Prevalence Rates Of Stunting Research Articles

Double burden of malnutrition among school-aged children and adolescents: evidence from a community-based cross-sectional survey in two Nigerian States

Background: Double burden of malnutrition (DBM) is the co-existence of overweight/obesity and undernutrition. Rising prevalence rates of childhood overweight/obesity in Nigeria have been reported, whilst undernutrition continues to be prevalent. This study aimed to estimate the prevalence and distribution of underweight, stunting, thinness, overweight/obesity, and DBM among school-aged children and adolescents in two Nigerian States. Methods: This was a community-based cross-sectional study carried out in Osun and Gombe States. A total of 1,200 children aged 6 – 19 years were recruited using multi-stage sampling technique. Weight, height and data on demographic, socio-economic, household/family characteristics of the children were collected using structured interviewer administered questionnaires. Nutritional status was calculated using the WHO 2007 reference values using BMI-for-age (thinness, overweight/obesity), height-for-age (stunting) and weight-for-age (underweight). DBM was described at the population and individual levels. Results: The mean age of the respondents was 11.6 ± 3.8 years. The overall prevalence rate of stunting was 34.9%, underweight was 13.5%, thinness was 10.3% and overweight/obese was 11.4% and 4.0% had individual level DBM, which typifies the DBM at individual and population levels. These rates differed significantly across demographic, socio-economic and household/family characteristics (p < 0.05). Gombe State, which is in the Northern part of Nigeria, had significantly higher burden of stunted, underweight and thin children than Osun State, while Osun State, in the Southern part of Nigeria, had a significantly higher burden of overweight/obesity. Conclusions: The study found evidence of DBM both at population and individual levels. The overall prevalence rates of stunting, underweight, thinness and overweight/obesity in this study were high, and they differed significantly across the demographic, socio-economic and household/family characteristics. There is the need for government and all other stakeholders to design nutritional educational programmes that will target both under- and over-nutrition among older children in the different contexts.

Double burden of malnutrition among school-aged children and adolescents: evidence from a community-based cross-sectional survey in two Nigerian States.

Background: Double burden of malnutrition (DBM) is the co-existence of overweight/obesity and undernutrition. Rising prevalence rates of childhood overweight/obesity in Nigeria have been reported, whilst undernutrition continues to be prevalent. This study aimed to estimate the prevalence and distribution of underweight, stunting, thinness, overweight/obesity, and DBM among school-aged children and adolescents in two Nigerian States. Methods: This was a community-based cross-sectional study carried out in Osun and Gombe States. A total of 1,200 children aged 6 - 19 years were recruited using multi-stage sampling technique. Weight, height and data on demographic, socio-economic, household/family characteristics of the children were collected using structured interviewer administered questionnaires. Nutritional status was calculated using the WHO 2007 reference values using BMI-for-age (thinness, overweight/obesity), height-for-age (stunting) and weight-for-age (underweight). DBM was described at the population and individual levels. Results: The mean age of the respondents was 11.6 ± 3.8 years. The overall prevalence rate of stunting was 34.9%, underweight was 13.5%, thinness was 10.3% and overweight/obese was 11.4% and 4.0% had individual level DBM, which typifies the DBM at individual and population levels. These rates differed significantly across demographic, socio-economic and household/family characteristics (p < 0.05). Gombe State, which is in the Northern part of Nigeria, had significantly higher burden of stunted, underweight and thin children than Osun State, while Osun State, in the Southern part of Nigeria, had a significantly higher burden of overweight/obesity. Conclusions: The study found evidence of DBM both at population and individual levels. The overall prevalence rates of stunting, underweight, thinness and overweight/obesity in this study were high, and they differed significantly across the demographic, socio-economic and household/family characteristics. There is the need for government and all other stakeholders to design nutritional educational programmes that will target both under- and over-nutrition among older children in the different contexts.

Stunting among Under Five Years Old Children in Rwanda: Influences of Family Planning Status and Household Size and Composition

Background&#x0D; Stunting is one of the main challenges resulting in high child mortality and morbidity thought out the world, especially in many developing countries, including Rwanda. The overall prevalence rate of stunting is estimated at around 38% of under five years old children in Rwanda.&#x0D; Objective&#x0D; To examine the influences of household size and composition and family planning status on stunting among children under five in Rwanda.&#x0D; Methods&#x0D; The current study is a nationally representative cross-sectional study that used the secondary data analysis of Rwanda Demographic and Health Survey (DHS) 2014-2015. Logistic regression analysis was used to examine the association between family planning and household size and composition.&#x0D; Results&#x0D; The sum-total of children under five in the household (log odds=0.373(p&lt;.05), CI=0.0577, 0.689), maternal age at childbirth (log odds=-0.682(p&lt;.05), CI=-1.222, -0.141), fertility preference (log odds =-0.296(p&lt;.05), CI=-0.549, -0.0427), and unmet need for family planning (log odds = 0.297(p&lt;.05), CI= 0.0193, 0.574) were statistically significant associated with stunting among studied children.&#x0D; Conclusion&#x0D; The findings of this study suggest a significant association between stunting and family planning and household size and composition.&#x0D; &#x0D; Rwanda J Med Health Sci 2021;4(1):112-130

Faktor-Faktor Keberhasilan Program Promosi Kesehatan “Gempur Stunting” Dalam Penanganan Stunting di Puskesmas Rancakalong Sumedang

The Indonesian government has set 60 priority districts/cities for stunting handling. Based on this determination, Sumedang is included in the priority district because in 2018 the stunting prevalence rate reached 32%. The selection conducted by Bappeda Sumedang contained 10 villages where the prevalence rate of stunting was high and three of them were villages in Rancakalong. To overcome this, the Rancakalong Community Health Center initiated the “Gempur Stunting” Health promotion Program which has succeeded in reducing the prevalence of stunting from 27.7% to 19.8%, making it an exemplary health promotion program. This research was conducted to determine the success factors of the "Gempur Stunting" health promotion. The results showed that reducing the highest stunting prevalence rate in Sumedang was due to the following supporting factors: (1) variations in community-based activities; (2) Good collaboration and coordination between related sectors, and (3) Reliability of the stunting-fighting health promotion program.

Modeling the predictors of stunting in Ethiopia: analysis of 2016 Ethiopian demographic health survey data (EDHS)

BackgroundDespite continued efforts to address malnutrition, there is minimal reduction in the prevalence rates of stunting in developing countries, including Ethiopia. The association between nutritional and socioeconomic factors collected from a national survey in Ethiopia and stunting have not been rigorously analyzed. Therefore, this study aims to model the effect of nutritional and socioeconomic predictors using 2016 Ethiopian Demographic Health Survey (EDHS) data.MethodsThis study is a secondary data analysis of the 2016 EDHS survey, which included 7909 children aged 6 to59 months. Descriptive statistics using frequency and percentage for categorical data and mean and standard deviation for metric data were conducted. Linearity, confounding, and multicollinearity were checked. Bivariable and multivariable logistic regression were carried out. The adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated. A receiver operative curve was built to estimate the sensitivity and specificity of the model.ResultsThe study identified that 39.2% of children included in this analysis were stunted. Furthermore, 76.47, 84.27, and 92.62% of the children did not consume fruits and vegetables, legumes and lentils, or meat and its products, respectively. Children aged 24 months to 59 months were found to be at 9.71 times higher risk of being stunted compared to their younger counterparts aged 6–24 months (AOR: 9.71; CI: 8.07, 11.6 children). Those children weighing below 9.1 kg were at 27.86 odds of being stunted compared to those weighing 23.3 kg and above. Moreover, mothers with a height below 150 cm (AOR: 2.01; CI: 1.76, 2.5), living in a rural area (AOR: 1.3, CI: 1.09, 1.54), and being male (AOR: 1.4; CI: 1.26, 1.56) were factors associated with stunting. The predictive ability of the model was 77%: if a pair of observations with stunted and non-stunted children were taken, the model correctly ranks 77% of such pair of observations.ConclusionThe model indicates that being born male, being from a mother of short stature, living in rural areas, small child size, mother with mild anemia, father having no formal education or primary education only, having low child weight, and being 24–59 months of age increases the likelihood of stunting. On the other hand, being born of an overweight or obese mother decreases the likelihood of stunting.

Sociocultural and economic determinants of stunting and thinness among adolescent boys and girls in Nepal.

Despite the increasing interest in the determinants of adolescent undernutrition in low- and middle-income countries, a comprehensive multi-level overview at the country level is missing. Using the nationally representative 2014 Nepal Adolescent Nutrition Survey, this study aimed to provide a comprehensive overview of the sociocultural and economic determinants of stunting and thinness of adolescent boys and girls in Nepal. Multivariate logistic regression models were used to estimate the associations between multiple individual, household and community determinants and stunting and thinness among 3773 adolescents aged 10-19 years (1888 boys and 1885 girls). The prevalence rates of stunting and thinness indicated suboptimal nutritional status and an inadequate growth environment in Nepali adolescents. The results highlighted an association of paternal occupation and education, household income, number of earning household members, geographical place of residence, caste/ethnicity and nutritional knowledge with stunting, with higher odds for males and older adolescents. Paternal occupation, education, household income, geographical region, caste/ethnicity and nutrition knowledge were associated with thinness, with higher odds for males and younger adolescents. The findings underscore the importance of involving adolescents, their parents and their communities in interventions. Such interventions should not only be aimed at improving adolescent nutrition but also at optimizing adolescents' growth environment for better health and development. Future research should focus on context-specific causal pathways and mechanisms through which sociocultural and economic determinants influence nutritional outcomes within broader societal, cultural and political settings. A longitudinal approach, including a range of dietary and nutrition indicators would allow understanding how and when the relative importance of these factors change during adolescence.

Risk factors for malnutrition among school-aged children: a cross-sectional study in rural Madagascar

BackgroundFor over 20 years, Madagascar has been challenged by continued high prevalence of stunting, underweight and wasting among children under 5 years of age. Yet, nutritional status of post-under-five age group has never been assessed in the country, despite its importance in relation not only to physical health but also to cognitive capacity and educational achievements of children. This study aims to estimate prevalence of malnutrition among schoolchildren aged 5–14 years in Madagascar. It further attempts to identify the possible risk factors for their malnutrition. This is the first study that estimates prevalence of malnutrition among school-aged children in Madagascar.MethodsA cross-sectional household survey was conducted in Antananarivo-Avaradrano district, Analamanga region, Madagascar. The study targeted 393 first and second graders 5–14 years of age enrolled at 10 primary schools, where school-feeding was implemented. Data were collected from anthropometric measurements, their subsequent household structured interviews and observations. Bivariate (Chi-square test or Mann-Whitney’s U test) and multivariable (logistic regression) analyses were performed, to identify the possible risk factors associated with malnutrition.ResultsThe overall prevalence rates of stunting, underweight and thinness were 34.9%, 36.9% and 11.2%, respectively. Nineteen children (4.8%) suffered from all the three forms of undernutrition. Older schoolchildren had a significantly greater likelihood of being stunted, underweight and thin. The greater number of members a household had, the higher likelihood of being stunted and thin its schoolchild had. Children having lower Household Dietary Diversity Score were more likely to be underweight. Yet, ‘Had lunch at school yesterday’ was associated neither with being stunted nor with being underweight and thin. This implies room for improvement of the current school feeding program.ConclusionsPrevalence rates of stunting and underweight among 393 children examined were as high as the national averages among children under 5 years of age. Adequate food availability and dietary diversity over a sufficient period (incl. 5–14 years of age) are necessary for increasing likelihood of catch-up in height-for-age and weight-for-age, which are expectable during adolescence. To supplement inadequate household dietary diversity practices, school-feeding program may need to use more animal-protein ingredients.

Association between household dietary diversity and nutritional status of children (6\u201336 months) in Wenchi Municipality, Brong Ahafo Region, Ghana

BackgroundOne in five Ghanaian children is chronically malnourished. Childhood undernutrition remains a public health concern in Ghana; therefore, research is needed to identify modifiable risk factors to inform health programming. This study evaluated household dietary diversity (HDD) as a determinant of nutritional status of pre-school children in Wenchi Municipality, Ghana.MethodsAn analytical cross-sectional study involving 590 mother-child pairs was conducted in Wenchi Municipality. A two-stage cluster sampling procedure was used; clusters were first selected followed by the selection of children using simple random sampling. Socio-demographic, dietary, and anthropometric data were collected in face-to-face interviews. HDD scores were calculated using data from 24-h dietary recalls based on 12 standard food groups consumed by the households in the past 24 h preceding the survey and categorised into low (1–5 food groups) and high (6–12 food groups) HDD categories using the mean HDD score. Anthropometric indices (stunting, wasting, and underweight) were defined as anthropometric z-scores < − 2 standard deviations using the WHO growth standards. Chi-square and logistic regression analyses were used to study the association between HDD categories and stunting or wasting while controlling for potential confounders.ResultsThe mean age of the respondents was 27.3 [95% confidence interval = 26.8–27.8] years, and majority of them (58.3%) were within the age group 20–29 years. The prevalence rates of stunting, wasting, and underweight in the children were 38.6%, 11.0%, and 13.1%, respectively, while 36.4% of the households had low dietary diversity. There was no association between HDD categories and stunting (adjusted OR = 1.18, 95% confidence interval [CI] = 0.79–1.76, p = 0.409) or wasting (adjusted OR = 0.97, 95% CI = 0.54–1.73, p = 0.910).ConclusionsThere was a high prevalence of stunting in children and many households consumed less diverse diet in Wenchi Municipality. There is a lack of evidence of an association between HDD and stunting or wasting in the population studied. Interventions to improve child growth and HDD are needed to promote and protect child health.

Assessing the Factors Affecting Malnutrition in Northern Ghana

Malnutrition is a matter of public concern worldwide, and remains the greatest challenge in Sub-Saharan Africa. The literature shows that, malnutrition is one of the major causes of childhood deaths and developmental problems around the globe. This study analyzed the factors affecting stunting and wasting in children 0-59 month's old in Northern Ghana using secondary data from Feed the Future Northern Ghana survey data. The study found that the prevalence rate of stunting was 37.14%, 35.79%, and 25.11% for the Northern, Upper East and Upper West regions respectively, while the prevalence of wasting was found to be 11.11%, 11.24%, and 7.31% for these regions. The study also found that the age of child, household total expenditure, region, age of the head of household and household access to safe drinking water were found to be significantly associated with both stunting and wasting. Furthermore, the gender of child, and household location in an urban area, were also found to be significantly associated with only stunting while household access to productive capital was also found to be significantly associated with only wasting. In conclusion, these factors identified should be taken into account when designing interventions on malnutrition in Northern Ghana.

Nutritional Status among Children under Five Years in Amman, Jordan

Objectives: There is scarcity of data on malnutrition among children in Jordan. Therefore, this study was conducted to assess the nutritional status and estimate the prevalence rates of stunting, underweight, and wasting and their associated factors among children under five. Subjects and Methods: A cross-sectional study was conducted between January and April 2017 among children under five years in Amman, Jordan. All Jordanian children under five years who visited the selected health centers for vaccination or accompanied their mothers during the study period were included in this study. Mothers or caregivers of children were interviewed face-to face using the study questionnaire. Weight in kilograms and height in centimeters were measured for all children. Anthropometric indices were calculated using reference medians recommended by the World Health Organization. Results: This study included a total of 923 (463 boys and 460 girls) children. The prevalence rates of stunting, underweight, and wasting were 6.2%, 3.8%, and 2.8%, respectively. Multivariate analysis showed that low birth weight was significantly associated with stunting (OR = 2.9, 95% CI: 1.4,6.0; p-value=0.003) and underweight (OR =5.6, 95% CI: 2.5,12.3, p-value &lt;0.001). Compared to exclusive breastfeeding, mixed feeding was associated with increased odds of stunting (OR =2, 95% CI: 1.1-3.9, p-value =0.029) and underweight (OR = 2.2, 95% CI: 1.002, 5.0; p = 0.049). None of the variables were significantly associated with wasting. Conclusions: The prevalence rates of stunting, wasting and undernutrition among children under five years in Jordan are low. Low birth weight and mixed feeding were associated with higher rates of malnutrition.

Weight and height faltering in the indigenous children (Orang Asli) of Peninsular Malaysia during the first 2 years of life.

Information on the growth status of indigenous children is useful for developing intervention strategies, but the data are limited. This study determined the prevalence of undernutrition among under-five indigenous children (Orang Asli) and tracked the growth status of Orang Asli children aged 0-3 years. This study had two phases: a cross-sectional growth study of under-five Orang Asli children (N=304; Phase 1) and a 2-year prospective cohort growth study of Orang Asli children aged 0-3 years (N=214; Phase 2) in the Temerloh district of Pahang, Malaysia. Weight-for-age, length/height-for-age, weight-for-length/height, and body mass index-for-age were determined. The prevalence rates of stunting, underweight, wasting, and thinness in under-five Orang Asli children (Phase 1) were 64%, 49%, 14%, and 12%, respectively. In the cohort of 214 children (Phase 2), weight-for-age was initially documented and maintained closely at -1.50 standard deviations (SD) in the first 6 months, but it declined to approximately -2.00 SD at 15 months and remained close to -2.00 SD thereafter. Length/height-for-age declined rapidly to approximately -2.50 SD at 18 months and fluctuated between -2.30 and -2.50 SD thereafter. Weight-for-length/height increased sharply to -0.40 SD at 2-3 months, declined gradually to less than -1.00 SD at 12 months, and plateaued between -1.00 and -1.30 SD thereafter. Undernutrition is prevalent among Orang Asli children, with length rather than weight faltering being more pronounced in the first 2 years of life. Identifying the causes of early growth retardation in this population is required to inform future preventive strategies.

Factors Enhancing Household Nutrition Outcomes in Potato Value Chain in South-Western Uganda

In Uganda, agricultural commercialization has been promoted to reduce poverty and improve household food security. South-western Uganda, the major producer of potato, has been considered the food basket of the country but it has one of the highest prevalence rates of stunting in children under 5. This study considered potato enterprise as a key pathway for enhancing household food and nutrition security because it has become a major income source and staple in the diets of many households in the area and most urban areas in the country. The objective was to determine factors that influence farm household nutrition and food security outcomes. Through a survey, data were collected from 434 randomly selected potato farmer households. Descriptive and econometric methods were used in data analysis. Results show that household dietary diversity score was low (3.2) for most (57%) of the households. Only 38% were food secure. The main factors enhancing household nutrition outcomes were size of land, livestock units owned, proportion of household income spent on food, and education of household head, while farmer’s experience in potato production had a negative effect. The size of land owned, crop diversification, income from potato, age and education of household head, and a famer being male enhanced household food security outcomes. The study recommends promoting improved production practices to maximize land productivity, integration of livestock in potato production, and training women and men in household food and nutrition and related use of income.

Household Food Insecurity and Its Association with Nutritional Status of Children 6-59 Months of Age in East Badawacho District, South Ethiopia.

Background. Ethiopia has one of the highest child malnutrition rates in the world. Food insecurity is one of the determinant factors of malnutrition in developing countries; however its role remains unclear. Objective. To assess household food insecurity and its association with the nutritional status of children 6–59 months of age in East Badawacho District, South Ethiopia. Methods. A community based cross-sectional study was conducted from February 20 to 30, 2014 on a sample of 508 mother/child pairs of 6–59-month-old children. Sample households with eligible children were selected using systematic random sampling technique. Both bivariate and multivariate analysis were used to identify factors associated with nutritional status of children. P value of <0.05 was considered as statistically significant. Result. The prevalence of household food insecurity was 75.8%. The prevalence rates of stunting, underweight, and wasting among children were 45.6%, 26.3%, and 14.6%, respectively. Household food insecurity was significantly associated with underweight (AOR = 3.82; CI = 1.78–8.19) and stunting (AOR = 6.7; CI = 3.71–12.1) but not with wasting. Conclusion and Recommendation. Household food insecurity and the prevalence rates of stunting, underweight, and wasting, among children 6 to 59 months, were high. Intervention programs should focus on improving household food insecurity and nutritional status of children.

Physical growth curves of indigenous Xavante children in Central Brazil: results from a longitudinal study (2009–2012)

Background: The nutritional profile of Indigenous children in Brazil is comparable to those observed in some of the least developed regions of the world.Aim: Weight and height growth curves were characterised based on longitudinal data from a local Indigenous population experiencing the double burden of child under-nutrition and adult obesity.Subjects and methods: Anthropometric data were collected in six waves from 2009–2011 for children <10 in two proximate Xavante villages in Central Brazil. Prevalence rates for stunting, wasting and thinness were calculated using WHO references. Weight and height data were adjusted for generalised additive mixed models to generate growth curves.Results: Prevalence rates of stunting and wasting were high, but cases of thinness and excess weight were negligible. Weight and height began close to WHO medians, but fell substantially before 12 months. Boys but not girls were able to catch-up in weight before age 10. From 3–10 years, height for both sexes remained between −2 and 0 z-scores.Conclusion: Impaired Xavante growth before 1 year followed by inconsistent recovery before 10 years reflects health and wellbeing disparities with regard to the Brazilian national population and a complex epidemiology of growth involving rapid nutritional change.

Prevalence of Chronic Malnutrition (Stunting) and Determinant Factors among Children Aged 0-23 Months in Western Ethiopia: A Cross-Sectional Study

Introduction: Poor growth especially stunting is associated with impaired development which is apparent in the relationship between growth status and school performance and intellectual achievement. Thus, previous studies in Western Ethiopia were not addressed factors associated with stunting. Objective: To assess prevalence and determinants of stunting among less than 24 months children in East Wollega Zone, West Ethiopia. Methods: A community based cross-sectional study design using two-stage cluster sampling survey was conducted on 593 households from April to May, 2014 in three randomly selected districts of East Wollega Zone to assess factors associated with stunting. A structured and pre-tested questionnaire was used to obtain information on demographic and socio economics characteristics, feeding practices, dietary diversity and anthropometric measurement of children aged less than two years. Bivariate and multivariable logistic regression models were fit to identify significant predictors of stunting at P<0.05. Results: Prevalence of stunting and severe stunting were 15.7% (95% CI: 12.7-18.7) and 0.3% (95%CI: 0.1-0.5) for children aged <24months. Stunting was associated with illiterate mothers (AOR = 3.84; 95% CI 1.49-9.91) and nonexclusive breast feeding (AOR = 2.12; 95% CI 1.19-7.79). Children who consumed vegetables and fruits (AOR = 0.51; 95%CI 0.28-0.95) and boiling drinking water (AOR = 0.61, 95% CI: 0.39 - 0.97) were significantly reduced odds of being stunted. Conclusion and recommendation: The prevalence rate of stunting in the study area was found low. Stunting was significantly associated with the illiterate mothers and non-exclusive breastfeeding practice. Thus, an organized effort should be made at all levels to improve maternal education and exclusive breastfeeding practice of the poor rural population particularly mothers

Implication of World Health Organization growth standards on estimation of malnutrition in young Chinese children

The aim of this study was to determine how malnutrition rates change in young Chinese children when 2006 World Health Organization (WHO) growth standards are used instead of 1978 WHO/National Center for Health Statistics reference. Cross-sectional survey data were used from rural western China and the Tibet region. The heights and weights of children of <36 months of age were measured. The nutritional status of the children was assessed by two references. Using 2006 reference instead of 1978 reference, the prevalence of stunting increased significantly (17.9% vs. 12.3% in rural western China and 37.5% vs. 28.1% in rural Tibet). The prevalence of underweight was lower in rural western China (7.7% vs. 11.7%) than rural Tibet (13.1% vs. 15.3%). For all ages, the prevalence of stunting increased and the greatest relative increase appeared in the first six months (102.9% in rural western China vs. 134.9% in rural Tibet). With respect to underweight, the relative increase occurred only during the first six months (314.3% in rural western China vs. 48.1% in rural Tibet); however, the reduction was observed in other age groups. For young Chinese Han and Tibetan children, the difference in estimation of malnutrition between two references differed in magnitude. The scale of change in the prevalence rates of stunting and underweight is much greater when 2006 reference was introduced.

Nutritional status of indigenous children: findings from the First National Survey of Indigenous People's Health and Nutrition in Brazil.

IntroductionThe prevalence of undernutrition, which is closely associated with socioeconomic and sanitation conditions, is often higher among indigenous than non-indigenous children in many countries. In Brazil, in spite of overall reductions in the prevalence of undernutrition in recent decades, the nutritional situation of indigenous children remains worrying. The First National Survey of Indigenous People’s Health and Nutrition in Brazil, conducted in 2008–2009, was the first study to evaluate a nationwide representative sample of indigenous peoples. This paper presents findings from this study on the nutritional status of indigenous children < 5 years of age in Brazil.MethodsA multi-stage sampling was employed to obtain a representative sample of the indigenous population residing in villages in four Brazilian regions (North, Northeast, Central-West, and Southeast/South). Initially, a stratified probabilistic sampling was carried out for indigenous villages located in these regions. Households in sampled villages were selected by census or systematic sampling depending on the village population. The survey evaluated the health and nutritional status of children < 5 years, in addition to interviewing mothers or caretakers.ResultsHeight and weight measurements were taken of 6,050 and 6,075 children, respectively. Prevalence rates of stunting, underweight, and wasting were 25.7%, 5.9%, and 1.3%, respectively. Even after controlling for confounding, the prevalence rates of underweight and stunting were higher among children in the North region, in low socioeconomic status households, in households with poorer sanitary conditions, with anemic mothers, with low birthweight, and who were hospitalized during the prior 6 months. A protective effect of breastfeeding for underweight was observed for children under 12 months.ConclusionsThe elevated rate of stunting observed in indigenous children approximates that of non-indigenous Brazilians four decades ago, before major health reforms greatly reduced its occurrence nationwide. Prevalence rates of undernutrition were associated with socioeconomic variables including income, household goods, schooling, and access to sanitation services, among other variables. Providing important baseline data for future comparison, these findings further suggest the relevance of social, economic, and environmental factors at different scales (local, regional, and national) for the nutritional status of indigenous peoples.

Ethnic differences on nutritional status of children under 3 years old in poor counties of the western China

To explore the ethnic differences on nutritional status of children under three years old, in the western areas of China and to identify the affecting factors. 14 072 children under the age of three years and their mothers were recruited, using the proportion population sampling method in 45 counties in the western areas of China. Height and weight were used as the measurement on nutrition of children. Height and weight of children with Han, Uyghur, Tibetan and Zhuang ethnicities were all lower than the WHO standards and with differences on height and weight among them. There were also ethnic differences on the status of malnutrition. Prevalence rates of stunting were 14.7%, 20.3%, 26.9% and 26.5% for Han, Uyghur, Tibetan and Zhuang ethnicities, respectively. Prevalence rates of underweight were 6.1%, 10.7%, 6.8% and 15.5% among the Han, Uyghur, Tibetan and Zhuang ethnicities, respectively. The prevalence rates of wasting were 4.2%, 5.3%, 2.9%, 8.9%, and of under nutrition were 19.2%, 25.5%, 30.3% and 36.5% for the Han, the Uyghur, the Tibetan and the Zhuang ethnicities, respectively. When factors as family size, years of schooling of parents, family numbers, sex, age (months), mother's height and weight, ways of feeding and sources of family income etc. were adjusted, children with Uyghur, Tibetan, Zhuang and other ethnicities were still presented more malnutrition than the children with Han ethnicity. There were differences on malnutrition status of children under the age of three years among the studies on different ethnicities. Undernutrition was less than nutritional status, seen in children of the Han nationality than other minority ethnicities. Ethnicity seemed to be related to differences in the nutritional status of children in western China while children of the Han nationality would be better than other minorities on nutritional status if they were in same living conditional.

Study on the references regarding height and prevalence of stunting among children and adolescents aged 7 to 18 years of Chinese Han ethnicity

To develop the reference on height among children and adolescents aged 7 to 18 years of Chinese Han ethnicity in different administrative districts of China and to use this height reference for screening stunting. Results from the national screening program were compared with the WHO references. Data from the Chinese National Survey on Students Constitution and Health in 2005 was used to develop the height references through LMS method. Differences among the references on height for children and adolescents in different districts (I-IV) were remarkable. The highest was seen in the Second Districts while the lowest was seen in the First Districts among those at the age of 18, with differences as 3.18 cm for boys and 2.92 cm for girls. The heights from the inland were shorter than that of the WHO references, with the differences ranging from 0.31 cm to 5.07 cm for boys, and from 0.98 cm to 4.22 cm for girls. The prevalence rates of stunting were 2.22%, 2.29%, 5.25%, respectively according to local references, national references and the WHO references. Universal height references from the whole nation could not discriminate the variations caused by geographic conditions and hereditary factors related to socio-economic situations. Height references should be developed locally, to evaluate height levels of the areas.

Nutritional and health status of primary school children in rural Uganda

Poor nutrition and health can affect children’s education. The nutritional status of school children (9-15 years) was assessed in Kumi district, Eastern Uganda in 2006-2007. Selection of schools was done using modified cluster sampling involving 34 schools (n=645). Assessments for nutritional status were done anthropometrically (height and weight), biochemically (iron, n=145; iodine, n=87; and vitamin A, n=145) and assessment for health status was done following the formal ether concentration technique for examination for intestinal helminths (n=189) and a quick malaria (n=119) test for malaria parasites. Prevalence rates for stunting, underweight and thinness were 8.7% (95CI 6.7-11.1); 13.0% (95CI 10.6-15.8); and 10.1% (95CI 7.9-12.6), respectively of which males and the older age group of children were more affected. Prevalence rates for iodine deficiency, anaemia, iron deficiency and vitamin A deficiency (VAD) were 3.4% (95CI 0.9-9.1); 24.1% (95CI 17.7-31.6); 82.1% (95CI 75.2-87.7); and 30.3% (95CI 23.3- 38.2), respectively. Anaemia (measured as haemoglobin status), iron deficiency (measured as serum Ferritin) and VAD (measured as serum retinol) were higher among females (26.3%, 95CI 17.5-36.7; 83.8%, 95CI 74.4-90.7; 33.8%, 95CI 24.0-44.6) compared to males (21.5%, 95CI 12.8-32.8; 80%, 95CI 69.0-88.4; 26.2%, 95CI 16.6-37.8). Geohelminth (S.mansoni &amp; N.americanus) and malaria parasitemia were 4.8% and 46.2%, respectively. Prevalence rates for stunting, iodine deficiency and geohelminth infections were low. The high prevalence rates of wasting/thinness, underweight, iron and vitamin A deficiencies show these as significant public health problems among school children in Kumi district. There is a need to focus attention on nutritional and health conditions of school children to improve their conditions. Much can be done to prevent malaria infection by promoting the use of Insecticide Treated Nets and chemoprophylaxis. The biennial dosage with albendazole for deworming, and universal use of iodized salt in Uganda are success stories that should continue; iron deficiency anaemia can be controlled through nutrition education, provision of nutritious school meals coupled with control of malaria and deworming. Since many children attend school, such services if delivered through school systems would assist those school children who most need them.