WHO Child Growth Standards Research Articles

Factor Associated with Nutritional Status Among Children Aged 6 – 59 Months in Colol Public Health Center: A Cross-Sectional Study Article Sidebar

Objective: Malnutrition is one of the main factors influencing growth and development in children. Undernourishment still became a significant public health issue, including in Indonesia. This study aims to assess the prevalence and risk factors of nutritional status among children aged 6-59 months in Colol Public Health Center, East Manggarai Regency, and Indonesia. Material and Methods: A cross-sectional observational community-based study was conducted in the working area of Colol Public Health Center in August 2023. This study included 138 parents and children aged 6 to 59 months who visited Posyandu, chosen by a simple random cluster sampling technique. The data were collected using a structured questionnaire, secondary data from the Maternal and Child Health (MCH) book, and anthropometrical measurements. Three anthropometric indicators (underweight, stunted, and wasted) were assessed according to the 2006 WHO Child Growth Standards and analyzed by SPSS 25.0. Bivariate and multivariate analyses were used to identify risk factors associated with children’s nutritional status. The statistical significance was stated at p-value <0.05 with 95% confidence intervals. Results: The prevalence of underweight, stunted, and wasted among children aged 6-59 months was 18.8%, 22.4%, and 6.5%, respectively. The multivariable logistic regression model showed that low birth weight increased the risk of underweight (AOR = 13.73 (95% CI: 2.40-78.63)), stunted (AOR = 30.55 (95% CI: 3.16-295.09)), and wasted (AOR = 12.16, 95% (CI: 2.02-73.37)) among children aged 6-59 months. Children with mothers aged <20 or > 35 years old increased odds for underweight (AOR 2.99 (95% CI: 1.13-7.94)). Meanwhile, children aged 24-59 years old were more likely stunted (AOR 4.89 (95% CI: 1.89-12.64)). Conclusion: Undernutrition still becomes a public health problem among children aged under 5 years old in the working area of Colol Public Health Center, East Manggarai Regency. Low birth weight, age of the mother <20 or > 35 years old, and age of the children 24-59 years are significantly associated with nutritional status. The primary health center should cooperate with stakeholders across sectors, especially promoting programs to prevent low birth weight

Should a single growth standard be used to judge the nutritional status of children under age 5 years globally: Yes

Childhood nutritional status serves as a lens through which nations and communities identify missed opportunities to improve health and wellbeing across the life cycle, as well as economic development and other related sectors. Countries have committed to the global nutrition targets endorsed by the World Health Assembly in 2012, which were included in the Sustainable Development Goals framework under the target to end all forms of malnutrition by 2030. The child malnutrition indicators for tracking countries’ progress toward the agreed-upon targets are based on standard definitions of nutritional status against the widely adopted and used World Health Organization (WHO) Child Growth Standards. The standards were based on a sample of healthy breastfed infants and young children from diverse ethnic backgrounds and cultural settings as part of the WHO Multicentre Growth Reference Study. The WHO Child Growth Standards developed represent the best description of physiological growth for children aged <5 y. The standards depict normal early childhood growth under optimal environmental conditions and can be used to assess children everywhere, regardless of ethnicity, socioeconomic status, and type of feeding.

Understanding the Crisis: Prevalence and Key Determinants of Stunting in Children Aged 2 to 5 Years in an Afghan Refugee Camp in Kohat.

Stunting, characterized by impaired growth and development due to malnutrition and illness, is a significant public health concern with profound implications for cognitive and physical development. This issue is particularly severe in refugee settings, where food insecurity and limited access to healthcare exacerbate the problem. This study aimed to evaluate the prevalence and determinants of stunting among children aged 2 to 5 years in an Afghan refugee camp in Kohat, Pakistan. A cross-sectional observational design was employed, collecting data from children aged 2 to 5 years who had resided in the camp for at least six months. A pre-validated, standardized questionnaire was administered to parents or guardians to gather data on socio-demographic factors, dietary intake, and health history. Stunting was defined as a height-for-age Z-score less than -2 SD from the median of the WHO Child Growth Standards. Anthropometric measurements were taken following WHO guidelines. Bivariate and multivariate logistic regression analyses were conducted to identify predictors of stunting. Out of 384 children, 153 (40%) were found to be stunted. The prevalence was slightly higher among boys (80 out of 153, 52%) compared to girls (73 out of 153, 48%). Significant predictors of stunting included a lack of parental education (adjusted odds ratio (AOR) for fathers 1.8, 95% confidence level (CI) 1.2-2.9; AOR for mothers 2.1, 95% CI 1.3-3.4), a history of infectious diseases (AOR 1.9, 95% CI 1.2-3.0), and low dietary diversity (AOR 2.3, 95% CI 1.4-3.7). The study highlights the high prevalence of stunting among children in the refugee camp, underscoring the need for comprehensive interventions targeting healthcare improvement, parental education, economic support, and dietary diversity to reduce stunting rates and improve children's health outcomes.

Prevalence and sociodemographic factors associated with double burden of malnutrition among children under 5: a cross-sectional analysis of NFHS-4 data in India

BackgroundThe double burden of malnutrition (DBM), characterised by the coexistence of undernutrition and overnutrition, poses a significant public health challenge, particularly in low- and middle-income countries. India, being one of...

Evaluation of Nutritional Status using Head Circumference among Bhil, Dhodia and Kinnaura tribal Preschool Children, India

Background: Undernutrition is a major problem in developing countries, especially among tribal pre-school children. Many studies have been undertaken on preschool tribal children in different parts of India, but by considering different ecological zones, no previous studies have been taken into account for determining nutritional status using head circumference. Head circumference for age Z-score (HCAZ) is also a useful index for determining the nutritional status of pre-school children. Objectives: The aim of the study is to assess the nutritional status based on head circumference of preschool children of the Bhil, Dhodia and Kinnaura tribes. Methods: The present study was undertaken among 509 boys and 476 girls. Among which, 168 boys and 185 girls belonged to the Bhil tribe from Barmer district, 164 boys and 142 girls belonged to the Dhodia tribe from Valsad district, and 177 boys and 149 girls belonged to the Kinnaura tribe from Kinnaur district. WHO Child Growth Standards (2007) were utilized to determine Z-scores for head circumference for age (HCAZ). The standard formula was used to compute HCAZ: Z-score= (X- Median value of WHO 2007)/ standard deviation, WHO (2007). Moderately undernourished: &lt;-2SD and severely undernourished: &lt;-3SD were considered following the WHO standard (2007). Results: From this study, it was found that among Bhil preschool children, 28.3% of boys and girls are undernourished, 33.6% of boys and 31.3% of girls are suffering from malnutrition among Dhodia boys, and 13.5% of boys and 17.2% of girls are undernourished among Kinnaura tribe. Conclusion: Regular intervention programmes need to be done by the authority to spread awareness among the people of these tribal communities so that the health condition of preschool children improves.

Factors Affecting Stunted Status in Children Under Two Years at Karya Mulia Public Health Center 2023

Background Stunted (short stature), defined as a height-for-age condition less than two standard deviations below the median of the WHO child growth standards, is caused by inadequate nutritional intake during the first 1000 days of life. Various factors contribute to the stunted status in children. Therefore, this research focuses on factors that can be examined at primary healthcare facilities, such as public health centers, and their relationship with the stunted status in children. Objective To determine the relationship between birth weight, basic complete immunization, and vitamin A supplementation on the stunted status of children aged 12-23 months at Karya Mulia Public Health Center, Pontianak, in the year 2023. Methods This study employed an analytical design with a cross-sectional approach. A total of 86 research samples were selected using total sampling techniques that met the sample criteria. Bivariate analysis was conducted using the fisher’s exact test and chi-square test. Results The results indicate no significant relationship between birth weight (0.623), basic complete immunization (0.342), and vitamin A supplementation (0.602) on the stunted status of children aged 12-24 months at Karya Mulia Public Health Center in 2023, statistically with p-value &gt; 0.05. Conclusions There is no relationship between birth weight, basic complete immunization status, and vitamin A supplementation on the stunted status of children aged 12-23 months at Karya Mulia Public Health Center.

Nutritional Status and Body Composition at Diagnosis, of South Indian Children with Acute Lymphoblastic Leukaemia (ALL).

Accurate estimation of body composition, particularly, Body Cell Mass (BCM), which is independent of hydration status is important in children with cancer. This study aimed to accurately measure the anthropometry and body composition of children with Acute Lymphoblastic Leukaemia (ALL) at diagnosis and compare them with healthy children from South India. This was a cross-sectional study in children aged 2 to 8 y with ALL from St. John's Medical College Hospital, Bengaluru, and age and sex-matched, normal-weight children recruited as controls from communities. Anthropometry (weight, height, circumferences), skinfolds and body composition measurements using a whole-body potassium counter were performed. Body mass index-for-age, weight and height for age z-scores were calculated using WHO child growth standards. Biochemical markers, dietary intake and physical activity details were recorded. Categorical and continuous variables were analyzed by chi-square and independent t-tests respectively. Results: The mean age of the children with ALL (n = 39) was 4.6±1.9 y and control group (n=39) was 4.7±1.9 y; 61.5% were boys. The prevalence of underweight, overweight/obesity and stunting were 17.9%, 7.7%, and 10.3% respectively. The mean weight and height, of children with ALL and children in the control group were 16.8±6.2 kg and 16.4±4.1 kg, 104.3±14.9 cm and 105.1±12.2 cm, respectively with no statistical difference. Children with ALL showed lower body cell mass index kg/m2 (4.6± 0.8), compared to children in the control group (4.7±0.9) p=0.527, but higher fat mass index kg/m2 (3.6±1.1 vs. 3.4±0.8) p=0.276. At diagnosis, anthropometric and body composition measurements were similar between children with ALL and children in the control group. The BCM showed a non-significant trend of being lower in children with ALL, which requires close monitoring during treatment. Evaluating early-stage nutritional status and body composition can help in planning appropriate interventions during treatment to prevent long term non-communicable diseases.

THE RIGHTS OF STUNTED CHILDREN TO HEALTH SERVICES IN DONGGALA DISTRICT

Children are a gift from God Almighty, whose dignity needs to be protected and their rights guaranteed to grow and develop by their nature. Child health problems in terms of nutrition are one of the priorities of the United Nations. Stunting cases are cases of toddlers who have a length or height that is less than the WHO child growth standards. Article 6 paragraph (1) of the Convention on the Rights of the Child reads "States Parties subscribe to the inherent right of every child to life". The right to health is one of the rights inherent in children and adults. One of the Health Rights for children is the fulfillment of children's nutrition and nutrition, so as not to cause stunting of children. SSGI data from Donggala Regency includes districts that have high stunting cases, with a stunting rate in 2023 of 32.4%. This paper aims to find out and analyze the extent of the convention's implementation on the right of stunting children to health services, the factors that cause the high stunting rate in Donggala Regency, and efforts to provide health services for stunting children.

Concurrence of anemia and stunting and associated factors among children aged 6 to 59 months in Peru.

Anemia and stunting are two health problems in the child population; therefore, their concurrence needs to be quantified. We estimated the prevalence of concurrent anemia and stunting (CAS) in children aged 6-59 months and identified the factors associated with this condition. The data came from the Demographic and Health Survey of Peru (DHS), 2022. The study design was cross-sectional and included 19,191 children. Height and hemoglobin measurement followed the specifications of National Health Institute of Peru. To reduce error in measures, the anthropometry personnel was training, the quality of measuring equipment was ensuring, and protocolized techniques and procedures was applying. Hemoglobin concentration was measured in capillary blood using the Hemocue model Hb 201+. Stunting was defined as a height-for-age Z-score less than minus two standard deviations (SD) from the median, following the 2006 WHO child growth standard. Anemia was classified into mild (10.0 to 10.9 g/dL), moderate (7.0 to 9.9 g/dL), severe (< 7.0 g/dL), and no anemia (11.0 to 14.0 g/dL). We performed a bivariate analysis to evaluate factors associated with CAS. To include variables in the multivariate analysis, we applied a statistical criterion (p < 0.10 in the crude analysis) and an epidemiological criterion. We used a binary logistic hierarchical regression model. The prevalence of CAS was 5.6% (95%CI: 5.2 to 5.9). The modifiable factors associated with higher odds of CAS were: "poorest" (aOR: 3.87, 95%CI: 1.99 to 7.5) and "poorer" (aOR: 2.07, 95%CI: 1.08 to 3.98) wealth quintiles, mother with no formal education or primary (aOR: 2.03, 95%CI: 1.46 to 2. 81), father with no formal education or primary (aOR: 1.55, 95%CI: 1.16 to 2.07), no improved water source (aOR: 1.36, 95%CI: 1.10 to 1.68), no roof with improved material (aOR: 1.49, 95%CI: 1.12 to 1.98) and low birth weight (aOR: 7.31, 95%CI: 4.26 to 12.54). In Peru, five out of every 100 children suffer from anemia and stunting simultaneously; there are modifiable factors that, if addressed, could reduce their prevalence.

IMPACT OF MALNUTRITION ON PEDIATRIC HEART FAILURE ANALYZING Z-SCORES AT PRESENTATION

Pediatric heart failure represents a critical health concern characterized by the heart's inability to effectively pump blood, often resulting from congenital heart defects, myocarditis, and cardiomyopathies. Malnutrition has emerged as a recognized comorbidity in pediatric heart failure, significantly impacting patient outcomes. This study aimed to investigate the relationship between malnutrition and pediatric heart failure by analyzing Z-scores at presentation to guide targeted interventions and improve patient management. The study employed a retrospective observational design and was conducted at the Department of Pediatric Cardiology, Lady Reading Hospital, Peshawar, from January 2023 to January 2024. A total of 764 pediatric patients with heart failure were included in the analysis. Nutritional status was assessed using weight and height measurements, and Z-scores were calculated based on WHO Child Growth Standards. Data analysis was performed using IBM SPSS version 22. Results revealed varying degrees of malnutrition among pediatric heart failure patients, with 62.8% classified as severely malnourished, 28.4% as moderately malnourished, and 8.8% as mildly malnourished. The calculated Z-score of -3.2 indicated significant malnutrition among the study population. Furthermore, a negative correlation (r = -0.32, p &lt; 0.001) between Z-score and left ventricular ejection fraction was observed, suggesting a link between malnutrition severity and cardiac dysfunction. These findings underscore the high prevalence of malnutrition among pediatric heart failure patients and its substantial impact on outcomes. Early nutritional assessment and intervention are crucial for optimizing patient care and enhancing outcomes in children with heart failure. Collaborative, multidisciplinary approaches that integrate cardiac and nutritional management strategies can comprehensively address the diverse needs of this vulnerable population.

Interstate migration and its association with the prevalence of stunting in under-five children of the migrant families in Delhi-NCR, India: a cross-sectional study

Background: Interstate migration in India is increasing every year. Children of the migrant families often face poor living conditions and insufficient nutrition, as a result of various socio-economic determinants. This study aimed to understand the association between rural-to-urban migration and under-five stunting, and the various determinants involved. This study allows researchers to make pre and post pandemic comparison of stunting among migrant children in Delhi, since it was carried-out post the second wave of the COVID-19 pandemic. Methods: A community-based cross-sectional survey was carried-out in the bhatti mines area of south Delhi, using a systemic sampling method. 100 households each of migrants and non-migrants were approached, and height of the under-five children was measured. Stunting was estimated using WHO child growth standards. Information on demography and socio-economic determinants was collected from the mothers using a questionnaire. Results: Stunting was recorded in 62% of the migrant under-five children and 27% in the non-migrant children, with a significant difference between the two groups (p value &lt;0.001), indicating a significant association between migration and stunting. Source of drinking water (p&lt;0.05) and recurring episodes of diarrhea (p&lt;0.05) were also found to be strongly associated with under-five stunting. Conclusions: Under-five nutritional deficits lead to compromised immunity and delay in physical and mental growth and development. It is important to recognize and address the diverse needs of the under-five migrant population’s health in order to avoid stunting and other serious manifestations.

Exploring The Interplay of Stunting and Upper Respiratory Infection in Kronjo Health Center: A Cross-Sectional Study

Background: Stunting, a prevalent form of chronic malnutrition, presents a significant public health challenge globally, particularly in low-income nations like Indonesia. This study investigates the prevalence and interaction of stunting and upper respiratory infections (URIs) among toddlers aged 12-59 months in Kronjo Health Center, a rural health center in West Java.&#x0D; Methods: Employing a cross-sectional design with total sampling, data were collected from October to November 2023. Height measurements were interpreted according to WHO child growth standards, and statistical analysis was performed using the Pearson chi-square 2x2 test.&#x0D; Results: The study involved 146 toddlers, with the majority being female (52.7%) and aged 12-23 months (34.9%). Most mothers had a high school education (39.7%), practiced breastfeeding (67.8%), and participated in basic pediatric immunization programs (61%). Additionally, 15 toddlers (10.3%) had a history of low birth weight, and a significant proportion were exposed to household smoking (n = 122; 83.6%) and lived in crowded households with six or more family members (n = 45; 30.8%). The study revealed a stunting prevalence of 46.6% and a URI prevalence of 63% among toddlers aged 12-59 months in Kronjo Health Center. Statistical analysis indicated a significant association between stunting and URIs (p-value = 0.035).&#x0D; Conclusion: This study highlights a significant association between stunting and URI among toddlers aged 12-59 months in Kronjo Health Center, emphasizing the importance of addressing both conditions in rural health settings.

Stunting and its association with education and cognitive outcomes in adulthood: A longitudinal study in Indonesia.

Stunting is associated with adverse outcomes in adulthood. This article specifically aims to analyse the relationship between childhood stunting and education as well as cognitive outcomes for adults in Indonesia. Pooled data from wave one (1) and two (2) of the Indonesia Family Life Survey (IFLS) in 1993 and 1997 identified a sub-sample of 4,379 children aged 0-5 by their height-for-age (HAZ) to be compared for their differences in educational outcomes and cognitive abilities in 2014. HAZ was used to proxy relative height to determine stunting status based on 2006 WHO child's growth standards. Education and cognitive abilities outcomes include years of schooling, age of school entry, grade repetition, and scores for cognitive and math tests. The study employs estimation models of pooled regressions and instrumental variable (IV) to address problems of endogeneity and bias from omitted variables. Stunting and relatively small stature had significant associations with cognitive development, and they worked as intermediaries to cognitive developmental barriers as manifested in reduced educational outcomes. A lack of one SD in HAZ was associated with 0.6 years shortened length of the school, 3% higher chances of dropouts from secondary school, and 0.10-0.23 SD lowered cognitive and numerical scores. Similarly, stunting is associated with decrease cognitive test scores by 0.56-0.8 SD compared to non-stunting, two years less schooling, and 0.4 years of delayed entry to school. As for cognitive abilities, stunting is associated with lower cognitive and numerical abilities by 0.38-0.82 z-scores. Growth retardation during childhood in Indonesia was associated with lower cognitive abilities, particularly during school age, and this correlation faded as individuals grew up. Subsequently, growth retardation is significantly linked to lower educational outcomes. Impaired growth has implications for reduced lifetime earnings potential mediated by diminished cognitive capacity and lower educational attainment. The finding suggests that development in Indonesia during recent decades has not provided an adequate environment to enable children to achieve their potential educational outcomes.

STUNTING PREVENTION THROUGH FIRST 1.000 DAYS OF LIFE (HPK) PROGRAM EDUCATION IN MANUKAN KULON SUB-DISTRICT, TANDES DISTRICT, SURABAYA

The stunting prevalence rate in Indonesia in 2022 is still 21.6%, especially in East Java, the stunting prevalence rate still reaches 19.2%. The Surabaya City Government has a target to declare zero stunting by 2023 through the 1000 HPK Movement. One thousand HPK is the period from conception to the age of 24 months which is an important period to improve children's health because if at this time there is a developmental and functional delay in children, it cannot be changed or only partially reversible. Children are stunted if their height for their age is more than two standard deviations below the median WHO child growth standard. Community service activities in the form of education for the 1000 HPK Movement will be held on Saturday, July 22, 2023 at Balai RW 02 Manukan Kulon Village. Community service activities are carried out in the form of nutrition counseling and interactive dialogue between resource persons and participants. The educational activity was attended by pregnant women, breastfeeding mothers, and mothers who have children less than 2 years old with a total of 35 participants. The results of Wilcoxon's test on the Pre-test and post-test filled by participants showed that there was an increase in the knowledge of education participants about the 1000 HPK Movement. This activity is expected to be a provision for participants in preparing healthy children and avoiding stunting.

Analysis Of Determinants Of Stunting Incidents In Children Toddler In The Area Of The Bukal District Health Center, Buol District

According to UNICEF, stunting is defined as the percentage of children aged 0-59 months with a height below minus (moderate and severe stunting) and minus three (chronic stunting) measured by WHO child growth standards. Stunting in toddlers manifests chronic nutritional deficiencies both during pregnancy and during the birth process. This research aims to analyze the determinants of stunting in children under five regarding parenting patterns, access to health services, nutritious food, and clean water and sanitation in the Bukal District Health Center Area, Buol Regency. The research was conducted in the Bukal Community Health Center Working Area, Buol Regency. The sample in this study was the entire population of 322 mothers of toddlers in the Bukal District Health Center Area, Buo Regency. This research was an analytical survey research with a cross-sectional design. Based on the findings, it can be concluded that: There is a relationship between parenting pattern factors and the incidence of stunting in children under five in the Puskesmas area, Bukal District, Buol Regency with a p-value = 0.000, ,There is a relationship between the factor of access to health services and the incidence of stunting. In children under five in the Puskesmas area, Bukal District, Buol Regency with a p-value = 0.000, , There is a relationship between the factor of access to nutritious food and the incidence of stunting in children under five in the Puskesmas area, Bukal District, Buol Regency with a p-value = 0.000, There is a relationship between access to clean water and sanitation and the incidence of stunting with a p-value = 0.000. This study concludes that health services are the most related factor, with a significant value of 0.004 and a Wald value of 8.310, meaning that access to health services has a risk of 8,310 times the risk of stunting.

Changes of anthropometric indicators of lithuanian first-graders in 2008–2019 according to International Obesity Task Force (IOTF) and World Health Organization (WHO) definitions

IntroductionThe monitoring of children’s growth plays a crucial role in assessing their growth patterns and indicating their weight status. Overweight and obesity, determined by cut-offs of body mass index (BMI), are most commonly associated with unhealthy nutrition, non-communicable diseases, and other health disorders. The World Health Organization (WHO) initiated the WHO European Childhood Obesity Surveillance Initiative (COSI) to measure routinely trends in children’s anthropometric changes, which allow intercountry comparisons within the European Region. Lithuania joined the COSI initiative. Our study aims to evaluate and compare underweight, normal and elevated weight (overweight and obesity) changes of Lithuanian first-graders during eleven years period.MethodsThis study was composed according to the COSI study protocol, and it compares the five rounds of anthropometric measurements of Lithuanian first-graders (7-8-year-old) from 2008 to 2019. The main analysed variables were weight and height; calculated BMI, weight-for-age (W/A), height-for-age (H/A) and body mass index-for-age (BMI/A) z-scores. Changes of the indicators were evaluated according to the International Obesity Task Force (IOTF) cut-offs and WHO child growth standards, grouped by 4 estimates: underweight (thinness), normal weight, overweight and obesity. All comparisons were performed between age groups, gender and COSI round year.ResultsThe mean values for weight, height, W/A and H/A Z-scores were significantly higher for both age and gender groups when comparing later COSI round years (2016 or 2019) to earlier years (2008–2013, in some cases 2016 is included in this range). Time trends of the WHO growth standards and IOTF cut-offs indicate significant decrease among 7-year-old overweight group for boys and girls. Also, a significant decrease was indicated among boys aged 8 years in the overweight group according to the WHO definitions. The only significant increase in trend were expressed in girl’s group with obesity aged 8 years according to IOTF cut-offs.ConclusionThe prevalence of overweight and obesity of first-grade children in Lithuania indicates positive changes, that is the proportion of children with elevated body weight decreased, during eleven-year period. However, it is important to continue the monitoring of children’s growth tendencies.

Factors affecting stunting among 3–12 years old girls of Purba Medinipur, West Bengal, India

Stunting is the impaired growth and development in children caused due to poor nutrition, recurrent infections and lack of psychosocial stimulus. Because stunting affects physical development and inhibits the child from attaining his full cognitive development as an adult, children may never regain the height lost due to stunting. Stunting (Low height-for-age) in infants and young children is a simple, wellknown indicator of undernutrition. The current study sought to determine the effects of socio-economic and demographic factors on the frequency of stunting among Bengalee girls. The study was carried out in the Deshopran block and Haldia municipality area (West Bengal, India). The total number of participants included in the study was 530 Bengalee girls. 53.39% (283) of study participants were urban residents while 46.61% (247) were rural residents. Stunted growth in children was defined as the height for a given age in children less than two standard deviations of the WHO Child Growth Standards. The prevalence of stunting among girls in our study was 11.13%. The predictor variables with substantial associations with stunting in the binary logistic regression (BLR) analyses were further used in the multiple binary logistic regression (MBLR) analyses. Odds ratios with 95% confidence intervals were used to calculate the stunting risk. Results showed that the risk of stunting was significantly associated with low birth weight, presence of younger brothers, a large number of family members and place of delivery. Improving maternal and child access to nutrient-rich food, decreasing infectious disease, and promoting women empowerment initiatives are the main recommendations for resolving the issue.

Trends and Determinants of Children's Wasting and Women's Thinness in Chad, 2015 to 2021.

Cross-sectional surveys using the Standardized Monitoring and Assessment of Relief and Transitions methodology have been conducted annually in Chad since 2015 to evaluate population-level nutritional status. This analysis characterizes national and subnational trends in child wasting and women's thinness from 2015 to 2021 in Chad and identifies risk factors during the COVID-19 pandemic. Annual survey data with 12,000 to 15,000 households were included. Wasting was estimated for children 6 to 59 months using the WHO child growth standards, and among women 15 to 49 years, thinness was defined as mid-upper arm circumference <23 cm. Trends were stratified by agroecological zone, and chi-square tests used to assess statistical significance. Simple and multivariate logistic regression models were conducted for 2020 and 2021 to identify risk factors of wasting and thinness. About 11,958 to 17,897 children and 9883 to 15,535 women contributed values each year. National wasting and thinness rates did not significantly decrease over the 7-year period (wasting: 14.1% to 12.1%, P = .43; thinness: 15.2% to 13.4%, P = .51) and wasting rose from 2020 to 2021. The Saharan and Sahelian zones had consistently higher rates compared to the Sudanian zone. Younger age, male sex, inadequate infant and young child feeding practices, and poorer household socio-economic factors were associated with greater odds of child wasting. For women, younger age, lack of nutrition knowledge, and poorer household socio-economic factors increased the odds of thinness. Undernutrition in Chad has not improved since 2015, and the COVID-19 pandemic likely exacerbated the crisis among children nationally and among women subnationally. Multisectoral approaches and regional targeting of interventions are recommended.

Unhealthy weight among young children in the Middle East and North African region.

To understand early-life growth in the Middle East and North Africa (MENA) region, and how it has changed over time, we estimated the prevalence of wasting and overweight at ages under 5 years. Cross-sectional data from twenty-nine Demographic and Health Surveys with direct anthropometric data and parent-reported demographic information were examined. The study utilised the WHO Child Growth Standards to classify overweight (weight-for-height z-score ≥ 2 sd above the median), wasting (weight-for-height z-score ≤ 2 sd below the median) and unhealthy weight defined as either wasting or overweight. Nationally representative for nine of the MENA countries (Armenia, Azerbaijan, Egypt, Jordan, Mauritania, Morocco, Tunisia, Turkey and Yemen). Children under age 5 from nine MENA countries between 1987 and 2016 (n 155 961). Across the region, at the most recent time point, between 7·3 and 23·6 % of children experienced unhealthy weight (Jordan - 7·3 %, Egypt -23·6 %); 1·7 and 16·6 % had wasting (Turkey, Yemen) and 2·0 and 15·0 % had overweight (Yemen, Egypt). Overweight was more common than wasting in all countries except Yemen and Mauritania. Between 1987 and 2016, the prevalence of unhealthy weight in the region increased (10·0-18·4 %) due to increases in both wasting and overweight. Boys had a higher prevalence of unhealthy weight than girls. Undernutrition continues to be a problem in some countries in the MENA region, and overnutrition is emerging as a health concern in many countries in the region. Countries in the region must advance programmes that reduce undernutrition while not overlooking or inadvertently promoting overnutrition.

Body composition from birth to 2 years.

Providing all infants with the best start to life is a universal but challenging goal for the global community. Historically, the size and shape of infants, quantified by anthropometry and commencing with birthweight, has been the common yardstick for physical growth and development. Anthropometry has long been considered a proxy for nutritional status during infancy when, under ideal circumstances, changes in size and shape are most rapid. Developed from data collected in the Multicentre Growth Reference Study (MGRS), WHO Child Growth Standards for healthy infants and children have been widely accepted and progressively adopted. In contrast, and somewhat surprisingly, much less is understood about the 'quality' of growth as reflected by body composition during infancy. Recent advances in body composition assessment, including the more widespread use of air displacement plethysmography (ADP) across the first months of life, have contributed to a progressive increase in our knowledge and understanding of growth and development. Along with stable isotope approaches, most commonly the deuterium dilution (DD) technique, the criterion measure of total body water (TBW), our ability to quantify lean and fat tissue using a two-compartment model, has been greatly enhanced. However, until now, global reference charts for the body composition of healthy infants have been lacking. This paper details some of the historical challenges associated with the assessment of body composition across the first two years of life, and references the logical next steps in growth assessments, including reference charts.