Underweight Children Research Articles

Inpatient Morbidity and Mortality of Severely Underweight Children Was Comparable to That of Severely Wasted Children in Dhaka, Bangladesh.

Both wasting and undernutrition are responsible for multiple morbidities and increased mortality in younger children hospitalized for acute illnesses. The question of whether children who are suffering from severe underweight are as vulnerable as children suffering from severe wasting needs to be researched further. We aimed to compare the morbidity and mortality of severely underweight but not severely wasted (SU-nSW) children with that of severely wasted (SW) children admitted to inpatient wards of a hospital. Data from 12,894 children aged < 5 years were collected using cross-sectional methods from Dhaka Hospital, International Centre for Diarrhoeal Disease Research, Bangladesh between March 2019 and December 2021. After exclusion of non-desired populations (N = 8,834), comparisons between SU-nSW (N = 1,876) and SW (N = 2,184) children were observed. The risk of morbidities and mortality among SU-nSW and SW children was analyzed after adjusting for age and sex. Inpatient morbidities were mostly similar among children with sepsis (adjusted odds ratio [aOR]: 0.90; 95% CI: 0.69, 1.19; P = 0.472) and convulsions (aOR: 0.84; 95% CI: 0.51, 1.37; P = 0.475). Dehydration (aOR: 0.71; 95% CI: 0.62, 0.81; P < 0.001) and hypokalemia (aOR: 0.58; 95% CI: 0.42, 0.79; P = 0.001) were more likely associated with SW children than with SU-nSW children. Pneumonia/severe pneumonia was more likely to affect SU-nSW children (aOR: 1.24; 95% CI: 1.02, 1.48; P = 0.018). Death was comparable between the two groups (aOR: 1.32; 95% CI: 0.70, 2.49; P = 0.386). This study underscores the importance of implementing present treatment guidelines for severe acute malnutrition in the facility-based management of severely underweight children as well.

Determining the risk factors of under-five morbidity in Bangladesh: a Bayesian logistic regression approach

PurposeChild morbidity prevents Bangladesh from reaching the target for the Sustainable Development Goals (target 3.2) despite the country’s success in reducing child mortality rates. As a result, it's crucial to consider a child's health-related issues. Therefore, this study aims to explore the prevalence and factors associated with under-five child morbidity in Bangladesh.MethodsThe Bangladesh Demographic and Health Survey, 2017–2018, a secondary cross-sectional survey data, was used in this study, which collected information using a two-stage systematic sampling design. After association test, Bayesian estimation of binary logistic regression model was used to identify the significant risk factors of morbidity among under-five children, and a trace plot was used to try to figure out the convergence of simulation.ResultsAccording to the prevalence analysis of this study, it can be noted that more than one-thirds of under-five children in Bangladesh suffered from at least one of the child health-related problems, and of these, the highest prevalence of child morbidity was found in the Barisal division of Bangladesh (~ 42%). According to the Bayesian logistic regression results, higher child age and maternal education are associated with a potential decrease in the risk of child morbidity in Bangladesh. Again, male children had a 7% higher risk of morbidity than female children. Another finding was that underweight children suffered 31% more fever/diarrhea/ acute respiratory infection (ARI) related problems than others.ConclusionsAccording to this study’s findings, child morbidity is still a significant issue in Bangladesh. Therefore, progress on risk factors, such as maternal education, child nutrition, etc., should be the focus of policymakers' intervention.

Relationship between zinc levels, anthropometric parameters and socio-demographic status among primary school pupils in a semi-urban community in Nigeria

Background: Zinc plays important roles in many biological processes in the body such as acting as a catalyst for numerous enzymes involved in nucleic acid metabolism cellular replication tissue repair and the growth of tissues hence, the study was aimed to determine the relationship between zinc levels, anthropometric parameters and socio-demographic status among primary school pupils. Methods: The study was a cross-sectional descriptive design carried out among four hundred primary school pupils between the ages 6-12 years in Ogbomoso. Questionnaires were distributed to obtain socio-demographic information from pupils and blood was collected for serum zinc analysis using ELISA technique. The data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 21 Results: The level of serum zinc deficiency in the study population was 9.5%. Serum zinc levels are significantly higher among younger age groups compared to older age groups (F=6.913, p value=0.001). The family size and socio-economic class are significantly associated with zinc levels. Zinc level was significantly lower in underweight children (0.389±0.25) compared to normal weight (0.819±0.39), overweight (0.991±0.62) and obese children (0.654±0.41), F=7.264, p=0.001 Conclusions: Zinc deficiency is an important component of nutritionally related morbidity worldwide. Zinc supplementation or food fortification among school children will have beneficial effects on the incidence and outcome of serious childhood infectious diseases.

Body Mass Index and Nutritional Intake among Primary School Children in Urban Area, Egypt

Abstract Introduction Primary school children are more vulnerable to malnutrition; underweight or obesity. Continuous nutritional assessment of the vulnerable groups is very important for the evaluation of current health status, besides future planning for prevention and control programs. Aim of the Work To assess the nutritional status and body mass index among primary school children attending primary healthcare centre in 10th of Ramadan city, El Sharqia Governorate, Egypt, and to identify different demographic factors that can affect nutritional status among them. Materials and Methods A cross-sectional study was conducted among 60 randomly selected primary school children. An interview questionnaire was used to collect data including demographic characteristics, family history of obesity, food intake using food frequency formula and the pyramid of food servings. Anthropometric characteristics including weight, height and BMI was estimated. Results The age ranged (6-12) for males and (6-9) for females, the mean was 8.62 and SD was 1.69. The mean height and weight of studied children were 127.33 ± 11.20 cm and 36.23 ± 13.74 kg respectively. Most of them had normal current weight (41.7%) and normal birth weight (86.7%). Overweight and obese represent 8.3% and 16.7% respectively, while underweighted children represent 33.3%. BMI was associated with child age, family opinion in child weight, birth weight and family history of obesity. Most of studied children took sufficient amount of animal protein, while consuming grains &amp; carbohydrates, beans, vegetables, fruits and fats 4-6 times per week. 80.0% consume sweets &amp; processed sugar 4-6 times per week. Consumption of junk foods and soft drinks and juices was high (66.7% for each) 4-6 times per week. Diet was statistically associated with BMI (frequency and standard requirements); overweight and obese children took carbohydrates &amp; grains, soft drinks &amp;juices and junk foods in amounts that above the standard requirements and in higher frequency compared to underweight and normal weight children (≥4 times per week). The consumption of vegetables and fruits was not related to BMI as most of participated children took them at the standard requirement. Conclusion and recommendations The prevalence of malnutrition disorder (underweight and obesity) among primary school children in 10th of Ramadan City is considerable. High BMI was associated with high frequency of eating carbohydrates&amp; grains, soft drinks &amp; juices, fats and junk foods and their daily requirements. Low BMI in underweight children not related to significant type of food as they mainly took their standard requirements in frequency around 4 times per week. Feasible and effective nutritional and educational programs for primary school children must consider child characteristics and eating habits.

Type of School as a Socioeconomic Indicator and its Impact on the Nutritional Status, School Performance, Self-Esteem of Basic School Students (10-12 Years Old) in Khartoum Locality, 2014

Adolescence, a critical phase of rapid physical, social, and psychological growth, encompasses individuals aged 10 to 19 years, Evaluating nutritional status for decades has involved standard methods like dietary, anthropometric, biochemical tests, and clinical signs, often incorporating socioeconomic status (SES) as a key determinant. The study aimed to assess the nutritional status of students (10-12 years old) attending three types of basic schools whose families’ SES was categorized according to school fees paid as high, medium and low. Methodology: This cross-sectional community-based study investigated the influence of family socioeconomic status (SES) on the nutritional status, school performance, and self-esteem of children aged 10-12 years attending basic schools 2014. 210 participants were chosen. Data were collected through anthropometric measurements and a questionnaire covering demography, dietary patterns, self-esteem assessments, and school performance obtained from schools. Statistical package for social sciences version 26 used for analysis. Result: Data from 210 students (45.2% boys, 54.8% girls) The findings revealed a significant impact of family SES (P=000) on nutritional status, energy and protein intake, school performance, and self-esteem. Low SES families had a higher prevalence of underweight children (66.7%), while high SES families had more overweight and obese children. Those from high SES consumed more animal foods, fast foods, fresh fruits, and vegetables compared to medium and low SES groups. High school grades were predominantly achieved by high and medium SES students, with low SES students obtaining lower grades. Normal-weight students exhibited better school performance and self-esteem than overweight, obese, and underweight students. In conclusion, family SES significantly influenced the nutritional status, school performance, and self-esteem of children attending basic schools. Recommendations, to ensure students' well-being, ..

Bioleptin as a useful marker of metabolic status in children with diabetes mellitus type 1.

The purpose of our study was tomeasure the level of leptin and biologically active leptin (bioLEP) in children with type 1 diabetes, depending on the duration of diabetes and its degree of metabolic control. The study included 94 children (58 boys and 36 girls). In a group of children with diabetes, 40 patients were newly diagnosed with type 1 diabetes, 40 children who have diabetes for more than a year (20 with good metabolic control and 20 with poor metabolic control). The control group consisted of 14 healthy children. The serum level of leptin and bioLEP was measured using a sandwich enzyme-linked immunosorbent assay. To our knowledge, this is the first study to describe bioLEP levels among diabetic children with different forms of disease control. Lower levels of leptin were found in children with diabetes compared to healthy children. Furthermore, we found a statistically higher concentration of leptin in the group of children with newly diagnosed diabetes compared to children from the diabetic group with poor metabolic control and lower than healthy children (11.19 vs. 7.84 and 20.94 ng/mL). Moreover, children in the metabolically well-controlled group had statistically lower levels of this hormone (5.11 ng/mL) than healthy children. Leptin concentrations differed significantly between underweight, overweight, and obese children. In our study, the level of bioLEP differed significantly between children in the newly diagnosed diabetes group and children in the long-term, poorly controlled diabetes group and healthy controls. Despite many studies published in recent years, many aspects of leptin secretion, action, and mechanisms of its influence on carbohydrate and fat metabolism are still to be clarified. In our opinion, studies evaluating the status of bioLEP in diabetes can also contribute to a better understanding of the mechanisms regulating metabolism.

A Survey to Assess the Efficacy and Tolerability of Natural Appetite Stimulants in Pediatric Patients

Anorexia, a common symptom in children, leads to undernutrition, with over 60 million underweight children in India suffering from frequent illnesses. Lack of adequate diet, proper breastfeeding and sufficient protein contribute to increased incidence of undernutrition. Parents often complain their children don't eat enough, making mealtimes difficult and impeding growth. Appetite stimulants like cyproheptadine are available, but side effects like sedation, fatigue, disorientation, impaired coordination, restlessness, excitation and irritability limit their use especially in the pediatric population. The use of herbal supplements has increased worldwide, with parents seeking guidance from pediatricians and primary care professionals regarding the efficacy and safety of these products. The study was a retrospective study conducted via a questionnaire-based survey among all doctors between April and June 2023 to assess the efficacy and tolerability of natural appetite stimulants in pediatric patients. Results showed that patients in the age group of 0 to 5 years (23.1%) were the most common visitors in the doctor’s clinic and appetite stimulant agents were being prescribed most of the time (44.8%). They preferred prescribing natural appetite stimulant mostly (34.3%) for poor appetite (37.3%), followed by poor weight gain and growth (22.8%). The natural appetizer was found to nonaddictive and nonsedative with an improvement in the overall well-being (31.3%) among patients. The results suggest that the natural intervention has the potential to serve as a valuable adjunctive therapy in managing appetite challenges and promoting healthy weight gain in pediatric populations and to optimize pediatricnutrition and overall well-being.

Risk Factors Associated with Underweight Children Under the Age of Five in Putrajaya, Malaysia: A Case-Control Study

Risk Factors Associated with Underweight Children Under the Age of Five in Putrajaya, Malaysia: A Case-Control Study

Drivers of Nutritional Change in Pakistan: A Decomposition Analysis.

The global reduction in child undernutrition highlights the international and national commitment to prioritizing future generations' health. This study aims to find out the previous trends in nutrition and the key drivers of these changes in different regions of Pakistan. For empirical investigation, we employed a regression-based decomposition model by using two distinct rounds of demographic and health surveys: 2012-13 and 2017-18. Results showed children with stunted growth reduced substantially in Balochistan, while Punjab exhibited the highest progress for underweight children. Regression estimates showed that maternal nutritional status and household wealth were more pronounced in reducing all measures of child malnutrition. Some determinants, including mother age at marriage and prenatal visits to the hospital, are significant only for long-term nutritional status-stunting, while mother education contributed to reducing wasted and underweight children. The rest of the factors, like father education and household environment, appear to play a humble role in explaining nutritional improvements. From disaggregated analysis based on different regions, we found that modeled factors used in this study explained changes disproportionately. Thus, it is recommended to use multidimensional nutrition policies incorporating a broader range of sectors, and region-specific programs should be designed for more effective outcomes.

Short Term Effect of Lipid-Based Nutritional Supplement on Caloric Intake, Appetite, Glucose, and Insulin Levels in Moderately Malnourished Children

Background: Malnutrition is a major health problem specially effecting children under the age of 5 years. Malnutrition has serious outcomes such as suppressed immune system, delayed and stunted growth, slow wound healing etc. Objective: To look into the impact of a lipid-based nutritional supplement on caloric intake, appetite, glucose and insulin levels of school going children of age 5-10years. Methods: In this single blind randomized controlled trial, 38 children with BMI (Z score between-2 and -3SDS) were randomly allocated to Lipid based nutritional supplements &amp; Placebo groups. They were given supplements (535kcal) /Placebo (92kcal). They were served ad libitum buffet meals (breakfast and lunch). The appetite responses were measured by marking the Likert scale questionnaire at 0, 30, 60, 120, 150, 180, 210 and 240 minutes. The total caloric intake was calculated for the ad libitum buffet breakfast and lunch. The insulin and glucose levels were measured using COBAS C3 analyzer. Result: On the trial day, there was no significant difference in total caloric intake between lipid based nutritional supplements LNS (766.3272.4) kcal and Placebo (806311.5) kcal. Appetite was measured using a Likert scale, but no significant differences were found between the two groups. There was also no significant difference between glucose in the LNS vs. PLACEBO, i.e. (929.13 vs.97.111.7) mg/dL and insulin (1.6±0.97 vs. 2.09±1.15) µU/mL in both the groups. Conclusion: In mildly underweight children the Lipid based nutritional supplements reduces the caloric intake from the regular habitual diet, which extends to the lunch time. This suppression of caloric intake might be related to the changes in appetite.

Short Term Effect of Lipid-Based Nutritional Supplement on Caloric Intake, Appetite, Glucose, and Insulin Levels in Moderately Malnourished Children

Background: Malnutrition is a major health problem specially effecting children under the age of 5 years. Malnutrition has serious outcomes such as suppressed immune system, delayed and stunted growth, slow wound healing etc. Objective: To look into the impact of a lipid-based nutritional supplement on caloric intake, appetite, glucose and insulin levels of school going children of age 5-10years. Methods: In this single blind randomized controlled trial, 38 children with BMI (Z score between-2 and -3SDS) were randomly allocated to Lipid based nutritional supplements &amp; Placebo groups. They were given supplements (535kcal) /Placebo (92kcal). They were served ad libitum buffet meals (breakfast and lunch). The appetite responses were measured by marking the Likert scale questionnaire at 0, 30, 60, 120, 150, 180, 210 and 240 minutes. The total caloric intake was calculated for the ad libitum buffet breakfast and lunch. The insulin and glucose levels were measured using COBAS C3 analyzer. Result: On the trial day, there was no significant difference in total caloric intake between lipid based nutritional supplements LNS (766.3272.4) kcal and Placebo (806311.5) kcal. Appetite was measured using a Likert scale, but no significant differences were found between the two groups. There was also no significant difference between glucose in the LNS vs. PLACEBO, i.e. (929.13 vs.97.111.7) mg/dL and insulin (1.6±0.97 vs. 2.09±1.15) µU/mL in both the groups. Conclusion: In mildly underweight children the Lipid based nutritional supplements reduces the caloric intake from the regular habitual diet, which extends to the lunch time. This suppression of caloric intake might be related to the changes in appetite.

FACTOR ASSOCIATED WITH UNDERWEIGHT AMONG CHILDREN BELOW 24 MONTHS OF AGE

Background: Underweight children are those whose weight-for-age Z-score is less than minus two standard deviations (-2 SD) from the reference population median. Children who are malnourished during their first two years of life and gain weight quickly later in childhood and adolescence are at a significant risk of developing chronic disorders connected to nutrition. This study aimed to explore the factors associated with underweight among the children below 24 months. Methods: A cross-sectional study was conducted among 304 mothers with children below 24 months. Probability proportional to size (PPS) method was used to identify the sample size in each ward and simple random sampling with lottery method was used to select the children from each ward. Data was collected through face-to-face interview using a pre-tested structured questionnaire and anthropometric measurement. Data were processed using IBS SPSS v.16.0. Results: The prevalence of underweight among children below 24 month was found to be 25% (76). In this study ethnicity of a children (p≤ 0.001), occupation of a mother (p=0.018), mother’s age at her first baby (p=0.014), and age of a children (p=010) and diarrhea in last 6 months (p=0.000) were found to be associated with underweight. Conclusions: The study identified that ethnicity, age of mother at her first baby, occupation of mother, age of children and sign of diarrhea in children were associated with underweight. Different family and child health related programs should be done to provide education about the childhood illness and infestation, child feeding practices and healthy care of child in order to reduce the underweight.

Effect of nutrition intervention on cognitive development among malnourished preschool children: randomized controlled trial

Childhood malnutrition impairs health, development, and productivity in adulthood. Underweight children have been found to have a variety of cognitive abnormalities. The present study examined the effect of a nutrition-focused intervention on cognitive development among malnourished preschool children between 3 and 5 years of age residing in selected villages of Udupi district, Karnataka. A cluster of 12 villages was chosen randomly. The trial had enrolled preschool children (n = 253) from randomly assigned selected villages to intervention (n = 127) and control arms (n = 126). The mothers in the intervention arm received nutrition-focused intervention and reinforcement of health teaching for 12 months. The post-intervention outcome on the cognitive development of malnourished children was measured at 6 months and 12 months. Statistical analyses indicated that 52% of children in the intervention group had average cognitive development scores on the pre-test, whereas on the post-test, only 5.5% were in the average level of cognitive development. In the control group, the average cognitive development status of the children decreased from 44.4% in the pretest to 26.2% in the post-test. The cognitive development of malnourished children in the intervention group improved compared to the control group (p < 0.001). This study revealed that home-based nutrition-focused food helps to enhance children’s cognitive development.Trial registration: ctri@gov.in. CTRI/31/03/2017/008273 [Registered on: 31/03/2017].

Data analysis of malnutrition in India: a review of numerous factors

Malnutrition is one of the most critical areas which needs government focus as it plays a crucial role in a country's economic and social development. In recent times, India is proving to be one of the fastest-growing countries in the South Asian region. Malnutrition and hunger rate is reduced to achieve The United Nation's second Sustainable Development Goal, Zero Hunger, to end world hunger by 2030. However, some states of India still serve as home to a more significant number of stunted and underweight children, especially in Bihar and Meghalaya, respectively. (NFHS-5) The current paper focuses on data analysis of malnutrition in India including several factors based on the qualitative research method. A systematic study was done to collect data by reviewing thousands of national- international journals and reports of 3rd, 4th and 5th NFHS and Globally hunger index of India, and WHO report on malnutrition in India. The government of India took the step of launching Poshan Abhiyan in 2017, which needs to be more focused on ruler areas of India.

Women's empowerment and child nutrition in a context of shifting livelihoods in Eastern Oromia, Ethiopia.

Agriculture, and particularly livestock and animal source foods, has been closely linked to improvements in human nutrition. Production, income, and women's empowerment improve household food security and child nutritional outcomes in interacting ways. Khat production in Eastern Ethiopia is changing the economic and livelihood landscape for communities that have traditionally relied upon small-scale mixed agriculture and livestock production. How this shifting livelihood landscape and the empowerment of women in these communities are affecting nutritional outcomes has not been investigated. Using cross-sectional data collected during formative research for the Campylobacter Genomics and Environmental Enteric Dysfunction (CAGED) project, we developed models to examine the roles of livelihood activities, including livestock production, staple crop production, and khat production, and women's empowerment in child nutrition outcomes. Survey participants were randomly selected mothers of children aged 10-15 months from Haramaya district, Eastern Hararghe, Oromia, Ethiopia. Nested logistic regression models were performed for each nutrition outcome: children's animal source food consumption, children's dietary diversity, and child stunting, wasting, and underweight. Explanatory variables included those for livelihood (tropical livestock unit, crop production, and khat production ladder) and women's empowerment (as indicated by domains of the Women's Empowerment in Agriculture Index), and covariates including child sex, mother's age, mother's education, assets, income, and kebele. Results indicated that khat production and tropical livestock units were not significantly associated with any of the child nutrition outcomes. However, results did indicate that the odds of reporting child animal source food consumption in households where the mother was empowered in the leadership domain was 3.33 times that in households where the mother wasn't (p < 0.05). In addition, the odds of having a stunted child in households where the mother was empowered in the time domain was 2.68 times that in households where the mother wasn't (p < 0.05). The results from this study both support and complicate the existing literature on the associations between women's empowerment in agriculture and child nutrition outcomes, underscoring the important role that livelihood, contextual factors, and location may have on the complex relationship between empowerment domains and nutritional outcomes.

Association of Body Mass Index With Disease Progression in Children With Charcot-Marie-Tooth Disease.

The aim of this study was to evaluate the impact of body mass index (BMI) on disease progression over 2 years in children with Charcot-Marie-Tooth disease (CMT). BMI was classified in 242 participants aged 3-20 years with CMT enrolled in the Inherited Neuropathy Consortium, using the International Obesity Task Force (based on adult BMI values, kg/m2) criteria. Groups were categorized as severely underweight (BMI <17 kg/m2), underweight (BMI ≥17 to <18.5 kg/m2), healthy weight (BMI ≥18.5 to <25 kg/m2), overweight (BMI ≥25 to <30 kg/m2), and obese (BMI ≥30 kg/m2). Disease severity was assessed using the CMT Pediatric Scale (CMTPedS), a clinical outcome assessment of disability (0-44 points, mild to severe). At baseline, compared with individuals being of a healthy weight (mean CMTPedS 15.48, SD 9.22), children who were severely underweight (mean CMTPedS difference 9.03, 95% CI 0.94-17.12; p = 0.02), underweight (mean CMTPedS difference 5.97, 95% CI 0.62-11.31; p = 0.02), or obese (mean CMTPedS difference 7.96, 95% CI 1.03-14.88; p = 0.015) exhibited greater disability. At 2 years, compared with individuals being of a healthy weight (mean CMTPedS 17.53, SD 9.41), children who were severely underweight exhibited greater disability (mean CMTPedS difference 9.27, 95% CI 0.90-17.64; p = 0.02). Over the 2-year periods, the mean CMTPedS for the whole sample deteriorated by 1.72 points (95% CI 1.09-2.38; p < 0.001), with severely underweight children progressing at the fastest rate (mean CMTPedS change of 2.3, 95% CI 1.53-6.13; p = 0.21). In children who did not have a change in BMI categories over 2 years (69% of sample), CMTPedS scores deteriorated faster in those who were severely underweight (mean CMTPedS change 6.40 points, 95% CI 2.42-10.38; p = 0.01) than those of healthy weight (mean CMTPedS change 1.79 points, 95% CI 0.93-2.69; p < 0.001). For children who changed BMI categories (31% of sample), CMTPedS scores deteriorated faster in children who became overweight/obese (mean CMTPedS change 2.76 points, 95% CI 0.11-5.41; p = 0.031). Children with CMT who were severely underweight, underweight, or obese exhibited greater disability at baseline. Over the 2-year period in those whose BMI remained stable, severely underweight children deteriorated at the fastest rate. For children who changed BMI categories over the 2 years, CMTPedS scores deteriorated faster in children who became overweight/obese. Interventions that maintain or improve BMI toward healthy weight may reduce disability in children with CMT.

Nourishing the Nation's Future: The Pioneering Role of Integrated Child Development Services in India's Effort to Combat Child Malnutrition

Background: In India, a considerable portion of the population suffers from undernutrition, contributing to poor health. Under and over-nutrition continue to pose a severe threat to the country despite the increase in economic development and significant measures taken by the Indian government to address the issue of the dual implications of malnutrition. India has the highest rates of underweight children worldwide. The Indian government has started several initiatives to address the issue of early childhood development. One such program with goals for nutrition intervention and early child development is called Integrated Child Development Services (ICDS). &#x0D; Method: It focuses on the helping hand given by ICDS in reducing malnutrition in children aged 0-5 years by comparing data from the National Family Health Survey rounds conducted in India during 2005-06 and 2015-16. The study utilizes several parameters to highlight the program contribution, such as the nutritional status of children, Anemia, immunization coverage, antenatal care, health care, and child mortality. It also highlights the main issues and challenges the policymakers face in implementing the ICDS program.&#x0D; Results: ICDS program has significantly improved in providing services to the beneficiaries, including children aged 0-59 months and pregnant and lactating women.&#x0D; Conclusion: Despite several positive changes in ICDS schemes, the program failed to deliver the services efficiently nationwide. It has great potential to contribute to child development, but several loopholes need to be channelized properly.

Body mass index in relation to symptom presentation on diagnosis of eosinophilic esophagitis in children

BackgroundThe relationship between body mass index (BMI) and eosinophilic esophagitis (EoE) among children is not well characterized. ObjectiveTo evaluate the presentations of EoE in pediatric patients of different weight classes. MethodsRecords of newly diagnosed children with EoE at an academic center from 2015 to 2018 were evaluated regarding demographics, symptom presentation, and endoscopic findings and compared among the underweight, normal weight, overweight, and obese groups. ResultsThere were 341 patients aged 0 to 18 years old newly diagnosed with EoE from 2015 to 2018 (68.3% male, 233 of 341; 80.9% White, 276 of 341). Of the 341, 17 were underweight (4.9%), 214 normal weight (62.8%), 47 overweight (13.8%), and 63 obese (18.5%). Children with obese and overweight BMI were more likely to be diagnosed at an older age (P = .005) and to present with a chief complaint of abdominal pain (P = .02). Normal- and under-weight children were more likely to have an immunoglobulin E–mediated food allergy (P = .02). Normal weight children were more likely to be tested for food allergies (P = .02) and inhalant allergies (P = .004) and have linear furrows on endoscopy (P = .03), compared with children with overweight and obese BMI. No significant differences were found regarding race, sex, type of insurance, atopic dermatitis, asthma, or allergic rhinitis in relation to BMI status and EoE diagnosis. ConclusionNearly one-third of children were obese or in overweight status on diagnosis with EoE. Children with BMI in the overweight or obese range were more likely to be older at diagnosis and to have a chief complaint of abdominal pain on presentation.

Factors associated with Childhood Anthropometric Measurements in Nepal: A Provincial-Level Analysis Based on NDHS Data 2016

The study assesses the prevalence of and factors affecting the anthropometric measurements i.e. stunting-WAZ, wasting-WHZ and underweight-WAZ each below -2 SD from the median of the reference population, among children below 5 years of age group in newly structured seven Provinces of Nepal by different background characteristics using Nepal Demographic and Health Survey (NDHS) Data, 2016. Anthropometric indicators are far worse in Madhesh and Karnali provinces than the national average. The highest share of stunted children is in Karnali Province whose size at birth is very small (70.0%) against the national average of 36 percent. Children in the poorest quintile and born from illiterate mothers of Madhesh Province and Karnali Province have highly suffered from stunting. Data shows that children born to illiterate mothers are highly wasted in Madhesh Province (23.8%). Underweight increased with an increase in the age of the children; increases with birth order in all Provinces. Except for Gandaki Province, underweight is more common in rural areas than in urban areas. The prevalence of underweight children is the highest in the poorest quintile of Madhesh Province i. e. 50 percent as compared to the national average of 27 percent. High birth order has significantly contributed to worsening childhood nutrition. The statistical test infers that childhood stunting and underweight are in aggregate strongly related to all variables except sex while wasting is strongly associated with only children’s age and their mother’s education. The author suggests applying provincial policies and programs based on the findings to tackle their poor anthropometric indicators.

Prevalence of Stunting, wasting and underweight among Santal children of Galudih, Purbi Singbhum district, Jharkhand, India

The objective of this study was to assess the differences in body stature (height), body weight, and frequency of stunted, wasted, and underweight children of the Santal ethnicity in Galudih area, Purbi Singbhum, Jharkhand, India. The study included 400 children (200 girls and 200 boys) aged between 3 and 6 years old. Stunting, wasting, and underweight were evaluated using &lt; -2 z-scores for H-A-Z (Height-for-age), W-A-Z (weight-for-age), and W-H-Z (weight-for-height) based on the reference values recommended by the NCHS (National Center for Health Statistics). The results revealed substantial age differences in mean body weight and height for both boys and girls, with boys having significantly higher weight than girls across all ages. The mean H-A-Z, W-A-Z, and W-H-Z values were lower than those reported by NCHS for all age groups and both sexes. The overall frequency of stunting, wasting, and being underweight was higher among girls compared to boys. The combined incidences of stunting, wasting, and underweight due to sex and age were 25.3%, 12.0%, and 31.8%, respectively. Using the WHO criteria for judging the austerity of malnutrition, the incidence of wasting (9-15%) was found to be high, while the overall frequency of stunting (24-27%) was medium, and underweight was very high (30%). In conclusion, the occurrence of undernourishment of Santal children in this study was concerning, and there is an urgent need for improved supplementary nutritional programs and public health awareness initiatives within this community.