Height Weight Research Articles

Exploring the Influence of Concurrent Nutritional Therapy on Children with Spinal Muscular Atrophy Receiving Nusinersen Treatment.

Background This study examines spinal muscular atrophy (SMA), a neuromuscular disease associated with malnutrition. Our goals are to assess how effectively screening tools can detect malnutrition and evaluate the impact of nutritional interventions on neurological outcomes, particularly motor functions. Methods Thirty-seven genetically diagnosed SMA patients (types 1, 2, and 3) under nusinersen therapy were included in the study. The nutritional status of these patients was assessed by using anthropometric measurements, including height for age (HFA), weight for height (WFH), and body mass index (BMI) before and after the study. Additionally, the risk of malnutrition was determined using screening tools, namely the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP). Nutritional counseling followed the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines and considered the patients' dietary history, including content and administration method. Motor functions were assessed by validated tests: the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP-INTEND) and the Hammersmith Functional Motor Scale-Expanded (HFMSE). Result The study showed an improvement in HFA, by a change from -0.95 to -0.65 (p = 0.015). Conversely, BMI scores decreased from 0.08 to -0.54 (p = 0.015), while WFH and MUAC showed no significant alterations (p = 0.135, p = 0.307). Following nutritional interventions, HFMSE demonstrated a median increase from 29.5 to 30.5 (p = 0.023). Patients identified as being at high risk for malnutrition based on PYMS and STAMP belonged to the moderate-to-severe malnutrition group (BMI Z-score ≤ -2, p = 0.001). Conclusions Use of screening tools in SMA patients is highly beneficial for the early detection of malnutrition. Future research should highlight the importance of combining nutritional management with nusinersen therapy to potentially alter the disease trajectory, especially in motor and neurological functions.

Impact of Maternal Viral Suppression on Growth Patterns for HIV-Exposed Uninfected Infants in Kenya.

Children born to mothers living with human immunodeficiency virus (HIV) are at risk for poor health outcomes but data characterizing these associations are limited. Our objective was to determine the impact of maternal viral suppression on growth patterns and malnutrition for infants who are HIV-exposed but uninfected (HEU). We conducted a retrospective cohort analysis of clinical data for infants who were HEU and their mothers (September 2015 - March 2019) in Kenya. Infants were stratified based on maternal viral suppression status (≥ or <1000 copies/mL); t-tests were used to compare groups. Growth indicators were evaluated with Chi-square, Fisher's exact, and area under the curve. Moderate-to-severe underweight status, stunting, and wasting were defined by weight-for-age (WFA), height-for-age (HFA), and weight-for-height (WFH), z-scores ≤2, and were used to define malnutrition. Multivariate logistic regression analyses were performed to evaluate potential associations with malnutrition indicators between WFH and HFA. Among 674 infants who were HEU, 48.7% were male and 85.0% had mothers who were virally suppressed. The median age at first and last clinic visits was 1.5 and 16.4 months, respectively. WFA and HFA z-scores over time differed by sex, and WFA and HFA differed based on maternal viral suppression (P < 0.05). Male infants had higher adjusted odds for stunted status, and as children aged, they had slightly increased odds of becoming underweight or stunted. Maternal viral suppression and timing of maternal antiretroviral therapy initiation in relation to the prevention of vertical transmission (PVT) enrollment did not significantly affect malnutrition indicators. Maternal viral suppression status was not associated with increased odds of more severe malnutrition indicators in children who were HEU. However, overall growth patterns over time, measured by z-scores of growth indicators, did differ based on maternal viral suppression status, and to a lesser degree, by gender.

Frequency of hospital acquired malnutrition at a tertiary care pediatric hospital.

Objective: To determine the frequency of hospital acquired malnutrition in hospitalized pediatric population. Design: Cross-sectional study. Setting: Department of Pediatrics, National Institute of Child Health, Karachi, Pakistan. Period: January 2023 to June 2023. Methods: The inclusion criteria were children (irrespective of gender) aged between 1 and 12 years who were admitted for at least 48 hours. Weight of the children was measured daily from the time of admission to discharge. The hospital-acquired malnutrition rate was determined by dividing the patients with decreased weight-for-height (WFH) or body mass index (BMI) z-scores by total samples, then multiplying by 100. Results: In a total of 367 children, the mean age was 6.4±2.8 years whereas 203 (55.4%) children were boys. Hospital stays ranged from 2 to 19 days, with a mean of 18±6.9 days. At the time of discharge, the mean weight to be 17.6±6.53 kg, indicating a mean weight drop of 1.3±1.14 kg from admission to discharge. Weight reduction during hospitalization was observed in all age groups, with the highest percentage observed in children aged 2 to 5 years (77.7%) and the lowest in those aged 1 to 2 years (38.9%). Significant changes were observed in both WFH z-scores (mean difference -1.06, ± 1.69, p&lt;0.001) for children under 60 months and BMI z-scores (mean difference -1.07, ± 4.63, p=0.023) for children over 60 months from admission to discharge. Conclusion: Hospital acquired malnutrition is common among pediatric patients and deteriorates when a child is hospitalized without attention to adequate nutritional support. Weight loss shows direct correlation with duration of hospitalization.

Artificial intelligence for the practical assessment of nutritional status in emergencies

AbstractThis paper describes a novel method for detecting child malnutrition based on artificial intelligence and facial photography. Estimates of severe and moderate acute malnutrition in children are critical for rapid emergency responses. However, the two traditional measurement methods, mid‐upper arm circumference (MUAC) and weight‐for‐height (WFH), are impractical in conflict and catastrophic disaster situations. They require well‐trained enumerators, cumbersome equipment, and close supervision. The Method for Extremely Rapid Observation of Nutritional Status (MERON) addresses the problem, using simple facial photographs. Facial features are extracted to predict Body Mass Index (BMI) in adults and Weight for Height Z Score (WFHZ) in children under five. MERON correctly predicts adult BMI classification with 78% accuracy. A variant of the model, trained on a sample of 3167 children in Kenya, successfully classified 60% of cases. On most measures, MERON was easier and more culturally acceptable to use than the traditional measurement methods. If MERON were to be trained and validated on a larger sample, with more extreme cases, it would provide a practical solution to a recurrent humanitarian problem.

Analysis of Correlated Outcomes of Anthropometric Measurements for Under-Five Children in Tanzania.

The study aimed at applying Multivariate Generalized Linear Mixed Models to examine factors associated with correlation outcomes, in particular, anthropometric measurements among under-five children in Tanzania. Three anthropometric measurements: weight-for-age (WAZ), height-for-age (HAZ), and weight-for-height (WHZ) among under-five children in Tanzania were jointly modeled to identify common factors associated with childhood malnutrition. A total of 9052 children with valid measures of height and weight were processed and analyzed. The results indicate that WAZ was correlated with HAZ (P-value < 2e-16) and WHZ (P-value < 2e-16). The Multivariate Ordered Logit Model has lower AIC = 53213.92 and BIC = 52727.95, indicating better model fit than the Multivariate Ordered Probit Model. In Tanzania, the age of the child, birth order, mother education level, child gender, mother working status, wealth index, marital status, and mother body mass index are important determinants of malnutrition among children under the age of five. Moreover, the common factors were child's age, Birth order, Mother's education attainment, child's sex, Mother working status, wealth index, Marital status, and Mother's Body Mass Index. As a result, emphasis should be placed on analyzing correlated health outcomes in order to draw conclusions about the factors that may have a mutual effect on anthropometric measurements.

Urinary antibiotic levels and risk of overweight/obesity in preschool children: A biomonitoring-based study from eastern China

There is limited evidence linking antibiotic exposure, particularly from contaminated food or drinking water, to childhood obesity. The study aimed to investigate the association between urinary antibiotic levels and overweight/obesity in preschool children. In the case-control study, 121 overweight/obese preschoolers and 242 controls (aged 3–6 years) from eastern China were enrolled in 2022 based on age, sex, and study site matching. Overweight/obesity was determined using body mass index (BMI) and weight for height (WFH) criteria derived from national data. A total of 50 antibiotics from 8 categories were analyzed using ultra-performance liquid chromatography and tandem mass spectrometry (UPLC-MS/MS). We identified major dietary patterns using principal component analysis (PCA) and examined the associations of antibiotic exposure with childhood overweight/obesity using multivariate logistic regression. Twenty-four individual antibiotics were detected in more than 10 % of the samples, and overall detection rates were up to 100 %. Overweight/obese children had a higher exposure to veterinary antibiotics (VAs) than normal weight children. PCA analysis showed that children who were overweight/obese had higher scores of “Aquatic products preferred dietary pattern” and “Cereals preferred dietary pattern” compared to children with normal weight. Multivariate logistic regression analyses indicated that exposure to elevated levels of deoxytetracycline (OR: 1.72; 95 %CI: 1.00–2.93) and quinolones (OR: 1.63; 95 %CI: 1.04–2.57) was significantly related to an increased risk of BMI-based overweight/obesity. Quinolones exposure was also significantly associated with WFH-based overweight/obesity, primarily in boys. After adjustment for all covariates, higher exposure to ofloxacin (of the quinolones) was significantly related to overweight/obesity in girls. Exposure to certain antibiotics, especially quinolones, may increase the risk of overweight/obesity in preschoolers. More prospective, well-designed studies are needed to clarify these findings.

Urban-rural differences in the association between long-term exposure to ambient particulate matter (PM) and malnutrition status among children under five years old: A cross-sectional study in China.

The evidence regarding the relationship between postnatal exposure of air pollution and child malnutrition indicators, as well as the corresponding urban-rural disparities, is limited, especially in low-pollution area of low- and middle-income countries (LMICs). Therefore, our aim was to contrast the effect estimates of varying ambient particulate matter (PM) on malnutrition indicators between urban and rural areas in Tibet, China. Six malnutrition indicators were evaluated in this study, namely, Z-scores of height for age (HFA), Z-scores of weight for age (WFA), Z-scores of weight for height (WFH), stunting, underweight, and wasting. Exposure to particles with an aerodynamic diameter ≤2.5 micron (μm) (PM2.5), particles with an aerodynamic diameter ≤10 μm (PM10) and particles with an aerodynamic diameter between 2.5 and 10 μm (PMc) was estimated using satellite-based random forest models. Linear regression and logistic regression models were used to assess the associations between PM and the above malnutrition indicators. Furthermore, the effect estimates of different PM were contrasted between urban and rural areas. A total of 2511 children under five years old were included in this study. We found long-term exposure to PM2.5, PMc, and PM10 was associated with an increased risk of stunting and a decreased risk of underweight. Of these air pollutants, PMc had the strongest association for Z-scores of HFA and stunting, while PM2.5 had the strongest association for underweight. The results showed that the odds ratio (OR) for stunting were 1.36 (95% confidence interval (CI) = 1.06 to 1.75) per interquartile range (IQR) microgrammes per cubic metre (μg/m3) increase in PM2.5, 1.80 (95% CI = 1.30 to 2.50) per IQR μg/m3 increase in PMc and 1.55 (95% CI = 1.17 to 2.05) per IQR μg/m3 increase in PM10. The concentrations of PM were higher in urban areas, and the effects of PM on malnutrition indicators among urban children were higher than those of rural children. Our results suggested that PM exposure might be an important trigger of child malnutrition. Further prospective researches are needed to provide important scientific literature for understanding child malnutrition risk concerning postnatal exposure of air pollutants and formulating synthetically social and environmental policies for malnutrition prevention.

Validity of STRONGkids and MUAC as nutritional screening tools for predicting acute malnutrition among hospitalized children in Accra, Ghana

Background: Malnutrition is commonly reported among hospitalized paediatric patients. However, it is often not diagnosed leading toprolonged hospital staysand other medical complications. Objective: This study aimed at evaluating the validity ofthe Screening Tool for Risk of Nutritional Status and Growth (STRONGkids) and mid-upper arm circumference (MUAC)for assessing malnutrition in paediatric inpatients between the ages of 6 months and 5 years. The weight-for-height (WFH) z-score was used as areference standard for the evaluation. Methods: A cross-sectional study design was used in this study. A total of 96 individuals were enrolled in the study from both the Princess Marie Louise Children’s Hospital and Korle Bu Teaching Hospital, located in Accra, Ghana. Data were collected on demographics, admission details, weight, height, MUAC, and length of hospital stay. The STRONGkids screening tool was used for nutrition risk screening. Data analysis was performed using R version 4.1.0. Descriptive statistics were used to report frequencies, averages, percentages, standard deviations, and interquartile ranges. Diagnostic values were computed for STRONGkids and MUAC using WFH z-scores. Cohen's kappa was utilized to measure inter-rater agreement, with statistical significance set at p &lt; 0.05. Results: Males accounted for 59.3%(n = 57/96)of the study sample. The prevalence of malnutrition in this study was 30%[n = 27/96; 95% confidence interval (CI): 21-39%]. The sensitivity and specificity of STRONGkids were 70% (95% CI: 52-86%) and 43% (95% CI: 31-55%), respectively. The sensitivity and specificity of MUAC were 45% (95% CI: 27-63%) and 93% (95% CI: 86-99%), respectively. The inter-rater agreement, based on two blinded assessments, for STRONGkids, was 0.57 (p= 0.006). Conclusion: The study revealed that STRONGkids had a low overall degree of validity, while MUAC had a high validity for specificity but lower validity for other diagnostic values. As a result, it is not recommended to use STRONGkids or MUAC individually for screening pediatric malnutrition in this setting, but rather in conjunction

Determinants of undernutrition among children aged 6-59 months during the COVID-19 pandemic: A hospital-based cross-sectional study in Ethiopia.

The public health problem of undernutrition is common in Ethiopia, particularly among children aged 6-59 months. However, determinants of undernutrition among children in this age group are not well investigated particularly within the context of COVID-19 pandemic. This study was, therefore, designed to assess the magnitude and determinants of undernutrition among children aged 6-59 months at Tirunesh Beijing general hospital, Ethiopia. An institutional-based cross-sectional study was conducted involving 283 children aged 6-59 months in March 2022. The data were collected using structured questionnaire and anthropometric measurements. Undernutrition was defined as a Z-score value of weight for height (WFH), height-for-age (HFA), and weight-for-age (WFA) <2SD as calculated by the world health organization plus software. A multivariable logistic regression model was used to identify the independent factors associated with undernutrition. p-values less than 0.05 were considered statistically significant. The response rate in this study was 97.9%. The overall magnitude of undernutrition was 34.3%, of which 21.2%, 12.7%, and 9.5% were stunted, underweight, and wasted, respectively. Occupation of mothers [AOR = 13.64, 95% CI (4.21-14.77)], amount of meal [AOR = 14.68, 95% CI (4.09-52.81)], feeding by caregivers [AOR = 8.96, 95% CI (2.81-18.60)], and breastfeeding [AOR = 0.06, 95% CI (0.02-0.22)] were significant predictors of undernutrition. The prevalence of undernutrition among children under the age of five remains high. Therefore, promoting breastfeeding and motivating children to feed adequate amount of meal are recommended. Besides, counseling and/or guiding caregivers on how to feed children shall be suggested. The findings could help inform the design and prioritization of effective intervention strategies at early life stage.

Child Anthropometry and Mortality In Malawi: Testing for Effect Modification by Age and Length of Follow-up and Confounding by Socioeconomic Factors

As shown in a review of 28 studies, anthropometric measurements of preschool-aged children are consistently related to the risk of subsequent mortality in community-based studies from Asia and Africa (Pelletier 1994). Although the results are consistent at this general level, a number of important questions remain concerning the relationship. The purpose of this study is to address two of these questions using data from a similar study conducted in rural northern Malawi: 1) In relation to screening, are the anthropometry-mortality relationships affected by the child's age and the interval between measurement and death ("length of follow-up") and 2) In relation to policy implications, is the anthropometry-mortality relationship due to confounding by socioeconomic factors, especially when considering mild-to-moderate malnutrition. The results reveal that mortality prediction is significantly affected by child's age and length of follow-up, but the strength and direction of this effect modification varies across the four commonly used anthropometric indicators [weight-for-age (WA), height-for-age (HA), weight-for-height (WH) and arm circumference-for-age (ACA)]. An important result for public health practice is that there are no statistically significant differences in prediction across these four indicators when applied to young children (6-23 mo) and employing a 1-y follow-up period. As regards confounding, the results indicate that the anthropometry-mortality relationship is not due to confounding by socioeconomic factors when all grades of malnutrition are considered. When only mild-to-moderate malnutrition is considered, statistically controlling for confounders reduces most of the anthropometric predictors to nonsignificance (probability values to > 0.20), but the strength of the association (odds ratio) remains of the same order of magnitude. However, when effect modification by child's age and length of follow-up is taken into account, the effect of mild-to-moderate malnutrition (WA and WH) remains statistically significant for young children dying with 1 y of follow-up.

Association between maternal stature and household-level double burden of malnutrition: findings from a comprehensive analysis of Ethiopian Demographic and Health Survey

BackgroundUndernutrition among under-five children is one of the intractable public health problems in Ethiopia. More recently, Ethiopia faced a rising problem of the double burden of malnutrition—where a mother may be overweight/obese, and a child is stated as having undernutrition (i.e., stunting, wasting, or underweight) under the same roof. The burden of double burden of malnutrition (DBM) and its association with maternal height are not yet fully understood in low-income countries including Ethiopia. The current analysis sought: (a) to determine the prevalence of double burden of malnutrition (i.e., overweight/obese mother paired with her child having one form of undernutrition) and (b) to examine the associations between the double burden of malnutrition and maternal height among mother–child pairs in Ethiopia.MethodsWe used population-representative cross-sectional pooled data from four rounds of the Ethiopia Demographic and Health Survey (EDHS), conducted between 2000 and 2016. In our analysis, we included children aged 0–59 months born to mothers aged 15–49 years. A total of 33,454 mother–child pairs from four waves of EDHS were included in this study. The burden of DBM was the primary outcome, while the maternal stature was the exposure of interest. Anthropometric data were collected from children and their mothers. Height-for-age (HFA), weight-for-height (WFH), and weight-for-age (WFA) z-scores < − 2 SD were calculated and classified as stunted, wasting, and underweight, respectively. The association between the double burden of malnutrition and maternal stature was examined using hierarchical multilevel modeling.ResultsOverall, the prevalence of the double burden of malnutrition was 1.52% (95% CI 1.39–1.65). The prevalence of overweight/obese mothers and stunted children was 1.31% (95% CI 1.19–1.44), for overweight/obese mothers and wasted children, it was 0.23% (95% CI 0.18–0.28), and for overweight/obese mothers and underweight children, it was 0.58% (95% CI 0.51–0.66). Children whose mothers had tall stature (height ≥ 155.0 cm) were more likely to be in the double burden of malnutrition dyads than children whose mothers’ height ranged from 145 to 155 cm (AOR: 1.37, 95% CI 1.04–1.80). Similarly, the odds of the double burden of malnutrition was 2.98 times higher for children whose mothers had short stature (height < 145.0 cm) (AOR: 2.98, 95% CI 1.52–5.86) compared to those whose mothers had tall stature.ConclusionsThe overall prevalence of double burden of malnutrition among mother–child pairs in Ethiopia was less than 2%. Mothers with short stature were more likely to suffer from the double burden of malnutrition. As a result, nutrition interventions targeting households’ level double burden of malnutrition should focus on mothers with short stature to address the nutritional problem of mother and their children, which also has long-term and intergenerational benefits.

Determinants of undernutrition among young children in Ethiopia

Ethiopia is one of the countries in sub-Saharan Africa with the highest burden of childhood undernutrition. Despite the high burden of this scourge, little is known about the magnitude and contributing determinants to anthropometric failure among children aged 0–23 months, a period regarded as the best window of opportunity for interventions against undernutrition. This study examined factors associated with undernutrition (stunting, wasting, and underweight) among Ethiopian children aged 0–23 months. This study used a total weighted sample of 2146 children aged 0–23 months from the 2019 Ethiopian Mini Demographic and Health Survey. The data were cleaned and weighted using STATA version 14.0. Height-for-age (HFA), weight-for-height (WFH), and weight-for-age (WFA) z-scores < − 2 SD were calculated and classified as stunted, wasting, and underweight, respectively. Multilevel mixed-effects logistic regression models adjusted for cluster and survey weights were used. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were estimated. Statistical significance was declared at p < 0.05. The overall weighted prevalence of stunting, wasting, and underweight respectively were 27.21% [95% CI (25.32–29.18)], 7.80% [95% CI (6.71–9.03)], and 16.44% [95% CI (14.90–18.09)] among children aged 0–23 months in Ethiopia. Female children were less likely to be associated with stunting [AOR: 0.68, 95% CI (0.54–0.86)], wasting [AOR: 0.70, 95% CI (0.51, 0.98)], and underweight [AOR: 0.64, 95% CI (0.49, 0.83)] than their male counterparts. Conversely, older children aged 12–17 months [AOR: 2.22, 95% CI (1.52, 3.23)] and 18–23 months [AOR: 4.16, 95% CI (2.75, 6.27)] were significantly at an increased odds of becoming stunted. Similarly, the likelihood of being underweight was higher in older age groups: 6–11 months [AOR: 1.74, 95% CI (1.15, 2.63)], 12–17 months [AOR: 2.13, 95% CI (1.40, 3.24)], and 18–23 months [AOR: 4.08, 95% CI (2.58, 6.44)] compared with the children younger than 6 months. Lower wealth quintile was one of the other significant determinants of stunting and underweight. The study’s findings indicated that the most consistent significant risk factors for undernutrition among children aged 0–23 months are: male sex, older age groups and lower wealth quintile. These findings emphasize the importance of strengthening nutrition-specific and sensitive interventions that address the immediate and underlying drivers of childhood undernutrition in early life, as well as targeting low-income households with male children, in order for Ethiopia to meet the Sustainable Development Goals (SDGs) 1,2 and 3 by 2030.

Prevalence of overweight/obesity and associated factors among under-five children in Ethiopia: A multilevel analysis of nationally representative sample.

BackgroundChildhood overweight and obesity are emerging public health challenges of the twety-first century. There was a 24% increase in the number of overweight children under the age of 5 years in low-income countries. Despite the significant risk of childhood overweight/obesity for non-communicable diseases, premature death, disability, and reproductive disorders in their adult life, little attention has been given. Therefore, we aimed to assess the prevalence of overweight/obesity and associated factors among under-five children.MethodsThis study was conducted using data from a nationally representative sample of the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS). The Mini EDHS was a community-based cross-sectional study that covered all the administrative regions of Ethiopia. The data collection was conducted between March 21, 2019 and June 28, 2019. Both descriptive and analytic findings were produced. The overweight/obesity was measured by the weight-for-height (WFH) index, more than two standard deviations (+2 SD) above the median of the reference population based on the BMI Z-score. To identify significantly assoResultsA total of 5,164 under-five children were included in this study cited factors of overweight/obesity, a multilevel binary logistic regression model was fitted to account for the hierarchical nature of the data. Adjusted odds ratio (aOR) with a corresponding 95% confidence interval (CI) was reported to show the strength of association and statistical significance. The overall prevalence of overweight/obesity was 2.14% (95% CI: 1.74–2.53). The odds of overweight/obesity was higher among children aged <6 months (aOR = 5.19; 95% CI: 2.98–9.04), 6–24 months (aOR = 1.97; 95% CI: 1.18–3.29), delivered by cesarean section (aOR = 1.75; 95% CI: 1.84–3.65), living in Addis Ababa city (aOR = 2.16; 95% CI: 1.59–7.81), Oromia region (aOR = 1.93; 95% CI: 1.71–5.24), having mothers with the age 40–49 years (aOR = 3.91; 95% CI: 1.90–16.92), uses traditional contraceptive methods (aOR = 2.63; 95% CI: 1.66–10.47) and households headed by male (aOR = 1.71; 95% CI: 1.84–3.48).ConclusionThis study showed that the prevalence of overweight/obesity among under-five was low in Ethiopia. There were several factors that affect childhood overweight/obesity including child age, maternal age, mode of delivery, sex of head of household, contraception use, and geography of residence. Therefore, strategies to reduce childhood overweight and obesity should consider an identified multitude of contributing factors.

Nutritional status of children with heart disease at the Komfo Anokye Teaching Hospital, Ghana

Background Undernutrition is associated with forty-five percent of all deaths in children under-five years. Irrespective of the type of heart disease (HD), malnutrition remains a constant phenomenon in children with both congenital and acquired HD. To minimize the long-term effect of malnutrition in a cohort of patient who have very limited chance of surgical treatment even when indicated, their nutritional statuses must be assessed periodically, and rehabilitation instituted early. The objective of this study was to assess the nutritional status of children attending the Pediatric Heart Disease clinic of the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana.&#x0D; MethodsA retrospective review of children up to fourteen years, enrolled into the Pediatric Heart Disease clinic with confirmed HD from November 2020 to June 2021 were systematically recruited. Their ages, weights, heights and mid-upper arm circumferences (MUAC) were measured by standardized methods to assess their nutritional status. Subsequently, their Weight-for-Height (WfH), Height-for-Age (HfA), Weight-for-Age (WfA), Body Mass Index-for-Age (BfA) and MUAC-for-Age (MfA) z-scores were determined based on the WHO Child Growth Standards (2006). Z-scores less than -2 standard deviations (SDs) or greater than +2SDs were considered abnormal. Data was collected and analyzed using Epidata and R statistical software respectively.&#x0D; ResultsA hundred and sixty-seven patient were recruited with 86 (51.5%) being females. The median age was 56 months (Range: 1 to 172). The mean z-score for the WfH was -1.21 (95%CI: -1.48 to -0.94), HfA -1.18 (95%CI: -1.44 to -0.93), WfA -1.81 (95%CI: -2.06 to -1.56), BfA -1.41 (95%CI: -1.61 to -1.21) and MfA -1.66 (95%CI: -1.87 to -1.46). None of the patients had a z-score greater than +2SD for all anthropometric methods determined. The percentage of children with z-scores less than -2SD for WfH was 20.5% (95%CI: 12.0 to 31.6), HfA 21.3% (95%CI: 14.4 to 29.6), WfA 41.5% (95%CI: 33.1 to 50.3), BfA 31.1% (95%CI: 23.1 to 40.2) and MfA 36.0% (95%CI: 28.6 to 44.0).&#x0D; ConclusionThere is a high prevalence of malnutrition, wasting and stunting among children attending the Pediatric Heart Disease clinic at KATH. Strategies should be put in place to improve their nutritional status, which in turn could improve surgical and long-term developmental outcome.

PREVALENCE OF FAT-SOLUBLE VITAMIN DEFICIENCIES ASSOCIATED WITH SEVERE ACUTE MALNUTRITION: A PROSPECTIVE OBSERVATIONAL STUDY

Background: Severe acute malnutrition (SAM), among children below five years of age is global health problem contributing to childhood morbidity, mortality and remains a major embarrassment to optimal human capital development in India. Objectives: Study aim was to accesses fat soluble vitamins deficiencies among children with SAM and outcomes after treatments with F-75/F-100 plus vitamins mix. Methods: The study was prospective observational conducted in the nutritional rehabilitation center (NRC) at district general hospital for 6 months. Anthropometric measurements were taken to determine their nutritional status. Results: 100 patients of NRC were enrolled in the study. Sixty nine percent (69) patients had weight/height (WT/HT) Z score&lt;−3 standard deviation (3 SD), 16 % with Z score&lt;−2 and 15% of them had Z score&lt;−4 malnutrition. Out of 100 children, 46% children were males, and 56% children were females. Vitamin E deficiencies (54%) were highly prevalent in hospitalized SAM groups, followed by 28% vitamin D and 18% were vitamin A deficient. Conclusion: Micronutrient deficiencies were highly prevalent with fat soluble vitamins and recovered on application of WHO protocols during hospitalization induced satisfactory fat-soluble vitamin status recovery significant (p&lt;0.05).

Prevalence of undernutrition and effectiveness of a community-based nutritional support programme to reverse stunting among children under five years of age in an urban slum in Kolkata, India: findings of a one-year longitudinal study

Background Stunting, defined as z-score height-for-age (HAZ) &lt; -2, is an important contributor to the burden of childhood undernutrition among slum-dwelling residents in India’s metropolitan areas. Calcutta Rescue (CR) is a non-governmental organisation that provides medical care and nutritional support to slum-dwellers in Kolkata, India. CR undertook a study in Liluah Bhagar, an urban slum, to 1) establish the prevalence of undernutrition among children under five years of age, 2) evaluate the impact of a pilot nutritional support programme on growth patterns of a consecutively selected group of stunted children, and 3) identify socio-economic predictors of stunting. Methods For the prevalence assessment (April-June 2018), we conducted anthropometric measurements using standardised World Health Organization (WHO) growth measurements for weight-for-age (WAZ), height-for-age (HAZ), and weight-for-height (WFH). For the longitudinal study, we recruited stunted children and collected anthropomorphic data every three months for one year (December 2018-December 2019). Results The prevalence assessment of 116 children revealed 59% of stunting, 44% underweight and 12% of wasting. Follow-up of 42 stunted children in a pilot nutritional programme improved stunting over time (b =0.07, 95% CI 0.05 to 0.039, P&lt;0.001), with a trend towards clinical improvement at one year. Linear mixed model analysis revealed household income was a negative predictor of stunting (b =-0.38, 95% CI -0.66 to -0.09, P=0.010). Conclusions This study highlights the burden of undernutrition in marginalised slum-dwelling children in India and the benefits of a pragmatic, education-focused nutritional intervention programme. Further studies are required to determine what predictors other than income are associated with stunting to then determine what interventions are likely to effect long-lasting and sustainable changes to growth in this vulnerable population.

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

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

Dental Caries Severity and Nutritional Status of Nigerian Preschool Children.

Malnutrition in children is one of the most prevalent global health challenges, and malnourished children have a higher risk of death from childhood diseases. Early childhood caries (ECC) is the most common chronic disease of childhood. Complications from ECC such as pain, loss of tooth/teeth, and infection can undermine a child's nutrition and growth. This study aims to evaluate the severity of decay, missing, and filled tooth (dmft) by nutritional status using the z scores of the anthropometric measurements: height for age (HFA), weight for age (WFA), weight for height (WFH), and body mass index for age (BMIA) among children with ECC in Nigeria. This is a cross-sectional study conducted in 5 local government areas (LGAs) in Lagos State, Nigeria. A multistage sampling technique was used. A total of 273 cases of ECC were included in the analyses (mean age 4.19 ± 0.96 y). Overall, the mean dmft was 3.04 ± 2.28, and most (96%) were accounted for by untreated decay. The distribution of dmft within the different z score categories of BMIA (<-3 = severely wasted, -2 to -3 = wasted, -2 to +2 = normal, +2 to +3 = overweight and >+3 = obese) showed the highest dmft scores among the combined severely wasted and wasted groups, lowest among children with normal z scores, and intermediate in the overweight and obese groups. There was a significant negative correlation between BMIA z score, WFH z score, and dmft (r = -0.181, P < 0.05 and r = -0.143, P < 0.05, respectively). However, the correlations between HFA z score, WFA z score, and dmft were positive but not significant (r = 0.048, P = 0.44 and r = 0.022, P = 0.77, respectively). Our study showed an increased severity of dental caries among severely wasted or wasted children with ECC compared to those of normal or overweight. The results from this study will raise awareness among clinicians and policy makers on the need for a primary prevention program for early childhood caries in countries with high burden of malnutrition and limited resources. Also, it will help draw the attention of clinicians to the caries status of malnourished children that can be managed to improve the nutritional outcomes.

Evaluation of the Effects of Malnutrition Detected in Children and Adolescents on the Adult Final Height

Aim: It is known that chronic malnutrition observed in the early childhood creates many negative results in adult life. Studies examining the effects of nutritional deficiency experienced at older ages and in adolescence are quite limited. In other words, the long-term consequences of nutritional defect in acute/ chronic moderate or mild malnutrition patients still remains important as an issue to be investigated. For this purpose; In this study, it was aimed to determine the final adult height (predicted adult height) of children and adolescents with different age distribution and who were diagnosed with malnutrition as a result of nutritional-endocrinological anthropometric evaluations, and to compare these data with their genetic potential. Material and Methods: The study included 21 cases diagnosed with malnutrition in the pediatric endocrinology department. After the detailed history of the cases, anthropometric measurements and physical examination, biochemistry, hormonal and micronutritional status, celiac antibody levels were evaluated. In the anthropometric evaluation of all cases, body weight, height, height deviation, bone age, target height, target height deviation parameters were used. Patients’ pubertal development was determined according to Tanner-Marshall staging. In the determination of the nutritional status of the patients, data including Weight for Age (WA), Height for Age (HA) and Weight for Height (WH) were used as a nutritional anthropometric measurement using the Gomez-Waterlow classification. In addition, the predicted adult height was calculated with special formulas based on skeletal ages in all cases. Predicted adult height data were obtained using Bayley N Pinneau tables. Results: Of the 21 cases with an average age of 9.81±4.34 years, 12 were prepubertal and 9 were pubertal. Acute episode over chronic malnutrition was found in 19 cases, chronic in 2 cases and acute malnutrition in one case. Considering the severity of malnutrition; WA parameter was determined as severe malnutrition in 1 case, mild-moderate malnutrition in 20 cases, HA parameter was determined as normal in 12 cases, mild-moderate malnutrition in 9 cases, WH parameter was determined as normal in 3 cases, mild-moderate malnutrition in 18 cases. While the predicted adult height of all cases was 164.89±7.96 cm, the target height average of these cases was 166.5±8.09 cm. It was observed that the predicted adult height compared to the target height was the lowest in the chronic group. In seven cases with bone age below 6 years of age, the actual height deviations were distinctly behind the target height deviation. All of these cases were compatible with chronic malnutrition. Conclusion: These results are valuable in terms of showing that malnutrition experienced in any period of growth may negatively affect the predicted adult height. On the other hand, this research; It emphasizes the importance of nutritional anthropometry in all cases with or without short stature. In addition, in another study we conducted in 11 adolescents, it was found that nutritional defect negatively affected growth by decreasing IGF1/IGFBP3 levels, and growth factors increased and growth was supported in the cases that were nutritionally supported. In this study, if the nutritional deficiency is not replaced in patients with malnutrition, it suggests that even if the actual height is not affected, there will be retardation in the final height of the patients.

Prevalence of Undernutrition and Effect of Body Weight Loss on Survival among Pediatric Cancer Patients in Northeastern Hungary.

Undernutrition is a prevalent condition in pediatric malignancy patients leading to unfavorable outcomes. The aim of this retrospective study was to determine the nutritional status and rate of undernutrition in 174 Hungarian pediatric patients with malignancies and the impact on 5-year survival based on anthropometric measurements. At the time of diagnosis, 5.0%, 4.6%, and 4.0% of patients were undernourished as determined by body weight (BW), weight-for-height (WFH), and body mass index (BMI) Z-score, respectively. The rate of undernutrition was 30.5% using ideal body weight percent (IBW%). Undernutrition at the time of diagnosis worsened the five-year overall survival only in solid tumor patients as defined by BMI Z-score and IBW%. Furthermore, 26.5% of patients became undernourished based on IBW% during the treatment period. Deterioration of nutritional status during treatment unfavorably influenced overall survival in both hematological and solid tumor subsets. Abnormal BW, WFH, and BMI Z-score were associated with poor prognosis in the hematologic group. The mortality risk was higher among hematologic patients with weight loss exceeding 20%. In conclusion, IBW% seems to be the most sensitive parameter to estimate undernutrition. Furthermore, BMI Z-score in both groups and severe weight loss in the hematological group may influence clinical outcome and play a role in prognosis assessment.