Prevalence Of Chronic Undernutrition Research Articles

Proximal determinants of suboptimal early child development during the first three years of life in socially deprived Mexican contexts.

Assessing the status and determinants of early child development (ECD) requires accurate and regularly updated measurements. Yet, little information has been published on the subject in low- and middle-income countries, particularly regarding the proximal determinants of childhood development in contexts of high social marginalization. This article analyzes the factors that favor or mitigate suboptimal ECD outcomes in Mexico. A cross-sectional study was conducted using recently collected data for 918 children aged 0-38 months from socially marginalized communities in 23 Mexican municipalities. The ECD outcomes of the children were estimated based on indicators of chronic undernutrition and neurodevelopment (normal, lagging and at risk of delay). The distribution of outcomes was described across the ECD proximal determinants analyzed, including the co-occurrence of chronic undernutrition and suboptimal neurodevelopment. Covariate-adjusted prevalence of the ECD outcomes and co-occurrences were calculated as post-estimations from a multiple multinomial logistic regression. The prevalence of chronic undernutrition was 23.5%; 45.9% of children were classified with neurodevelopmental lag, and 11% at risk of neurodevelopmental delay. The prevalence of stunting co-occurring with suboptimal neurodevelopment came to 15.4%. The results of the multinomial logistic regression model indicated that early gestational age, low birth weight, a low household socioeconomic level, being male and having numerous siblings were all associated with the co-occurrence of chronic undernutrition and suboptimal child neurodevelopment. This study identified important predictors of child development in the first three years of life, specifically in two of its principal indicators: nutritional and neurodevelopmental status. Most of the predictors observed can be improved by means of social programs and interventions. Trial registration: ClinicalTrials.gov ID: NCT04210362.

Association of trends in child undernutrition and implementation of the National Rural Health Mission in India: A nationally representative serial cross-sectional study on data from 1992 to 2015.

BackgroundIndia launched the National Rural Health Mission (NRHM) in 2005 to strengthen its primary healthcare system in high-focus and northeast-focus states. One of the NRHM objectives was to reduce child undernutrition in India.Methods and findingsWe used data from 1992, 1998, 2005, and 2015 National Family Health Survey (NFHS) of India to evaluate trends in child undernutrition prevalence before and after NRHM and across different categories of focus states. Stunting, Wasting, and Comprehensive Index of Anthropometric Failure (CIAF) were assessed using the World Health Organization (WHO) growth curves to assess chronic, acute, and overall undernutrition. The study included 187,452 children aged 3 years or under. Survey-weighted and confounder-adjusted average annualized reduction rates (AARRs) and predicted probability ratios were used to assess trends and socioeconomic disparities for child undernutrition, respectively. Nationwide, the prevalence of all types of undernutrition decreased from 1992 to 2015. However, the trends varied before and after NRHM implementation and differentially by focus states. After NRHM, acute undernutrition declined more rapidly among high-focus states (AARR 1.0%) but increased in normal-focus states (AARR −1.9% per year; p-value for the difference <0.001). In contrast, the prevalence of chronic undernutrition declined more rapidly (AARR 1.6%) in the normal-focus states in comparison to high-focus states (0.3%; p-value for the difference = 0.01). Income and caste-based disparities in acute undernutrition decreased but did not disappear after the implementation of the NRHM. However, similar disparities in prevalence of chronic undernutrition appear to be exacerbated after the implementation of the NRHM. Major limitations of this study include the observational and cross-sectional design, which preclude our ability to draw causal inferences.ConclusionsOur results suggests that NRHM implementation might be associated with improvement in wasting (acute) rather than stunting (chronic) forms of undernutrition. Strategies to combat undernutrition equitably, especially in high-focus states, are needed.

795Contribution of school meals provision/receipt to “catch up growth” in young children: A counterfactual approach

795Contribution of school meals provision/receipt to “catch up growth” in young children: A counterfactual approach

Assessment of an Educational Intervention to Improve Healthy Life Habits in Children Living in Vulnerable Socioeconomic Conditions.

Nutritional condition impacts academic performance and cognitive development. In Peru, the prevalence of chronic undernutrition in children is 6.9%, increasing the risk of mortality and morbidity. This study aimed to develop an educational intervention to achieve an improvement in the healthy habits of children in a primary education school in Lima who live in vulnerable socioeconomic conditions. We conducted a prospective quasi-experimental pre-test and post-test study of an educational intervention. The information was collected through the adaptation of the WHO questionnaire “Global School-based Student Health Survey” (GSHS), with anthropometric variables, socioeconomic level, hygiene and eating habits. One hundred eight students from 5 to 13 years old from Arenitas del Mar School in Lima (Peru) participated. The educational intervention improved eating habits. Fruit and vegetable consumption 3 or more times/day (50.9%) increased after the educational intervention (49% vs. 62.9%,) p < 0.0001. There was an improvement in hygiene habits, such as the frequency of handwashing with soap (32.4% vs. 63.9%) and the frequency of weekly bathing 4–6 times/week (25% vs. 47.5%) p < 0.0001. The educational intervention promoted better healthy living behaviors, eating habits and hygiene. This kind of initiative is a crucial tool to establish healthy living habits.

Undernutrition of Children in Massachusetts

Over the past 10 years, seven separate studies of children at risk from undernutrition in Massachusetts have been performed. The surveys have ranged from a statewide health center-based investigation to a house-to-house survey in a public housing project. All included children between 1 and 6 years of age. Chronic undernutrition was defined as a height-for-age less than the 5th percentile of the National Center for Health Statistics growth charts, and acute undernutrition was defined as a weight-for-height less than the 5th percentile. The prevalence of chronic undernutrition was greater than expected in four surveys, whereas no acute undernutrition was observed. The prevalence of obesity, defined as a weight for height greater than the 95th percentile, was increased in four of the seven surveys. These data suggest that chronic undernutrition is increased among children at risk in Massachusetts.

Acute and chronic undernutrition in Swaziland.

Information about infant feeding diarrheal illness and nutritional status from the Swaziland National Nutrition Status Survey is presented. This survey was conducted from September 1983 to January 1984 on a representative sample of preschool children (0-59 months) in the rural areas (n=4698) and a convenience sample of disadvantaged peri-urban children (n=772). Although rates of initiating breastfeeding were high in both rural (94.4%) and peri-urban (92.1%) areas introduction of breast milk substitutes was common and early; the median age of introduction was 1 month in the rural and <1 month in the peri-urban sample. Diarrheal illness was reported in 16.4% of rural and 14.5% of peri-urban children during the 2-week period preceding the study. Rates were highest among children 3-35 months of age. Chronic undernutrition without concomitant acute undernutrition was identified as the most common nutritional condition in the Swazi preschool population. Chronic undernutrition as measured by retarded linear growth was identified in 30.3% of rural and 23.0% of peri-urban children. Despite the relatively high prevalence of chronic undernutrition the study population exhibited a low level of acute undernutrition as measured by low weight-for-height. Only 0.9% of rural and 0.6% of the peri-urban children were acutely undernourished a prevalence slightly lower than the reference population. Overall Swazi children appear to be similar to or slightly better off nutritionally than children in other African countries that have been surveyed using similar methodology. (authors)