Risk Factors For Undernutrition Research Articles

Prevalence of Underweight, Stunting, and Wasting in Under-five Children of Kuwiran Village, Madiun Regency, Indonesia: August 2022

In 2021, the prevalence of underweight cases in Indonesia is recorded at 17%, an increase of 0.7% compared to 16.3% in 2019. One of the risk factors of undernutrition especially in children is the early marriages of the parents. There is an increase in early marriages by 175 pairs in Madiun Regency, East Java in 2020. Anthropometric measurement is an important part of handling nutrition, growth, and development problems such as being underweight, stunted and wasted which is in line with the objectives of the Indonesia Sehat program in the Rencana Pembangunan Jangka Menengah Nasional (RPJMN) 2020-2024 plan, namely improving the health and nutritional status of children. This descriptive study focuses on the anthropometric results of children under five who performed routine examinations in the period of August 2022 in the integrated healthcare center or Posyandu of Kuwiran Village, Madiun Regency, East Java, Indonesia. This study obtained data from the integrated healthcare center records using total sampling, which obtained 41 subjects. The results indicate that there is a 17.07% prevalence of underweight, 19.51% stunted, and 12.2% wasted from 41 under-five children who performed routine monthly measurements and check-ups at the integrated healthcare center of Kuwiran Village, Madiun Regency in the period of August 2022. The monthly prevalence of underweight and wasted children in Kuwiran Village alone is higher than the annual prevalence of underweight and wasted children in the Madiun Regency, East Java Province in 2021. However, the monthly prevalence of stunted children is lower than that of stunted children in East Java and Indonesia as a whole.

Attention, Praxis, and Reasoning Are Associated with Risk of Undernutrition in Older People with Cognitive Impairment.

Dementia is a risk factor for undernutrition. However, it is not clear if specific cognitive deficits have a higher risk of undernutrition and how much appetite/nutritional problems and caregiver stress mediate this association. To evaluate the relationship between nutritional status and severity of global and function-specific scores of cognitive dysfunctions, and to which extent this association is mediated by appetite/nutritional problems and caregiver stress. Cross-sectional analysis of the ReGAl study data, including 761 older adults attending a Memory Clinic. Nutritional status was evaluated with Mini Nutritional Assessment (MNA). The relationship between scores at neuro-cognitive tests and risk of undernutrition was evaluated using logistic regression models adjusted for potential confounders. To allow comparison between different tests, all scores were standardized. Mediation analysis was used to evaluate how much appetite/nutritional problems and caregiver stress mediate this association. Mean age was 77 years (SD: 9), 37.3% were women. Exploring different cognitive domains, a stronger association was documented for attentive matrices (OR:0.49, 95% CI: 0.34-0.72), the figure copy test (OR:0.63, 95% CI: 0.45-0.88), and the verbal judgement test (OR:0.61, 95% CI: 0.42-0.91). The proportion of the effect of cognition (MMSE) on nutritional status mediated by caregiver distress was 9.5% (95% CI: 0.002-0.27), the proportion mediated by appetite/nutritional problems was 11% (95% CI: -4.8-3.18). Risk of undernutrition is associated to cognitive decline; a stronger association was observed for attention, praxis, and reasoning. Caregiver distress is a mediator of this association. This information should be considered in the management plans of this population.

Prevalence of undernutrition and associated factors in young children in Malaysia: A nationwide survey.

IntroductionUndernutrition in young children is a significant public health problem globally. We determined the prevalence of and factors predisposing to stunting and underweight in children aged 1 to 5 years in Malaysia.Materials and methodsData were extracted from a cross-sectional nationwide campaign involving healthy children aged 1–5 years conducted over a 4-month period in 2019. We obtained information on demography, parental height and risk factors of undernutrition and anthropometric measurements (height and weight) of children enrolled. Age and sex-specific z-score for length/height-for-age (HAZ), weight-for-age (WAZ), body mass index (BMI) z-score (BAZ) and weight-for-height/length (WFH) z-score (WFHZ) were obtained using World Health Organization growth standards. The following definitions were used: (a) HAZ < −2 SD as stunted and −2 to −1 SD as at risk of stunting; (b) WFHZ < −3 SD as severe, −3 to < −2 SD as moderate wasting, and −2 to < +1 SD as normal; (c) WAZ −2 to −1 as at risk of underweight; (d) BAZ +1 to < +2 SD as at risk of and > +2 SD as overweight.ResultsOf the 15,331 children surveyed, prevalence of stunting and at risk of stunting were 16.1 and 20.0%, severe and moderate wasting were 4.0 and 6.1%, while 21.1% was at risk of underweight. Prevalence of at risk of and overweight 14.2 and 7.3%, respectively. One in fifth (25.0%) children had at least one form of undernutrition (stunting and/or underweight/wasting). Of the 1,412 (13.2%) children reported to have risk factors of undernutrition, 47.2% had feeding difficulties, 44.8% had poor dietary intake and 8.0% had both. Boys, paternal height < 156 cm and poor dietary intake were significantly associated with stunting and/or wasting. Compared with children with no risk factors, children with feeding difficulties were more likely to be wasted (AOR: 1.48, 95% CI: 1.18–1.85), and had at least one form of undernutrition (AOR: 1.45, 95% CI: 1.25–1.69).ConclusionsIn Malaysian children aged 1 to 5 years, dual burden of under- and overnutrition are common. Poor dietary intake and feeding difficulties were risk factors for undernutrition.

Risk factors for the double burden of malnutrition in children younger than 5 years in the Gaza Strip: a systematic review

BackgroundMalnutrition, the coexistence of both undernutrition and obesity, poses a considerable public health and economic burden worldwide. Globally, undernutrition is the largest cause of death in children younger than 5 years, being responsible for 3·1 million, or approximately 45%, of deaths in this population. Conversely, WHO estimated that, in 2016, 41 million children younger than 5 years were overweight or obese. The global problem of malnutrition can be ascribed to changing dietary and lifestyle habits and to the epidemiological transition of most countries. Developing communities, such as in the Gaza Strip, are thus subject to a double burden of preexisting widespread undernutrition and emerging obesity and chronic diseases. MethodsA systematic search and literature review was done in PubMed, Embase, and the Cochrane Library for articles discussing risk factors for obesity and undernutrition among Palestinians. Additionally, we reviewed UN Relief and Works Agency and Ministry of Health of the occupied Palestinian territory health annual reports. We included all original, population-based studies, irrespective of their design or publication status, language, or age of participants. We independently screened titles, abstracts, and full texts for eligibility, then extracted relevant data and assessed the risk of bias. We pooled the most common reported risk factors for the double burden of malnutrition in the occupied Palestinian territories (Gaza Strip and West Bank) for the period of June, 2017, to June, 2018. FindingsOf 432 publications retrieved, we included 23 eligible articles. The pooled risk factors for undernutrition and obesity in the Gaza Strip were poverty and poor socioeconomic situations (63%), poor awareness of healthy diets and lifestyle among communities (26%), developmental transition and urbanisation (6%), and others (5%). The political situation and the blockade in the Gaza Strip contributed to different weights of the risk factors above mentioned. All studies had a moderate to high risk of bias, especially selection bias. Annual health reports of UN Relief and Works Agency and Ministry of Health of the occupied Palestinian territory showed that overweight was in high prevalence in children younger than 5 years (6·5%), as were other problems of undernutrition, such as stunting (7·1%). InterpretationThe poor political and socioeconomic situation in Gaza compound the risk factors contributing to the high prevalence of malnutrition in the area. In addition, awareness about healthy lifestyles is scarce, which increases the prevalence of overweight and obesity in children. Urbanisation and developmental factors such as globalisation and technological developments added a small risk of overweight and obesity. FundingNone.

The Burden of Undernutrition and Its Associated Factors Among Children Below 5 Years of Age in Bambao Region, Comoros.

BackgroundUndernutrition remains a major public health problem in low- and middle-income countries and Comoros is no exception. This study aimed to examine the prevalence and identify the risk factors of undernutrition among children under-five years in Bambao region, Comoros.MethodsThis cross-sectional study was conducted in Bambao region among 837 under-five years and their caregivers. Analyses were conducted using both descriptive and logistic regression to examine the magnitude and factors associated with stunting, wasting and underweight.ResultsPrevalence of stunting, wasting and underweight were 21.6, 13.7, and 13.6% respectively. Factors associated with stunting were caregiver's secondary education level compared to no education (AOR = 1.89, 95% CI: 1.04–3.43, P < 0.04), age of child between 13–24 months compared to 0–12 months (AOR = 2.69, 95% CI: 1.44–5.01, P < 0.001), and food insecurity (AOR = 2.55, 95% CI: 1.20–5.41, P < 0.02). Children aged 25–59 months were 78% less likely to have wasting compared to those with 0–12 months (AOR = 0.22, 95% CI: 0.10–0.51, P < 0.001). Wasting was also associated with food insecurity (AOR = 2.70, 95% CI: 1.12–6.49, P < 0.03), and low birthweight (AOR = 3.21, 95% CI: 1.73–5.94, P < 0.001). Children aged between 25–59 months were 86% less likely to have underweight compared to those aged 0–12 months (AOR = 0.14, 95% CI: 0.06–0.36, P < 0.001). Food insecurity (AOR = 2.65, 95% CI: 1.08–6.54, P < 0.03), low birthweight (AOR = 3.15, 95% CI: 1.67–5.93, P < 0.001), and non-exclusively breastfeeding (AOR = 2.37, 95% CI: 1.15–4.90, P < 0.02) were also associated with underweight.ConclusionMore than one in five children under-five is stunted in Bambao region, Comoros. Moreover, more than 13% are underweight or wasted calling for streamlined efforts to address poor feeding practices, food insecurity, low birthweight, and socio-demographic disadvantages in this and other areas with similar context.

Risk Factors for Undernutrition among Children in South Central Somalia

Objectives: Undernutrition is a global public health challenge, especially in countries that experience extreme climate conditions and armed conflict. In Somalia, undernutrition is chronic, often graded for emergency response. The purpose of this study was to provide evidence on immediate, proximate, and distal risk factors for undernutrition in the most affected region of Somalia.&#x0D; Setting: Data for the study was from cross-sectional nutritional surveys implemented by the Somalia Food Security and Nutrition Analysis Unit. Sampling for the surveys followed a multistage cluster sampling methodology where in the first stage, 30 clusters were randomly assigned to villages, and then 30 households were randomly selected from each cluster. Generalized Estimation Equations were used to determine risk factors for undernutrition. Data analysis followed survey analysis procedures.&#x0D; Participants: 60,856 children aged 6-59 months from cross-sectional nutritional surveys implemented in South-Central Somalia from 2007 to 2012.&#x0D; Results: When factors at the individual, household, and society level were considered simultaneously, diarrhea diseases and geographical region were the main risk factors for underweight, child gender, meal frequency, and livelihood zone were risk factors for stunting, while diarrhea and livelihood zone were the risk factors for wasting. Geographical region and livelihood system were significant factors for undernutrition.&#x0D; Conclusions: Interventions to address undernutrition in Somalia should be tailored to the region and livelihood zone while prioritizing innovative climate-smart food production and addressing childhood illnesses. The study findings provide evidence to inform nutrition policy and programs that could eliminate nutrition disparities and the burden of childhood undernutrition in Somalia and other countries with similar contexts.

Association Between Household Food Insecurity and Nutritional Status Among Children of age

Household food insecurity (HFI) is considered one of the main risk factors of undernutrition. However, the evidence is not conclusive in our study settings. This study aimed to examine the association between HFI and nutritional status. It was a community-based cross-sectional observational study among children of age <5 years and their mothers (n = 257) conducted in a slum of Kolkata, West Bengal, carried out from March to May 2019. Data were analyzed using the Statistical Package for the Social Sciences software (version 16.0. Chicago, SPSS Inc.). Logistic regression analysis was performed to find out the association. The current study found that 72.4% of participants living in food-insecure households and the proportion of underweight, wasting, and stunting among the under-five children found to be 29.9%, 17.8%, and 27.2%, respectively. Bivariate analysis showed wasting and stunting associated with HFI, whereas in multivariable regression, only stunting remained significant. Food insecurity (FI) remains a predictor of chronic undernutrition (wasting and stunting) highlighting the need for multisectoral strategies and policies to combat FI and multiple forms of malnutrition which will lay the foundation for sustainable and inclusive growth.

Magnitude of Stunting and Associated Factors among Adolescent Students in Legehida District, Northeast Ethiopia.

Background Undernutrition including stunting particularly at an adolescent stage was not emphasized by various intervention strategies in the Ethiopian context. Assessing the magnitude and potential risk factors of undernutrition is thus helpful for policymakers to design appropriate intervention strategies. Hence, this study was aimed at assessing the magnitude of stunting and associated factors among adolescent students in Legehida district, Northeast Ethiopia. Methods A school-based cross-sectional study was conducted among 424 adolescent students from February 15th to March 15th, 2018. A stratified sampling followed by a simple random sampling technique was used to select the study participants. A pretested, structured, and self-administered questionnaire was used to collect the required data. Height was measured by using a portable stadiometer and the height-for-age (HFA) z-score was calculated as an indicator of stunting. SPSS version 25 and WHO AnthroPlus software were applied to analyze the data. A multivariable logistic regression analysis was performed to identify factors associated with adolescent stunting. Statistical significance was determined at a p value of <0.05 and association was described by using an odds ratio at a 95% confidence interval. Results A total of 406 adolescent students (with a response rate of 95.7%) participated in the study. The magnitude of stunting among adolescent students in this study was 24.9% (95% CI: 24.6%–35.3%). Conclusions Stunting among adolescent students was significantly associated with being male [AOR = 2.1; 95% CI: 1.73–5.90], meal frequency (<3/day) [AOR = 4.6; 95% CI: 2.61–8.24], infrequent handwashing practice [AOR = 3.6; 95% CI: 1.30–9.40], absence of latrine facility (AOR = 5.51; 95% CI: 3.03–9.9), and consumption of unsafe water [AOR = 2.8; 95% CI: 1.35–6.19]. Hence, conducting routine nutrition screenings and assessments, promotion of proper food intake, and emphasis on nutrition education and counseling are needed to be strengthened.

Machine learning algorithms for predicting undernutrition among under-five children in Ethiopia.

Child undernutrition is a global public health problem with serious implications. In this study, we estimate predictive algorithms for the determinants of childhood stunting by using various machine learning (ML) algorithms. This study draws on data from the Ethiopian Demographic and Health Survey of 2016. Five ML algorithms including eXtreme gradient boosting, k-nearest neighbours (k-NN), random forest, neural network and the generalised linear models were considered to predict the socio-demographic risk factors for undernutrition in Ethiopia. Households in Ethiopia. A total of 9471 children below 5 years of age participated in this study. The descriptive results show substantial regional variations in child stunting, wasting and underweight in Ethiopia. Also, among the five ML algorithms, xgbTree algorithm shows a better prediction ability than the generalised linear mixed algorithm. The best predicting algorithm (xgbTree) shows diverse important predictors of undernutrition across the three outcomes which include time to water source, anaemia history, child age greater than 30 months, small birth size and maternal underweight, among others. The xgbTree algorithm was a reasonably superior ML algorithm for predicting childhood undernutrition in Ethiopia compared to other ML algorithms considered in this study. The findings support improvement in access to water supply, food security and fertility regulation, among others, in the quest to considerably improve childhood nutrition in Ethiopia.

Prevalence of undernutrition and potential risk factors among children below five years of age in Somali region, Ethiopia: evidence from 2016 Ethiopian demographic and health survey

BackgroundChildhood under-nutrition is far-reaching in low and middle-income nations. Undernutrition is one of the major open wellbeing concerns among newborn children and youthful children in Ethiopia. The present study aimed to explore the potential risk factors of undernutrition among children under 5 years of age in Somali Region, Ethiopia.MethodsThe data for this study was extricated from the Ethiopian Demographic and Health Survey (EDHS) 2016. The data collected from 1339 children born 5 years before was considered within the analysis. A multivariable binary logistic regression analysis was utilized at a 5% level of significance to decide the individual and community-level variables related to childhood malnutrition.ResultsThe prevalence of stunting, underweight and wasting were 27.4, 28.7 and 22.7%, respectively. About 16.1% of children were both stunted and underweight; the extent of both being underweight and wasted was 11.7%, the prevalence of both stunted and wasted children was 5.5%, and all three malnutrition conditions were 4.7% children. Among the variables considered in this study, age of the child in months, type of birth, anemia level, size of child at birth, sex of the child, mothers’ BMI and sources of drinking water were significantly related to stunting, underweight and wasting in Somali Region.ConclusionsThe prevalence of stunting, underweight and wasting was relatively high. Undernutrition is one of the major open wellbeing concerns among children in Somali region. The impact of these variables ought to be considered to develop strategies for decreasing the lack of healthy sustenance due to undernutrition in the study areas. Hence, intercession should be centered on making strides for the under-nutrition determinant variables of the children to be solid, to improve the child’s wholesome status, and decrease child mortality quickly.

Prevalence and overlap of known undernutrition risk factors in children in Nairobi Kenya.

We aimed to describe the co‐occurrence of known risk factors for undernutrition and the prevalence of modifiable risks in wasted, stunted and healthy children. Quota sampling was used to recruit healthy [weight for age Z scores (WAZ) > −2 SD] and undernourished [weight for length (WLZ) or WAZ scores ≤ −2 SD] children aged 6–24 months from seven clinics in low‐income areas of Nairobi. Structured interviews were used to identify exposure to socioeconomic, water and hygiene, infant feeding, dietary and behavioural risks (low interest in food, high food refusal and force feeding). We recruited 92 wasted WLZ ≤ −2 SD, 133 stunted (length for age Z scores LAZ ≤ −2 SD) and 172 healthy (LAZ and WLZ > 2SD) children. Nearly all children were exposed to hygiene risks (90%) and low dietary diversity (95%) regardless of nutritional status. Stunted children were more likely to be exposed to socio‐economic risks (54% healthy, 64% wasted and 72% stunted; P = 0.001). Compared with healthy children, wasted and stunted children were more likely to be exposed to infant feeding (25% healthy, 40% wasted and 41% stunted; P = 0.02) and behaviour risks (24% healthy, 49% wasted, and 44% stunted; P = 0.004). Overall, wasted and stunted children were twice as likely to be exposed to more than three risks (23% healthy, 48% wasted, and 50% stunted; P = <0.001). They were also more likely to be exposed to more than three modifiable risks (dietary, handwashing and behaviour risks). Wasting and stunting are associated with exposure to multiple risk factors, many of which are potentially modifiable using targeted advice.

Differences in the socio-demographic determinants of undernutrition in children aged

ObjectivesThis study investigates the prevalence and determinants of undernutrition among children <5 years living in Bangladesh using the Composite Index of Anthropometric Failure (CIAF) and highlights the differences between urban and rural areas. Study designData are drawn from three cross-sectional Bangladesh Demographic Health Surveys conducted from 2007 to 2014. MethodsA Chi-square test was used to assess the prevalence of <5 years child undernutrition. Logistic regression analysis was performed to identify various sociodemographic risk factors. ResultsThe prevalence of undernutrition based on the CIAF was 52% among children <5 years in Bangladesh. The prevalence of undernutrition in children living in urban areas and rural areas were found to be 45% and 54%, respectively. As per the CIAF, undernutrition was highly prevalent among children in the older age group, children of uneducated and currently working mothers, those of underweight mothers, children of fourth and above in the birth order, children of fathers who were manual labourers, children of households who had no access to television and those in the poorest households whether in urban or rural areas. Children in the older age group, children of uneducated mothers, those with underweight mothers and those from the poorest households provided common key risk factors for undernutrition in both urban and rural areas. Children of fourth and above birth order and not watching television at all were additional risk factors of child undernutrition in rural areas. ConclusionHalf of the children in rural areas and two-fifths of them in urban areas are suffering undernutrition in Bangladesh, and several sociodemographic factors heighten the risks. Also, birth order and watching television were identified as the differential risk factors. This study therefore concludes that evidence-based interventions are needed to reduce the burden of undernutrition in children in the country.

Identifying Targets for the Prevention of Childhood Undernutrition in a Resource-Limited Peri-Urban Ecuadorian Community.

In middle-income countries, malnutrition concentrates in marginalized populations with a lack of effective preventive strategies. Identify risk factors for undernutrition in a peri-urban Ecuadorian community of children aged 12 to 59 months. Data from a cross-sectional survey in 2011 of children 1 to 5 years were analyzed including demographic data, medical history and examination, food frequency questionnaire (FFQ), anthropometric measurements, and blood for complete blood count, C-reactive protein, vitamin A, iron, and zinc levels. Dietary Diversity Score (DDS) was calculated from FFQ. Bivariate and multivariate analysis assessed effects on primary outcome of undernutrition by DDS, vitamin deficiencies, and demographic and nutritional data. N = 67, 52.2% undernourished: 49.3% stunted, 25.4% underweight, and 3% wasted; 74.6% (n = 50) were anemic and 95.1% (n = 39) had low serum zinc. Dietary Diversity Score was universally low (mean 4.91 ± 1.36, max 12). Undernutrition was associated with lower vitamin A levels (20 306, IQR: 16605.25-23973.75 vs 23665, IQR: 19292-26474 ng/mL, P = .04); underweight was associated with less parental report of illness (43.8%, n = 7 vs 80% n = 40, P = .005) and higher white blood count (13.7, IQR: 11.95-15.8 vs 10.9, IQR: 7.8-14.23 × 109/L, P = .02). In multiple regression, risk of undernutrition decreased by 4% for every $10 monthly income increase (95 CI%: 0.5%-7.4%, P = .02, n = 23); risk of underweight decreased by 0.06 for every increased DDS point (adjusted odds ratio: 0.06; 95 CI%: 0.004-0.91, P = .04, n = 23). In this peri-urban limited-resource, mostly Indigenous Ecuadorian community, stunting exceeds national prevalence, lower monthly income is the strongest predictor of undernutrition, lower DDS can predict some forms of undernutrition, and vitamin deficiencies are associated with but not predictive of undernutrition.

Assessment of Prevalence and Factors Associated with Malnutrition Among Under-Five Children in Debre Berhan Town, Ethiopia.

BackgroundMalnutrition is a deficiency or improper intake of energy and nutrients. It includes undernutrition (wasting, stunting, underweight, and mineral and vitamin-related malnutrition) and overnutrition.PurposeTo estimate the prevalence and identify the risk factors for undernutrition among under-five children in Debre Berhan Town, North Shewa, Ethiopia.MethodsA community-based cross-sectional study was conducted in Debre Berhan Town, from October 07, 2019 to January 24, 2020. Three hundred and eighty-five under-five children who were selected using systematic random sampling technique were included in this study. To collect data, a structured questionnaire and anthropometrical measurements were used. Data entry was done through Epi data 4.21, and for data analysis statistical package for social sciences version 20.0 was employed. Bivariate and multivariable logistic regression analysis was used to identify the factors associated with malnutrition. The statistical significance was stated at p value <0.05 with 95% confidence intervals.ResultsIn the overall sample the total prevalence of undernutrition in below age-5 children was 61 (15.8%), the corresponding figures for underweight, stunted, and wasting were 26%, 41%, and 33%, respectively. Factors that contributed to under-five undernutrition were maternal illiteracy, not breastfeeding exclusively, preterm birth, absence of antenatal care, exposure to infectious diseases and diarrhea.ConclusionThere was a higher prevalence of stunting (41%), wasting (33%), and being underweight (26%) in Debre Berhan town than the national (Ethiopia) or regional (Amhara) malnutrition prevalence. Mothers’ educational status should be improved by teaching them that proper nutrition is important for their child’s growth and development. Antenatal care for all pregnant women, education on child care, infection prevention, and child feeding should be provided and further strengthened.

Does Dental Caries Increase Risk of Undernutrition in Children?

A systematic review of the evidence on the impact of dental caries on malnutrition risk in children was conducted. To systematically review published evidence pertaining to the effect of dental caries severity and prevalence on risk of wasting or stunting in children. Four questions relating to caries of the permanent dentition, primary dentition, early childhood caries (ECC), and severe ECC as a risk factor for undernutrition were set. The target population was children aged 0 to 18 y from any country. Data sources included MEDLINE and Embase. All human epidemiological studies were included. Quality assessment excluded lowest-quality studies. Evidence synthesis by vote counting was depicted using harvest plots. A best available evidence approach was applied to narrative synthesis. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Of the 2,690 studies identified, 447 were screened in duplicate; of these, 117 underwent quality assessment, resulting in 46 included studies, of which 38 were included in vote counting (3 quasi-experimental, 1 cohort, 1 case control, and 33 cross-sectional studies). For the permanent dentition, findings were mixed; the balance of data showed no association between caries prevalence (7/11 studies) or severity (8/17 studies) with wasting. For the primary dentition, the balance of data showed a positive association between caries prevalence (10/15 studies) and severity (12/15 studies) with wasting, as well as between-caries prevalence (4/5 studies) and severity (6/6 studies) with stunting. Considering ECC only did not alter this pattern of findings. The balance of evidence suggests that dental caries in the primary dentition is associated with undernutrition. There is a need for well-designed trials on the impact of caries rehabilitation on growth trajectories of children from low- and middle-income countries and for prospective studies of the impact of caries severity on both stunting and wasting to confirm causality. The results of this study can be used by policy makers when considering the importance of oral health in addressing the United Nations Sustainable Development Goal to end all forms of malnutrition. The findings suggest that dental caries in the primary dentition may impair children's healthy weight gain. The findings indicate that higher-quality data are required to confirm a causal relationship and thus inform funding bodies of the need for research, especially in low- and middle-income countries, to substantiate the current knowledge and inform clear and accurate policy statements.

Risk Factors for Undernutrition at Admission Among Adult Hospitalized Patients at a Referral Hospital in Indonesia

Patients with undernutrition at admission have higher risks to worsen their nutritional status, which is linked to an increase in morbidity and mortality. This study investigated the prevalence of undernutrition at admission and its associated factors. A cross-sectional study was conducted on patients aged 18 to 59 years old in Internal Medicine ward at Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, between July and September 2019. Factors that might be associated with undernutrition at admission, such as age, sex, marital status, Charlson Comorbidity Index (CCI) and type of comorbidity, depression, and neutrophil–lymphocyte ratio (NLR), were assessed. Bivariate and multivariate analyses were used to determine the associated factors. Sixty hospitalized patients with median age of 42 years and 76.7% with married status joined the study. The most common reason for hospitalization was acute gastrointestinal disease with gallstones as the most common comorbidity. Undernutrition exists in 26.7% of subjects. High CCI score was observed among 11.7% subjects and half of subjects had NLR category ≥5. Bivariate analysis revealed that unmarried status, age ≥40 years, and malignancy were associated with undernutrition at admission. Logistic regression analysis showed malignancy as an independent predictor of undernutrition during the initial hospital admission (odds ratio [OR] = 11.8; 95% confidence interval [CI]: [1.1, 125.7]). The prevalence of undernutrition at admission was 26.7%. Factors associated with an increased prevalence of undernutrition at admission were age &lt;40 years, unmarried status, and malignancy. Malignancy was an independent factor of the prevalence of undernutrition at admission.

Prevalence of undernutrition and potential risk factors among children under 5 years of age in Amhara Region, Ethiopia: evidence from 2016 Ethiopian Demographic and Health Survey.

More than one-third of deaths during the first 5 years of life are attributed to undernutrition, which are mostly preventable through economic development and public health measures. The present study aimed to explore the potential risk factors of undernutrition among children under 5 years of age in Amhara Region, Ethiopia. Data from the 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A total of 974 children under 5 years of age were involved. A multivariable binary logistic regression analysis was used at a 5% level of significance to determine the individual- and community-level factors associated with childhood undernutrition. The prevalence of stunting, wasting and underweight was 46⋅3, 9⋅8 and 28⋅4%, respectively. About 23⋅1% of children were both stunting and underweight, 7⋅3% were both underweight and wasting and 4⋅5% of children had all three conditions. Among the factors considered in the present study, the age of a child in months, birth weight, mother educational level, sex of household head, sources of drinking water and the type of toilet facility were significantly associated with undernutrition in the Amhara Region. Undernutrition among under-five children was one of the public health problems in the Amhara Region. The potential risk factors should be considered to develop strategies for reducing undernutrition in the Amhara Region. Finally, improving the living standards of the children is important to get better health care, to enhance the child's nutritional status and to reduce child mortality.

Esophageal Atresia: Nutritional Status and Energy Metabolism to Maximize Growth Outcome.

Background: Long-term negative sequelae of esophageal atresia (EA) may induce poor growth and impaired nutritional status in childhood. We describe the nutritional profile and energy metabolism of children with repaired EA to identify malnutrition risk factors and optimize growth management. Methods: Twenty-one children (>4 years) were included, and anthropometric measurements, nutritional assessment, and energy metabolism were considered. The subjects were defined as undernourished if they met BMI < −2 standard deviation (SD). To grade undernutrition, we defined the prevalence of underweight, stunting, and wasting (cut-off level of <−2 SD). Medical records were reviewed for the type of EA and surgery and perinatal data. Results: Malnutrition was detected in 28.6% of children. Underweight was detected in 23.8% of patients (all with undernutrition p < 0.01). Wasting was noted in 28.6% of patients, of these 5 children were undernourished (p < 0.001) and stunting was noticed in only one patient with malnutrition (p = 0.5). Resting expenditure energy (REE) was lower in undernourished subjects compared to subjects with adequate nutritional status (p < 0.001). Malnutrition was associated to: type of EA (p = 0.003, particularly type A and C); intervention including deferred anastomosis due to long-gap repair (p = 0.04) with/or without jejunostomy (p = 0.02), gastric pull-up (p = 0.04), primary anastomosis (p = 0.04), pyloromyotomy in long-gap (p < 0.01); small for gestational age condition (p = 0.001). Conclusions: undernutrition risk factors, beyond the type of malformation, surgery, and perinatal factors, must be early considered to personalize nutritional programming. Energy metabolism is important to monitor the nutritional requirements. The management of nutritional issues is surely a contributory factor able to counteract the poor growth of children with EA.

A Study on Risk Factors of Under-nutrition of under-five children in an urban area of Malda district, West Bengal

Introduction: Under-nutrition is highly prevalent in developing countries including India. Many risk factors are responsible for the occurrence of under-nutrition. To understand area specific causes (risk factors) responsible for under-nutrition among under-five children in Malda town, a case control study was undertaken. Methods: Forty two cases with under-nutrition (weight for age &lt;-2SD) and 84 controls with normal weight (weight for age ≥ -2SD were selected from 6 ICDS centres in 1:2 ratio. Results: Of the selected cases, 22(52.4%) were moderately underweight and 20 (47.6%) were severely underweight; 57% were male &amp; 43% were female children. 55% Mothers of severely underweight children were illiterate whereas 65% fathers of severely under-weight children were labourer. From bivariate analysis it was reflected that no statistical differences were there between underweight &amp; normal weight children with respect to variables like family size, per capita family income, Maternal age at child birth, birth weight, breast feeding &amp; its duration, diarrhoea and worm infestation(p&gt;.05). Factors like fathers’ occupation, ARI (38.1% vs17.8%), feeding problems (65% vs. 40.5%), incomplete vaccination (73.8% vs39.3%) were associated with under-nutrition (P&lt;.01). Undernourished children showed statistical association with angular stomatitis, conjunctival xerosis, bilateral oedema &amp; severe wasting compared to normal nourished children. (p&lt;.01). Conclusion: Factors like fathers’ occupation, ARI, feeding problems, incomplete vaccination were associated with under-nutrition of under-fives attending ICDS centres in an urban setting of Malda district, West Bengal.

Socio-Demographic and Nutritional Status Correlates in Pulmonary Tuberculosis Patients in Calabar, Nigeria

Introduction: Tuberculosis (TB) continues to rank high in contributing to the global disability adjusted life years with 10 million new cases yearly worldwide. Having effective control of TB particularly in endemic communities should be predicated on understanding factors that drive its upsurge.&#x0D; Objectives: This study assessed the association between socio-demographic factors and nutritional status among adults with pulmonary TB in Calabar, Nigeria.&#x0D; Methods: A descriptive analysis of a randomized controlled study that enrolled 81 clinically diagnosed pulmonary TB patients that met the eligibility criteria. Data assessed were, socio-demographic, clinical, dietary, anthropometric, haematological and serum concentration of micronutrients. Results were presented in frequencies, percentages, tables and chart. Chi-square (ꭕ2) test was used to determine existence of associations between variables at 5% level, while, Pearson Correlation test was applied to determine the correlation between variables. P-value was used to determine significance of tests.&#x0D; Results: Using body mass index (BMI) as a proxy of nutritional status, results indicate that 33.4% of patients were undernourished with no discernible gender differences (p=0.254). Income level classification was observed to be statistically significantly associated with undernutrition (p=0.021), with those in the low-income category most at risk. Correlation analysis of key variables indicated that low serum ascorbate, zinc and retinol were independently associated with low BMI. These associations were statistically significant (p&lt;0.05).Singleness was identified as a risk factor for undernutrition (p=0.060). Low functional status proxied by Karnofsky score &lt;50% tended to align more with patients in the low income level category.&#x0D; Conclusion: Results consistently indicate that patients in the low income category had higher proportion of lower ranges of haemoglobin, protein parameters, serum ascorbate, zinc and retinol concentrations considered deficient. Thus, poverty alleviation strategies should be highly prioritized in TB programming for effective control.