity of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) and Pediatric Yorkhill Malnutrition Score (PYMS) screening tools. A total of 130 hospitalized children aged between 0 and 18 years were included in to study. A survey including demographic and clinical characteristics, STAMP and PYMS were applied to parents of the children. Patients were classified into nutritional risk groups through screening tools. Anthropometric measurements (body weight, length/height, and middle upper arm circumference (MUAC) of the children were taken. Body mass index-for-age and height-for-age z scores were calculated to assess acute and chronic malnutrition prevalence. MUAC-for-age z scores were calculated as well. To detect independent risk factors for acute and chronic malnutrition multivariable logistic regression models were constructed. A total of 14.6% of hospitalized children had acute malnutrition, 21.5% of children had chronic malnutrition and 27.7% of them had low MUAC standard deviation score (SDS) (less than-2). The independent risk factors for acute malnutrition were younger maternal age at birth and long length of stay (p<0.05). The independent risk factors for chronic malnutrition were being female, younger maternal age at birth, longer illness duration and having urological or allergy and immunological diseases (p<0.05). However, MUAC for age SDS groups were not related to any demographic and clinical factors, in children of all ages (p>0.05). Regarding the screening tools, PYMS displayed 100% sensitivity against acute malnutrition. While PYMS displayed better sensitivity to identify acute malnutrition than STAMP, STAMP was more sensitive than PYMS to detect chronic malnutrition and low MUAC SDS. Low MUAC for age SDS was not related to any demographic and clinical factors, in hospitalized children of all ages, unlike acute and chronic malnutrition, in this study. Pediatric screening tools mainly PYMS did not have high sensitivity to detect chronic malnutrition and low MUAC SDS, in hospitalized children. Therefore, the tools have to be used along with z scores of anthropometric parameters.

Food habits and risk factors for child malnutrition in rural families in the municipality of Soracá, Boyacá, Colombia

ABSTRACT Child malnutrition is a global public health problem which causes irreversible damage to physical and cognitive development in early childhood. In 2015, the National Survey of Nutrition reported that Boyacá, Colombia had a prevalence of chronic malnutrition of 11.6% above the national average, considering that Boyacá is predominantly rural territory. This article analyzes the risk factors that influenced the diets of children between 16 and 38 months among 27 rural families. Through a descriptive cross-sectional study, a survey of the socio-family characterization and knowledge, attitudes, and practices (KAP) were applied with participating families. It was found that among the nutritional risk factors in early childhood are low levels of maternal schooling, low economic income, and barriers to accessing health and education services. The results of this research enable contributions to the contextualization of public policies in health and nutrition with a territorial approach that allow the improvement of the quality of life in early childhood in rural areas.

Factors Predicting Chronic Malnutrition Among Young Children in Myanmar

Chronic malnutrition (i.e., stunting) is one of the significant health problems among children under five years old in Myanmar. The government has been trying to accelerate the reduction of malnutrition by collaborating and coordinating with other government and non-government organizations. However, the prevalence of chronic malnutrition remains high. This study examines the factors that could predict chronic malnutrition among young children using the Myanmar Demographic and Health Survey 2015–2016. Data record forms were used to collect the required information from the original data source. Descriptive statistics, the chi-square test, and logistic regression analysis were applied to analyze the data analysis and to determine the predictive power of independent variables. It was found that breastfeeding, birth weight, and family wealth index were significant predictors of childhood stunting. This study recommends emphasizing low-birth-weight infants to prevent chronic malnutrition and promote breastfeeding for all infants and children in Myanmar. Furthermore, policymakers should try poverty reduction and establish healthcare services that are easily accessible to the public, especially to the poor. Based on the findings of this study, more efforts to set up readily available public health services providing care for pregnant women and promoting breastfeeding would be some better precautions against chronic malnutrition for every child, particularly from developing countries.

High prevalence of chronic malnutrition in indigenous children under 5 years of age in Chimborazo-Ecuador: multicausal analysis of its determinants

BackgroundDespite the multiple initiatives implemented to reduce stunting in Ecuador, it continues to be a public health problem with a significant prevalence. One of the most affected groups is the rural indigenous population. This study aimed to analyze the prevalence of chronic malnutrition in indigenous children under 5 years of age and its association with health determinants, focusing on one of the territories with the highest prevalence of stunting.MethodsA cross-sectional study in 1,204 Kichwa indigenous children under the age of five, residing in rural areas of the counties with the highest presence of indigenous in the province of Chimborazo-Ecuador. A questionnaire on health determinants was applied and anthropometric measurements were taken on the child and the mother. Stunting was determined by the height-for-age z-score of less than 2 standard deviations, according to the World Health Organization´s parameters. Data were analyzed using bivariate and multivariate Poisson regression.Results51.6% (n = 646) of the children are stunted. Height-for-age z-scores were significantly better for girls, children under 12 months, families without overcrowding, and families with higher family income. The variables that were significantly and independently associated with stunting were: overcrowding (PR 1.20, 95% CI 1–1.44), the mother required that the father give her money to buy medicine (PR 1.33, 95% CI 1.04–1.71), the father did not give her money to support herself in the last 12 months (1.58, 95% CI 1.15–2.17), mother’s height less than 150 cm (PR 1.42, 95% CI 1.19–1.69) and the child was very small at birth (PR 1.75, 95% CI 1.22–2.5).ConclusionOne out of every two rural indigenous children included in this study is stunted. The high prevalence of stunting in the indigenous and rural population is multicausal, and requires an intersectoral and multidisciplinary approach. This study identified three fundamental elements on which public policy could focus: (a) reduce overcrowding conditions, improving economic income in the rural sector (for example, through the strengthening of agriculture), (b) provide prenatal care and comprehensive postnatal care, and (c) promote strategies aimed at strengthening the empowerment of women.

Prevalence and associated risk factors of chronic malnutrition amongst children under five in Eswatini.

BackgroundAbout 20 million children under fi-ve in Southern Africa have chronic malnutrition. This study determines the prevalence of chronic malnutrition and associated risk factors amongst children under five.AimTo determine the proportion of children with chronic malnutrition and investigate associated risk factors of chronic malnutrition.SettingThe study was conducted in communities in the four regions of Eswatini.MethodsThis study is a retrospective cross-sectional study that used data from a Multiple Indicator Cluster Survey (MICS) conducted in 2014. The study involved 3261 children who are under 5 years of age. Data on nutritional status and household characteristics were used. Logistic regression was used to identify factors associated with chronic malnutrition in the univariable and multivariable models, respectively.ResultsResults showed that 18.1% (confidence interval [CI]: 18.5–21.5) of children under five have chronic malnutrition. The highest prevalence was 20.8% (CI: 17.4–24.7) in the Shiselweni region, followed by the Manzini region with 17.6% (CI: 14.5–21.1) and the Lubombo region with 17.2% (CI: 13.9–21.2). The lowest prevalence of chronic malnutrition at 16.7% (CI: 13.6–20.3) was the Hhohho region. The results indicated that low birth weight (odds ratio [OR] = 4.63, CI: 1.12–19.2), mothers’ lack of education (OR = 1.50, CI: 1.04–2.17) and children aged 12–24 months (OR = 1.28, CI: 0.88–1.87) were significantly associated with chronic malnutrition.ConclusionThe findings showed that malnutrition is an important public health problem in children under five and needs a multisectoral response. Low birth weight, mothers’ education and the child’s age are risk factors associated with chronic malnutrition.ContributionThe results inform evidence-based programming for the prevention of chronic malnutrition in children thus assist the country to meet sustainable development goals.

Household Food Insecurity is a Predictor of Acute Malnutrition but Not Chronic Malnutrition among Children (6-59 Months Old): A Cross-Sectional in Tamale South Constituency

Background: The influence of household food insecurity on poor child growth has been widely studied. However, there is a lack of clarity in such relationships therefore, more studies are required. Hence, the present study evaluated household food insecurity and sciodemographic determinants of undernutrition in young children (6-59 months old) in Ghana. Materials and methods: This cross-sectional study was conducted in Tamale South using 240 mother-child pairs. Mothers and their children (6-59 months old) were recruited from child welfare clinics within the Constituency. Data were collected from face-to-face interviews using a structured questionnaire. Child anthropometric data were measured (weight and height/length) based on World Health Organization’s prescribed procedures. Child anthropometric Z-scores for the determination of acute and chronic malnutrition were generated using WHO Anthroplus 1.0.4. Household food insecurity access scale (HFIAS) was used to estimate household food insecurity. Binary logistics regression models were run using Statistical Product and Service Solutions version 24.0 to estimate the odds of acute and chronic malnutrition following the independent variables (HFIAS and sciodemographic factors). Results: The prevalence of acute malnutrition (wasting) was 7.5%. Also, the prevalence of chronic malnutrition (stunting) was 29.2%. In multiple binary logistics regressions model, there was a significant relationship between higher scores of HFIAS and the odds of acute malnutrition [1.34(1.07-1.68); P=0.010]. In the study, children aged 6-23 months had lower odds for chronic malnutrition [0.36 (1.20-0.66); P=0.001] compared with their colleagues (24-59 months old). Conclusions: In the study, we found a medium and a high prevalence of acute and chronic malnutrition, respectively. Also, HFIAS was a significant predictor of acute malnutrition but not chronic malnutrition. Further, children less than 24 months old compared with those aged 24-59 months old had lower odds for chronic malnutrition. To reduce the odds for acute malnutrition, nutrition and health authorities in the Tamale South Constituency ought to intensify education on strategies to increase household food security status.

Desnutrición crónica en niños menores de cinco años de la comunidad indígena awá, Barbacoas (Nariño, Colombia), 2019

Introduction: Chronic malnutrition in children under 5 years old is defined as stunting due to recurrentnutritional deficiencies associated with poverty, maternal health, and nutrition. This study aimed to identify the prevalence of chronic malnutrition and associated factors in children under 5 years old from the indigenous Awá community, at Barbacoas, Nariño in 2019. Materials and methods: A cross-sectional study was conducted, which included 527 children under 5 years old from the Awá community who attended a health institution for growth and development program. Chronic malnutrition was evaluated as an outcome, whereas sociodemographic, nutritional and other health characteristics as associated factors. Chi-square, Fisher’s exact, and Mann–Whitney’s U test were used to determine statistical association. Additionally, the relationship was adjusted through a multiple logistic regression model. Results: Chronic malnutrition was found in 17.6% of children. The statistical association was found in children of the adolescent mother, incomplete vaccination schedule, and age and birth weight. Conclusion: In children under 5 years old in the Awá community, the frequency of chronic malnutrition is above the average for the general population in Colombia. Prioritizing the active search for chronic malnutrition in children whose mothers are adolescents and those with low birth weight and incomplete vaccination is important.

Social capital and its relationship with malnutrition and anemia in children from rural coastal Ecuador.

Social capital is considered an important determinant of health and overall wellbeing; however, to the best of the authors' knowledge, literature relating social capital to malnutrition in developing countries is still relatively small. This article examines the relationships between social capital and chronic malnutrition and anemia in a population of rural coastal children in Ecuador. A cross-sectional study in two groups of 246 and 282 children under 5 years and their families was performed. Anemia and chronic malnutrition were analyzed as outcome variables. Variables about social capital were identified on the basis of the Social Capital Assessment Tool of the World Bank. Bivariate and multivariate logistic regression analyses were conducted. The prevalences of anemia and chronic malnutrition in the children were 15.0% and 12.8%, respectively. At the multivariate analysis, the variable 'mother has borrowed money' had an inverse association with chronic malnutrition (prevalence ratio (PR) 0.43, 95% confidence interval (CI) 0.20-0.90). Receiving and providing help after the earthquake of 2016 was significantly associated with a lower prevalence of chronic malnutrition (PR 0.52, 95%CI 0.28-0.97), but not with anemia. However, a mother being part of a community organization was associated with a 1.90 times higher prevalence of anemia (95%CI 1.04-3.48) in children than mothers who were not part of a community organization. The relationship between maternal social capital and the nutritional status of their children in rural communities seems to be positively related. However, a mother's participation in community organizations increases the prevalence of anemia in the children. These mixed results highlight the need for further studies focused on the different types of social capital and how they impact on health in deprived areas.

A Comparative Study to Assess the Nutritional Status of Urban and Rural Pre-school Children

Background of the Study: Stunting, wasting, and underweight are the important nutritional status indicators for children. “While stunting is caused by long-term insufficient nutrient intake and repeated infections, wasting is a result of acute food shortage and illness. Wasting, on the other hand, is a strong predictor of mortality and requires urgent response. Underweight combines information about linear growth obstruction and weight for length/height” [7]. Understanding differences in the determinants of childhood malnutrition between urban and rural areas is important to design appropriate, relevant program and policy implementation. Aims &amp; Objectives: The aim of the study is to assess and compare the prevalence of underweight, stunting and wasting among pre-school children in rural and urban area. Methodology: Convenient random sampling technique was used to gather data in 100 samples, 50 each from rural and urban population. Data was collected by using structured interview and anthropometric assessment. The questionnaire consisted of two parts, i.e., demographic data and questions regarding anthropometric assessment, age, height, weight etc. The three nutritional status indicators, HAZ - z-score for height-for-age, (Stunting), WAZ - z-score for weight for age (Underweight), WHZ- z – score weight for height (Wasting) were calculated using WHO Anthro survey application. Results: This study revealed that Prevalence of acute malnutrition (stunting) among rural pre-school children is 28% which was higher than the prevalence of acute malnutrition in urban pre-school children which was only 18 %. Prevalence of Underweight among rural pre-school children is 36% which was higher than the prevalence of underweight in urban pre-school children which was only 34 %. Prevalence of chronic malnutrition (wasting) among rural pre-school children is 32% which was lower than the prevalence of chronic malnutrition in urban pre-school children in which it was 46%. There is no significant association between the nutritional status of the rural and urban pre-school children with the selected demographic variables. This indicates even though there was a significant difference between the rural and urban pre-school children, both group of children are at the risk of one or other malnutrition related problems. Conclusion: This study suggests that even though there was a significant difference between the rural and urban pre-school children, both group of children are at the risk of one or other malnutrition problem.

High-Prevalence Stunting in Preschool Children (1-5 Years) Attending Selected Health Centers in a Food Rich Area-Bushenyi District Southwestern Uganda.

The prevalence of stunting among children in Uganda and Sub-Saharan Africa is still high, and if Uganda is to achieve the food-related Sustainable Development Goals (SDGs), it must urgently invest in improving nutrition and sanitation. In a food rich area like Bushenyi, chronic undernutrition could be due to several other factors than mere scarcity of food. The Objective(s). This study was carried out to determine the prevalence and socioclinical factors responsible for chronic undernutrition (stunting) among preschool children aged 1–5 years in selected Health facilities in Bushenyi district. Methodology. This was a cross-sectional study assessing the prevalence of stunting and its associated factors among children aged 1–5 years attending selected health centers in Bushenyi District. Data was collected using a pretested questionnaire, taking anthropometric measurements (height/length), and stool analysis for eggs of soil-transmitted helminthes. Prevalence of stunting was presented as percentages. Logistic regression with adjusted prevalence ratio was performed to test the association between the sociodemographic and clinical factors and stunting at bivariate levels of analysis. Results. Most of the children were female, with a median age of 2.1 years and resided in semiurban areas of Bushenyi with their parents. Prevalence of stunting was 89.3%. Only 10.7% of the children were infested with soil-transmitted helminthes. Children likely to be stunted were those who drank unboiled water and were exclusively breastfed. Conclusion. There is a high prevalence of chronic malnutrition in Bushenyi district associated with parents'/care takers' low level of knowledge.

Evidence of Malnutrition and its Associated Factors among Under-five Children in Danko-Wasagu Kebbi State, North-western Nigeria

Malnutrition is a major health problem worldwide and causes about 2.3 million deaths among under-5 children in low- and middle-income countries annually including Nigeria. Therefore, the present study was designed to assess the nutritional status of under-five children (0-59 months) and associated factors in Danko-Wasagu. The socio-demographic characteristics, prevalence of childhood diseases, anthropometric parameters and dietary pattern of the children were evaluated. The results indicated that 54.8% of the caregivers are young adults within 20 to 24 years of age with 41.7% having two living children. In addition, 58% of the caregivers have monthly family income below ₦20,000 with no any formal education. The Mid Upper Arm Circumference (MUAC) and Weight-for-Height (WFH) indices indicated that none of the children had Severe-Acute-Malnutrition (SAM). However, there was 65.5% prevalence of diarrhea, 45.2% with dermatitis and 25.0% with acute respiratory infections. In addition, stunting, underweight and wasting among the children investigated were 72.7%, 29.8% and 11.9% respectively. Consumption of cereals based diet by the children was 92.7% while 28.6% and 31.0% of the children met the minimum dietary diversity and minimum meal frequency respectively. Caregiver’s age was observed to associate significantly (p&lt;0.05) with wasting, underweight and stunting among the children. Altogether, the presentstudy demonstrated a high prevalence of chronic malnutrition and childhood diseases even though without any case of SAM in the study area.&#x0D; Keywords: Malnutrition, Nutritional status, Under-five-children, Childhood diseases, Dietary pattern

Determinants of child malnutrition in Togo: An analysis by disparities according to place of residence

The objective of this paper is to analyze the main determinants likely to influence the nutritional status of children under five years of age in Togo. Logistic regression is used to analyze the effect of socio-economic factors on malnutrition and then a method of decomposition of the factors (Oaxaca and Blinder decomposition) was used to analyze the sources of the gap in the prevalence of chronic malnutrition in urban and rural Togo. The data used came from the MICS survey, 2017. Children residing in rural areas and aged between 6 and 59 months are likely to show stunted. Household wealth and the level of education of mothers are also linked to chronic malnutrition. A child born with a previous birth interval less than or equal to 2 years has a 59% chance of showing stunting. The results of the decomposition show that the difference in the prevalence of stunting is due to the specific characteristics of its environment. The difference explained in this decomposition is mostly income inequality as measured by the wealth index.

Decomposing socioeconomic gap in chronic malnutrition among preschool children in Pakistan

• South Asia hosts 57.9 million stunted children of the world. • 46.7% children aged 24–48 months are stunted in Pakistan. • Poverty constrains the adequate stimulation of all aspects of childhood development. • Mother education contributed to 43.6% of the socioeconomic gap in stunting in Pakistan. In developing countries, the high prevalence of chronic malnutrition is a complex development issue due to its close association with poverty and inequality. This study makes the first attempt to explore the factors contributing to the socioeconomic gap (SEG) in stunting among preschool children in Pakistan. This research used a sample of 3,478 under-five children extracted from the Pakistan Demographic and Health Survey 2017–18, a cross-sectional data set. A Chi-square test was used to analyze the association between stunting and socio-demographic characteristics. Fairlie nonlinear inequality-decomposition technique was used to elucidate the factors contributing to the stunting between poor and rich. Univariate analysis showed a higher prevalence of stunting among children aged 24–48 months, short birth-spacing, non-utilization of complete antenatal care services, children without immunization, small birth size, uneducated parents, Sindh and Balochistan, and poor. In Decomposition analysis, an overall gap in the mean prediction of stunting estimated to be 17% between the rich and poor. In the overall inequality, the share of the explained gap was 93.16%, while unexplained accounted for 6.84% of the total gap. Maternal education (43.6%), father’s education (28.3%), antenatal care index (21.1%), mother body mass index (11.8%), and birth size (5.2%) were found to be leading contributing factors of explain socioeconomic gap in stunting. The knowledge generated through this study may help policymakers to develop synergies between nutrition programs and poverty reduction strategies.

Impact of the extension of a performance-based financing scheme to nutrition services in Burundi on malnutrition prevention and management among children below five: A cluster-randomized control trial

Malnutrition is a huge problem in Burundi. In order to improve the health system response, the Ministry of Health piloted the introduction of malnutrition prevention and care indicators within its performance-based financing (PBF) scheme. Paying for units of services and for qualitative indicators is expected to enhance provision and quality of these nutrition services. The objective of this study is to assess the impacts of this intervention, on both child acute malnutrition recovery rates at health centre level and prevalence of chronic and acute malnutrition among children at community level. This study follows a cluster-randomized controlled evaluation design: 90 health centres (HC) were randomly selected for the study, 45 of them were randomly assigned to the intervention and received payment related to their performance in malnutrition activities, while the other 45 constituted the control group and got a simple budget allocation. Data were collected from baseline and follow-up surveys of the 90 health centres and 6,480 households with children aged 6 to 23 months. From the respectively 1,067 and 1,402 moderate and severe acute malnutrition transcribed files and registers, findings suggest that the intervention had a positive impact on moderate acute malnutrition recovery rates (OR: 5.59, p = 0.039 -at the endline, 78% in the control group and 97% in the intervention group) but not on uncomplicated severe acute malnutrition recovery rate (OR: 1.16, p = 0.751 -at the endline, 93% in the control group and 92% in the intervention group). The intervention also had a significant increasing impact on the number of children treated for acute malnutrition. Analyses from the anthropometric data collected among 12,679 children aged 6-23 months suggest improvements at health centre level did not translate into better results at community level: prevalence of both acute and chronic malnutrition remained high, precisely at the endline, acute and chronic malnutrition prevalence were resp. 8.80% and 49.90% in the control group and 8.70% and 52.0% in the intervention group, the differences being non-significant. PBF can contribute to a better management of malnutrition at HC level; yet, to address the huge problem of child malnutrition in Burundi, additional strategies are urgently required.

Non-Adherence to WHO Recommendations Regarding Infant Feeding Practices Results in Dilemma of Malnourishment: A Community-Based Prospective Cohort Study Conducted in Karachi, Pakistan

BackgroundThe prevalence of chronic malnutrition and its associated morbid outcomes has been a significant cause of health loss globally, affecting millions of children hampering their mental, physical, social, and immune system development. World Health Organization's (WHO) recommendations presenting infant feeding guidelines have largely controlled this burden. However, developing countries including Pakistan have failed to promote these guidelines and still succumb to a huge burden of morbidity and mortality secondary to malnourishment among infants.MethodologyOur study is a prospective cohort including 300 infants without predisposing congenital anomaly, followed from 6 months to 18 months of age. The primary outcome involved was classifying patients as malnourished based on anthropometric measurements, assessing the prevalence of co-morbidities and comparison of results in compliance with WHO guidelines.ResultsA total of 276 infants were included and the rest were lost to follow-up. Stratification on socioeconomic status was done; 53% of infants were diagnosed as malnourished, either due to stunted growth, underweight, or both. The odds of development of malnourishment based on non-adherence to WHO guidelines on breastfeeding were 2.87 (p=0.001). The incidence of morbid complications was higher in the malnourished group, including gastrointestinal and respiratory tract infections.ConclusionThe implementation of WHO recommendations on infant feeding techniques can prove to be a pivotal instrument to control the soaring index of morbidities and mortalities associated with malnourishment. A strong focus on parental education and awareness among masses is required for its promulgation and controlling the infant health burden linked to this preventable condition.

The Articulated Nutritional Program and its impact on chronic malnutrition in children under five years of age. Dirección Regional de Salud Callao, 2009-2015

Objective: To determine the impact of the Articulated Nutritional Program (PAN) on chronic malnutrition in children under five years of age, its correlation with the PAN’s budget execution, and the prevalence of chronic malnutrition at the Dirección Regional de Salud (DIRESA) Callao, 2009-2015. Materials and methods: A quantitative, qualitative, observational, ecological, correlational, longitudinal and retrospective study was carried out. The Pearson correlation coefficient was determined in the quantitative analysis. Qualitative data was obtained from in-depth interviews with the support of a semi-structured guide.Results: There is no relationship between the PAN’s Modified Institutional Budget (PIM) and the prevalence of chronic malnutrition (p value 0.92). There is no relationship between the budget execution of the PIM and the prevalence of chronic malnutrition (p value 0.355). The factors that influenced the execution of the PAN are untimely budget, delayed implementation of the PAN, difficulties in the organization of health services, and population with little education on child and migrant care.Conclusions: No positive impact was found between the PAN and the decrease in the prevalence of chronic malnutrition at the DIRESA Callao between 2009 and 2015. The qualitative factors that influence the PAN were related to processes and the organization of the DIRESA Callao, with the exception of the population corresponding to an external factor.

Nutritional Status Evaluation of Children Under Two Years of Age in 03 Provinces of Mozambique

According to 'Countdown to 2015', more than 114,000 children die each year in Mozambique before reaching their fifth birthday. And is estimated 45% of these deaths is linked to malnutrition. The purpose of this study was to determine the prevalence of chronic malnutrition, acute malnutrition and underweight in children under 2 years of age. A cross-sectional study was made at Cabo Delgado, Niassa and Nampula’s province in Mozambique. Anthropometric measurements (height for age, weight for height and weight for age) were made to 689 children under 2 years age. A team formed by 6 pollsters, 3 controllers and 6 nurses conducted the anthropometric measurements from April to June 2015. The anthropometric indicators used to access the nutritional status were: height-for-age (HA), weight-for-height (WH) and weight-for-age (WA). Measures were expressed in the form of a Z-score, which include: HAZ &lt; −2 (stunting/chronic malnutrition), WHZ &lt; −2 (wasting) and WAZ &lt; −2 (underweight). The total rate of positive cases of malnutrition was: 51.6% stunting (320/619), 9% of wasting (56/613) and 17.9% (119/662) of underweight. Stunting prevalence was especially high among children with 6-11 months old. Stunting prevalence was higher in Niassa (55.7%) compared to Cabo Delgado (50.5%) and Nampula (39.2%).The rate of acute malnutrition was three times higher in rural communities (10%) compared to urban communities (7%). Underweight prevalence was higher in Cabo Delgado (23.8%) compared to Nampula (20.4%) and Niassa (14.4%). Our findings allowed us to draw recommendations to improve the implementation of health programs against malnutrition in these provinces.

A Multi-causal Model for Chronic Malnutrition and Anemia in a Population of Rural Coastal Children in Ecuador

ObjectivesChronic malnutrition and anemia are prevalent in developing countries. This research aimed to determine the prevalence of chronic malnutrition and anemia and their associated factors in children under five using a multi-causal model in a rural community in the coast of Ecuador.MethodsThe study included 314 children under 5 years old who were residents of San Isidro, Ecuador. Indicators of chronic malnutrition and anemia were identified. Mothers/caregivers were surveyed on socio-economic and environmental conditions, feeding and care practices, access to health services and biological characteristics. Bivariate and multivariable Poisson regression were performed.ResultsThe prevalence was 12.42% (n = 39) for chronic malnutrition and 16.98% (n = 54) for anemia. There was a significant and independent association between chronic malnutrition and family income less than $80 USD per month (Prevalence Ratio [PR] = 2.74, 95% CI 1.04, 7.20), maternal height less than 150 cm (PR 3.00, 95% CI 1.69, 5.32) and residence in a household with more than 4 children (PR 3.05, 95% CI 1.48, 6.29). Anemia was 2.57 times higher (95% CI 1.17, 5.65) in children with more than two episodes of diarrhea in the last 6 months. Prenatal care (5 to 8 visits) provided a protective effect for anemia (PR 0.48, 95% CI 0.27, 0.89).Conclusions for PracticeFindings support the need for comprehensive interventions targeted toward chronic malnutrition and anemia in children from rural coastal communities. Improvement of socioeconomic conditions, family planning, prenatal care and reduction of diarrheal diseases should be prioritized.