WHO Child Growth Research Articles

Comparison of Cognitive Function in Children with Stunting and Children with Undernutrition with Normal Stature.

Background Stunting is the impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation. Children are defined as stunted if their height-for-age is more than two standard deviations below the WHO Child Growth Standards median. According to the Indonesia Basic National Health Survey 2013, Indonesia's stunting prevalence reached 37.2%. Various studies have shown that impaired cognitive development is found in children with stunting and undernutrition. This study aims to determine cognitive development in stunted and undernutrition with normal stature children using the Bayley Scale of Infant Development III (Bayley-III). Methods A cross-sectional study on 51 children aged one month to 3 years who fulfilled the inclusion criteria and who visited the outpatient clinic of Dr. Cipto Mangunkusumo National General Hospital from June 2017 to January 2018 was performed. Cognitive development was assessed using the Bayley Scale of Infant Development, Third Edition (Bayley-III). Results 26 children with stunting and 25 children with undernutrition with normal stature participated in this study. There was a statistically nonsignificant trend toward lower median score percentiles in the stunted group compared to that in the undernourished with normal stature group in the motor (median (range) 1 (0.1–75) vs. 4 (0–79); p=0.183), cognitive (12.5 (0.1–75) vs. 16 (0.1–99.9); p=0.550), and adaptive behavior (7 (0.1–75) vs. 12 (0.1–58); p=0.657) domains. Conclusions There is a trend toward lower cognitive, motor, and adaptive behavior abilities in stunted children compared to undernourished children with normal stature which needs further study. In addition, children with undernutrition have below-average abilities across all domains even before stunting has occurred.

The effect of Centella asiatica ethanolic extract on expression of glucose transporter 1 and osteocalcin on stunting larvae of Zebrafish (Danio rerio)

Stunting is known as length for age below minus two standard deviations (<-2 SD) of the WHO Child Growth Standard nutritional status. Several causes are identified, including exposure to pesticides (rotenone), which works by inhibiting mitochondrial complex I as an ATP-producing site and generate oxidative stress that affects glucose delivery and bone elongation involving GLUT 1 and osteocalcin. Centella asiatica is a high antioxidant herbal plant with anti-inflammatory properties. This study aimed to investigate the effect of Centella asiatica ethanolic extract on the rotenone-induced stunting zebrafish (Danio rerio) larvae model through GLUT 1 and osteocalcin expressions. This study found that 12.5 ppb of rotenone can induce about 6 dpf (day post-fertilization) zebrafish larvae into stunting. The effect of Centella asiatica ethanolic extract on increasing body length in stunting zebrafish larvae works by increasing the expression of GLUT 1 and osteocalcin expressions. The correlation test showed a positive and strong relationship between this ethanolic extract level with GLUT 1 and Osteocalcin expression. Thus, the Centella asiatica ethanolic extract effectively promotes the body length by elevating the expression of GLUT 1 and osteocalcin in stunting zebrafish larvae.

The effect of air pollution and emotional and behavioral problems on preschoolers' overweight and obesity.

Childhood overweight and obesity (OWO) has risen dramatically in both developed and developing countries over the past few decades, creating a huge burden of disease. Ambient air pollution and emotional and behavioral problems are important influencing factors of OWO in preschoolers, but few studies have evaluated the impact of air pollution and emotional and behavioral problems on OWO of preschoolers in rural areas and their potential interactions. This study selected 3802 preschool children from 26 kindergartens in 4 rural areas of Anhui Province for a cross-sectional study. A total of 3636 individuals were included in the final analysis. In this study, outdoor air pollutants (PM2.5 and O3) were derived from the China Air Pollution Tracking (TAP) data set, matching preschoolers' external air pollution exposure according to their kindergarten address codes to neighborhoods or administrative villages. OWO were assessed based on WHO Child Growth and Development Standards. Generalized linear model (GLM) and interplot model were used to evaluate the separate effects and potential interactions of air pollutants and emotional and behavioral problems on preschoolers' OWO. In the separate analysis, we found a significant positive association between air pollution and emotional and behavioral problems and OWO among preschoolers. In the interaction analysis, air pollution could enhance the positive effect of emotional and behavioral problems on OWO in preschoolers. In addition, the effect of air pollution and emotional and behavioral problems on overweight and obesity was stronger in preschoolers aged 5 to 6years. Finally, we also found a stronger positive association between emotional and behavioral problems among girls, macrosomia, non-left-behind children, and preschoolers without eating problems. This study provided a scientific basis for the control of air pollution and overweight and obesity among preschool children in Anhui Province.

Accuracy of Fully Automated 3D Imaging System for Child Anthropometry in a Low-Resource Setting: An Effectiveness Evaluation in South Sudan

ObjectivesTo evaluate accuracy of child stature (height/length) and mid-upper arm circumference (MUAC) measurements produced by the AutoAnthro 3D imaging system developed by Body Surface Technology Inc following improvements to the software algorithm to improve accuracy and support automated processing, and hardware changes aimed to reduce cost.MethodsA two-stage cluster survey in Malakal Protection of Civilians (PoC) in South Sudan between September 27 and October 2, 2021. All children aged 6–59 months within selected households were eligible. For each child, manual measurements were obtained by two anthropometrists following the protocol used for the 2006 WHO Child Growth Standards (CGS) study. Scans were then captured by a different enumerator using a Samsung Galaxy 8 phone loaded with a custom software, AutoAnthro, and an Intel RealSense 3D scanner. Scans were processed using a fully automated algorithm. A multivariate logistic regression was fit to evaluate adjusted odds of achieving a successful scan. Accuracy of measurements were visually assessed using Bland-Altman (BA) plots and quantified using average bias, technical error of measurement (TEM), limits of agreement (LoA), and the 95% precision interval for individual differences.ResultsManual measurements were obtained for 539 age eligible children, from which scan derived measurements were successfully processed for 234 (43.4%) of children. Caregivers for at least 56 children (10.4%) refused consent for scan capture; additional scans were unsuccessfully transmitted to the server. Neither demographic characteristics of the children (age and sex), stature, nor MUAC were associated with availability of scan derived measurements (P > 0.05); team was significantly associated (P < 0.001). The average bias of measurements in cm was −0.5 (95% confidence interval (CI): −2.0, 1.0) for stature and + 0.7 (CI: 0.4, 1.0) for MUAC. For stature, 95% LoA was −23.9 to 22.9 cm. For MUAC, the 95% LoA was −4.0 to 5.4 cm. The TEM was 8.4 cm for stature and 1.8 cm for MUAC. All metrics of accuracy varied considerably by team.ConclusionsScan derived measurements were not of sufficient accuracy for widespread adoption. Differences in accuracy by team provide evidence that investments in training may be able to improve performance.Funding SourcesUSAID's Bureau for Humanitarian Affairs and Grand Challenges Canada.

Effects of an Amino Acid-Based Formula Supplemented with Two Human Milk Oligosaccharides on Growth, Tolerability, Safety, and Gut Microbiome in Infants with Cow's Milk Protein Allergy.

This open-label, non-randomized, multicenter trial (Registration: NCT 03661736) aimed to assess if an amino acid-based formula (AAF) supplemented with two human milk oligosaccharides (HMO) supports normal growth and is well tolerated in infants with a cow’s milk protein allergy (CMPA). Term infants aged 1–8 months with moderate-to-severe CMPA were enrolled. The study formula was an AAF supplemented with 2′-fucosyllactose (2′-FL) and lacto-N-neotetraose (LNnT). Infants were fed the study formula for 4 months and were offered to remain on the formula until 12 months of age. Tolerance and safety were assessed throughout the trial. Out of 32 infants (mean age 18.6 weeks; 20 (62.5%) male), 29 completed the trial. During the 4-month principal study period, the mean weight-for-age Z score (WAZ) increased from –0.31 at the baseline to +0.28 at the 4-months’ follow-up. Linear and head growth also progressed along the WHO child growth reference, with a similar small upward trend. The formula was well tolerated and had an excellent safety profile. When comparing the microbiome at the baseline to the subsequent visits, there was a significant on-treatment enrichment in HMO-utilizing bifidobacteria, which was associated with a significant increase in fecal short-chain fatty acids. In addition, we observed a significant reduction in the abundance of fecal Proteobacteria, suggesting that the HMO-supplemented study formula partially corrected the gut microbial dysbiosis in infants with CMPA.

Parenting Mothers with Stunting Toddlers at Banjangkaran II Community Health Center: A Qualitative Study

Stunting is an overview of stunted growth as a result of a lack of nutrient intake in the long term. According to the WHO Child Growth Standard, stunting is based on the index of body length for age (PB/U) or height for age (TB/U) with a limit (z-score) of less than -2 SD. This study will describe the pattern of parenting and the incidence of stunting in toddlers with UPTD. Banjarangkan II Community Health Center. This research is an observational study using a qualitative approach with a cross-sectional study design. This research was conducted on 8 mothers of stunting toddlers in the UPT working area. Banjarangkan II Community Health Center The instruments used in this study was an in-depth interview guide and observations on feeding habits, parenting habits, hygiene habits, and habits of receiving health services, as well as measuring children's height. In this study, it was found that the parenting pattern of mothers with stunting toddlers was still not good, seen in the habits of feeding, caregiving, hygiene, and getting health services. It is necessary to increase a mother's knowledge about parenting, both from feeding habits, caregiving, hygiene, and getting health services.

THE INFLUENCE OF SHORT MATERNAL HEIGHT ON STUNTING CHILDREN

Stunting is a condition of chronic malnutrition caused by inadequate nutritional intake over a long period. This condition is represented by a child's height based on age less than minus 2 standard deviations (&lt;-2SD) from the WHO Child Growth Standard. Stunting has long-term effects on children's health and intelligence. This study aims to analyze the effect of short maternal height on the incidence of stunting in the working area of the Raci Health Center. An observational analytic study with a case control approach was conducted in March-May 2021. The research sample consist of 130 mothers and children according to the inclusion and exclusion criteria and using purposive sampling technique. The independent variable in this study was maternal height and the dependent variable was stunting. Chi square statistical test was used to determine the level of significance in the data. Bivariate result showed that maternal height affected the incidence of stunting with ρ =0.003 and OR=3.222. Mother's height is a risk factor for stunting in children in the working area of Raci Health Center.

Prevalence and associated factors for stunting, underweight and wasting among children under 6 years of age in rural Hunan Province, China: a community-based cross-sectional study

BackgroundThe existing epidemiological data cannot represent the situation of undernutrition among Chinese children, particularly those in rural China. Hence, in this community-based cross-sectional study, the prevalence and associated factors of stunting, underweight and wasting among children (age < 6 years) from rural Hunan Province were analyzed.MethodsTotally 5529 children aged 0 to 71 months and their caregivers were randomly chosen by multistage stratified cluster sampling from 72 villages from rural Hunan, which were distributed in 24 towns of 12 counties. Data about the children and their mothers, caregivers and family conditions was acquired using unified questionnaire, and the length/height and weight of each child were measured using unified instruments. The prevalence of undernutrition among children was evaluated using the length/height for age, weight for age, weight for length/height, and body mass index for age z scores, which were computed according to the 2006 and 2007 WHO Child Growth Standards.ResultsThe prevalence of stunting, underweight, and wasting among the 5529 children were 4.4% (241), 3.9% (217), and 4.0% (221), respectively. The significant associated factors on higher risks of undernutrition in the children were low birth weight, maternal gestational weight gain <10 kg (stunting); low birth weight, maternal gestational weight gain <10 kg, ethnicity of caregivers being minority, large family size (underweight); low birth weight, ethnicity of caregivers being minority, large family size (wasting). High education level of caregivers and high family food expenditure were common protective factors for all three types of undernutrition, except that high family food expenditure was not protective against wasting.ConclusionsThe prevalence of stunting, underweight and wasting is low among rural children under age of 6 years in Hunan. As for the measures, the gestational care and reasonable diet of mothers should be strengthened, and nutritional deficiency during pregnancy be avoided, which will prevent low birth weight. The local economic development and the education level of caregivers need to be further improved, especially for minorities.

Overnutrition in Indian Children: Challenges and Opportunities.

Global and Indian data indicate that children from all the segments of population face dual nutrition burden and related health consequences. Long-term cohort studies have shown that both the under- and overnutrition are risk factors for overnutrition and non-communicable diseases in adult life. Halting the rise in overnutrition is one of the Sustainable Development Goal (SDG) targets to be achieved by 2030. With the development and inclusion of body mass index (BMI)-for-age in the WHO child growth standards, it has become possible to assess over- and undernutrition in short-statured children. In India, the Annual Health Survey (AHS) (2014) and the District Level Household Survey 4 (DLHS4) (2013) undertook measurement of height/length and weight (AHS 557016 and DLHS4 295663) in the 0–18-year of school-age children from selected households. Prevalence of overnutrition in 0–18-year children was calculated from these two surveys by using the WHO standards for BMI-for-age (BMI-for-age z scores (BAZ) > +2 in 0–5 and BAZ > +1 in 5–18-year children) as well as uniform norms of either > +1 or > +2 BAZ across 0–18-year children. An attempt was made to explore the policy and program implications of using different norms for assessing overnutrition in preschool and school age children in the Indian context. Body mass index-for-age curve for the 0–18-year Indian children was calculated and compared with the WHO BMI-for-age curve. Across 0–18-year children, the mean BMI-for-age of Indian boys and girls was lower than the mean of the WHO standards, but the trajectory followed was similar. Therefore, Indian high-risk under- and overnourished children can be monitored by using the WHO BMI-for-age curve. Irrespective of the cutoff used for BMI-for-age, prevalence of overnutrition was higher in preschool as compared to school-age children. Overnourished school-age children outnumbered preschool children, especially if the WHO cutoffs were used. The school health system may find it difficult to implement programs that aimed at detection and management of large number of overnourished children. If uniform norm of BAZ > +1 was used, prevalence of overnutrition in preschool children was high and almost similar to undernutrition. Currently, nutrition programs for preschool children are focused on undernutrition and they may find it difficult to manage program focused on overnutrition in large number of children. If the uniform norm of BAZ > +2 was used, both the prevalence of overnutrition and number of children requiring intervention were relatively low in all the age groups. The existing preschool and school nutrition programs can take up an integrated program aimed at early detection and effective management of both the under- (BAZ < −2) and overnutrition (BAZ > +2) in 0–18-year children and strive to achieve the SDG targets.

The Influence of Treatment with Ledipasvir/Sofosbuvir on Growth Parameters in Children and Adolescents with Chronic Hepatitis C.

Background: There are limited data available on the influence of direct-acting antivirals used to treat chronic hepatitis C (CHC) on growth in children. In this study, we aimed to analyze the growth parameters in children treated with ledipasvir/sofosbuvir (LDV/SOF). Methods: We included 38 patients (16 girls and 22 boys) aged 10–17 years treated with LDV/SOF for CHC (33 infected with genotype 1 and 5 with genotype 4; 36 were treated for 12 weeks, and 2 for 24 weeks according to the current guidelines). Patient weight and height were measured at baseline, after 4 weeks of treatment, at the end of the treatment (EOT), and 12 weeks and one year after the EOT. Body mass index (BMI), BMI z and height-for-age (HA) z scores were calculated according to the WHO Child Growth Standards and Growth reference data using the WHO anthropometric calculator AnthroPlus v. 1.0.4. In addition, correlations between BMI z scores and liver fibrosis (liver stiffness measurement, LSM), the aspartate transaminase (AST)-to-platelet ratio index (APRI), fibrosis-4 index (FIB-4) and liver steatosis (controlled attenuation parameter, CAP) were analyzed. Results: At baseline, 5/38 (13%) patients were obese (BMI z score > 2 SD), 4/38 (11%) were overweight, and 29 (76%) were normal. A significant increase was observed in mean weight, height and BMI both 12 weeks and one year after the treatment compared to the baseline, whereas no differences were observed for BMI z scores and HA z scores. Baseline BMI z scores correlated with alanine aminotransferase levels (r = 0.33, 95% CI 0.01–0.58, p = 0.04), LSM (r = 0.40, 95% CI 0.09–0.65, p = 0.01), the APRI (r = 0.33, 95% CI 0.02–0.59, p = 0.03), and the CAP (r = 0.40, 95% CI 0.08–0.64, p = 0.01). No similar correlations were reported at 12 weeks posttreatment. Conclusions: Treatment with LDV/SOF in children with CHC (genotypes 1 and 4) did not negatively influence the patients’ growth. However, higher baseline BMI z scores correlated with more advanced liver fibrosis and steatosis in children with CHC.

The Consecutive 3-month Length Increment to Predict Early Linear Growth Failure

AIM: This study aimed to assess the consecutive 3-month length increment thresholds, by the first 6 months, to predict stunted at the age of 6 months. METHODS: We analyzed data from the Bogor Longitudinal Study on Child Growth and Development in West Java, Indonesia. A total of 635 free of stunting at birth children were analyzed in this study. Early linear growth faltering, as the dependent variable, was the stunted at 6 months of age. The four thresholds of the consecutive 3-month length increment were considered in predicting stunted at the age of 6 months. The thresholds were a consecutive 3-month length increment below 25th percentile, 15th percentile, and 5th percentile of the WHO Child Growth Velocity Standard. The 4th threshold was generated from the Bogor Longitudinal Study sample and determined using receiver operating characteristic analysis. The sensitivity, specificity, PPV, and NPV of the thresholds were calculated. RESULTS: Among the thresholds, the 25th percentile of the WHO Child Growth Velocity Standard generates the highest sensitivity. The ability of the 25th percentile threshold to correctly identify children who had stunting at 6 months of age is 56.7%. However, the children whose experience a consecutive 3-month length increment below 15th percentile had highest risk to become stunted at the age of 6 months, adjusted by sex, birthweight, and birth length. CONCLUSION: A consecutive 3-month length increment could be beneficial as a tool in identifying infants at high risk of early linear growth failure in stunted prevalent population.

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.

Rapid Growth in Malnutrition Children Associated with Higher Systolic Blood Pressure in Adolescent

BACKGROUND: Several studies found that children experiencing rapid growth earlier in life might increase the risk of chronic disease. Cardiovascular disease and hypertension are common risk factors and have been the leading cause of death worldwide. However, studies investigating the effects of rapid growth in early life on blood pressure later in life are limited. AIM: This study aimed to analyze the association between rapid growth after the first 1000 days of life and blood pressure at 17−19 years old. METHODS: We analyzed 17-year follow-up cohort using secondary data from the Indonesian Family Life Survey from the second (1997), third (2000), and fifth wave (2014). The survey was conducted in 13 provinces in Indonesia. No more than 672 children under 2 years old were included in the study. Rapid growth was defined as an alteration in length or height-per-age and weight-per-age z-score, based on WHO Child Growth Standard, on 1997 and 2000 time frame which was greater than 0.67, experienced by children with malnutrition (low birth weight, stunted, underweight, and wasting). Blood pressure was measured three times by an oscillometric method in 2014. In addition, we used a one-way ANOVA (analysis of variance) test to assess the association of rapid growth on systolic blood pressure. RESULTS: Malnutrition children at 0-2-year-old that grow rapidly in length or height, had higher systolic blood pressure than normal children (p = 0.029). In contrast, there was no difference observed in systolic blood pressure in children with malnutrition and children who did not experience rapid growth in weight. CONCLUSIONS: Children who had a history of malnutrition earlier in life (0−23 months) and had rapid growth in length or height after the first 1000 days of life had higher systolic blood pressure than normal children and children with malnutrition who did not grow rapidly.

НУТРИТИВНЫЙ СТАТУС И КОМПОНЕНТНЫЙ СОСТАВ ТЕЛА ШКОЛЬНИКОВ 6-7 КЛАССОВ Г. ХАНТЫ-МАНСИЙСКА

The purpose of ̶assessment of the health and healthy lifestyle of schoolchildren of grades 6-7 of secondary schools in Khanty-Mansiysk based on the results of the analysis of physical development and nutritional status. In 411 children aged 11-14 years, body mass index and standard deviation from the reference median of WHO Child Growth Standards and body component composition were determined using the ABC-01 Medass bioimpedance analyzer in 59 children. It was revealed with a normal level of nutrition - 53.3% of the subjects, with overweight - 17.7%, with obesity - 14.4%, with reduced nutrition ̶12.4% and with malnutrition ̶2.2%. Obesity was more common among boys (64.4%). In children with excessive nutrition and obesity, significantly high indicators of fat mass, a decrease in the proportion of musculoskeletal mass, and impaired distribution of subcutaneous fat were revealed. In 16% of children with elevated BMI, the results of the fat content were within normal limits. Findings. The method of bioimpedansometry is indicated for children and adolescents with high BMI for the assessment of body fat mass and the diagnosis of obesity.

Assessment of dietary diversity and nutritional support for children living with HIV in the IeDEA pediatric West African cohort: a non-comparative, feasibility study

BackgroundNutritional care is not optimally integrated into pediatric HIV care in sub-Saharan Africa. We assessed the 6-month effect of a nutritional support provided to children living with HIV, followed in a multicentric cohort in West Africa.MethodsIn 2014-2016, a nutritional intervention was carried out for children living with HIV, aged under 10 years, receiving antiretroviral therapy (ART) or not, in five HIV pediatric cohorts, in Benin, Togo and Côte d’Ivoire. Weight deficiency was assessed using two definitions: wasting (Weight for Height Z-score [WHZ] for children<5 years old or Body-Mass-Index for Age [BAZ] for ≥5 years) and underweight (Weight for Age Z-score [WAZ]) (WHO child growth standards). Combining these indicators, three categories of nutritional support were defined: 1/ children with severe malnutrition (WAZ and/or WHZ/BAZ <-3 Standard Deviations [SD]) were supported with Ready-To-Use Therapeutic Food (RUTF), 2/ those with moderate malnutrition (WAZ and/or WHZ/BAZ = [-3;-2[ SD) were supported with fortified blended flours produced locally in each country, 3/ those non malnourished (WAZ and WHZ/BAZ ≥-2 SD) received nutritional counselling only. Children were followed monthly over 6 months. Dietary Diversity Score (DDS) using a 24h recall was measured at the first and last visit of the intervention.ResultsOverall, 326 children were included, 48% were girls. At baseline, 66% were aged 5-10 years, 91% were on ART, and 17% were severely immunodeficient (CD4 <250 cells/mL or CD4%<15). Twenty-nine (9%) were severely malnourished, 63 (19%) moderately malnourished and 234 (72%) non-malnourished. After 6 months, 9/29 (31%) and 31/63 (48%) recovered from severe and moderate malnutrition respectively. The median DDS was 8 (IQR 7-9) in Côte d’Ivoire and Togo, 6 (IQR 6-7) in Benin. Mean DDS was 4.3/9 (sd 1.2) at first visit, with a lower score in Benin, but with no difference between first and last visit (p=0.907), nor by intervention groups (p-value=0.767).ConclusionsThis intervention had a limited effect on nutritional recovery and dietary diversity improvement. Questions remain on determining appropriate nutritional products, in terms of adherence, proper use for families and adequate energy needs coverage for children living with HIV.Trial registrationPACTR202001816232398, June 01, 2020, retrospectively registered.

Penyuluhan Kesehatan Cegah Stunting dengan Perbaikan Pola Makan, Pola Asuh Dan Sanitasi pada Ibu Hamil di UPT Puskesmas Antang

: Stunting is a chronic malnutrition problem caused by lack of nutritional intake for a long time, resulting in growth disorders in children, namely the child's height is lower or shorter (short) than the standard age. The condition of a child's short body is often said to be a hereditary factor (genetic) from both parents, so that many people just accept it without doing anything to prevent it. In fact, as we all know, genetics is a determinant of health that has the least effect when compared to behavioral, environmental (social, economic, cultural, political) factors and health services. In other words, stunting is a preventable problem. Stunting is a growth failure problem experienced by infants under 5 years of age who are malnourished since in the womb until the baby is born. Assessment of stunting nutritional status can be done through anthropometric measurements of TB/U classified through nutritional classification status. Stunting is a condition where the child's height is shorter than the height of children his age. According to UNICEF, stunting occurs in children aged 0 to 59 months with a height below minus (moderate and severe stunting) and minus three (chronic stunting) measured from the WHO child growth standards. In Indonesia, stunting is still a health problem in quite a large number. Based on the 2013 Basic Health Research, around 37.2 percent of Indonesian children under the age of 5 are stunted.

A case-control study on body composition of teenagers with adolescent idiopathic scoliosis

Abstract Background Adolescent idiopathic scoliosis (AIS) is the most common form of spinal abnormality. It affects about 2-3% of all teenagers. Its etiology remains unknown but studies suggest that multiple factors may play a role. A growing body of evidence supports the role of body composition abnormalities including low body mass index (BMI) and low body fat percentage (BF%) as risk factors for AIS development. This study aimed to evaluate these indicators in a group of teenagers with AIS and compare them to age and gender-matched controls. Methods The study included 98 adolescents with AIS and 73 controls aged 11-18 years from Varna, Bulgaria. Data was collected after receiving informed consent from the parents. Data on AIS diagnosis and severity was collected from the available medical documentation. Anthropometrics were measured using calibrated Tanita BC-420MA (ISSO 9001) and following ESPEN guidelines. BMI for age and BF% for age were estimated using WHO Child Growth Standards and BF% reference curves for children. Results In the AIS group, 15% were underweight with BMI for age under -2SD. 11% were above +1SD indicating a risk of overweight or obesity. In comparison, 7% of the control group were underweight while 32% were at risk of being overweight or obese. There is a statistically significant difference between the BMI for age in the two groups (χ2=19.564 Đ¿рĐ, p &amp;lt; 0.005). In the AIS group, 47% had BF% for age under the 2nd percentile indicating underfat, while 7% of AIS cases had BF% for age above the 85th percentile indicating they are overfat or obese. In comparison, 15% of the control group were underfat while 19% were overfat or obese. There is a statistically significant difference between the BF% for age in the two groups (χ2=21,504 Đ¿рĐ, p &amp;lt; 0.001). Conclusions Children with AIS are more likely to be underweight and underfat compared to their healthy peers. Cases of having a high BF% and being overweight or obese are scarce amongst AIS patients. Key messages The majority of children with AIS have abnormal body composition compared to healthy age and gender-matched controls. Aspects of the nutritional status may play a role in the etiology of AIS. Children with low body fat might be at a higher risk of developing AIS. AIS screening programs should be directed towards underweight children.

Household Food Security Access and Nutritional Status among Early Adolescents in a Poor Neighborhood of Sinamangal, Nepal.

ABSTRACTBackgroundEarly adolescence is an important period of the life cycle wherein the food system plays a critical role in protecting food security as well as the nutritional needs essential for a healthy transition from childhood to adulthood. Despite the surging concerns regarding the food and nutrition security of adolescents throughout the nation, people in a poor neighborhood are often neglected and considered the most vulnerable.ObjectivesThis research aims to assess the status of household food security and nutritional status among early adolescents living in a poor neighborhood of Kathmandu, Nepal.MethodsUsing a cross-sectional study design, data was collected with the Household Food Insecurity Access Scale (HFIAS) tool. Nutritional status was measured using the WHO Child Growth Standard Reference 2007 Statistical Software for Social Science (SPSS) macro package based on BMI-for-age z-score, height-for-age z-score, and weight-for-age z-score, respectively. Data were entered in a predetermined format of SPSS version 20.0 and imported into STATA version 13.1 for univariate and bivariate analyses. Ethical approval was sought from the Ethical Review Board of Nepal Health Research Council (NHRC) prior to the study.ResultsMore than one-fifth (21%) of the households were food insecure. Based on BMI-for-age, 5.5% of the adolescents were found to be moderately undernourished and 2.6% were severely undernourished. The percentage of moderately and severely stunted adolescents were 8.4% and 5.8%, respectively, based on height-for-age. Based on weight-for-age, moderately and severely underweight adolescents accounted for 13.0% and 1.3% of the total.ConclusionThe prevalence of underweight, stunting, and wasting among early adolescents was high. The households in a poor neighborhood were also experiencing some form of food insecurity. This calls for targeted efforts to address malnutrition and improve the nutritional status of early adolescents, particularly in poor neighborhoods.

Marasmus and stunting in 2-month-old boy with pneumatocele

BackgroundNutrition is essential for humans and if inadequate may lead to undernutrition. Undernourished children are very susceptible to infections, such as pneumonia, one of its complications being pneumatocele, which is a more severe condition. Pulmonary pneumatoceles are thin-walled, air-filled cysts that develop within the lung parenchyma and have been found in 2.4 percent of 493 infants and children with pneumonia. However, in staphylococcal pneumonias, the frequency of pneumatocele can reach as high as 85 percent. Infants and young children are more likely to have pneumatoceles. It is critical to distinguish marasmus with pneumatocele from many other similar diagnoses. Failure to recognize can lead to incorrect diagnosis and treatment, causing more harm than good to patient care. This case highlights the importance of maintaining a high suspicion of pneumonia in neonates even with normal radiological findings and of searching for pneumatoceles. Case DescriptionWe report a case of marasmus and stunting accompanied by pneumatocele in a 2-month-old boy. The diagnosis was made based on history, physical examination, anthropometric examination using the WHO child growth standards, laboratory tests, and radiological imaging. Management of the patient was according to a multidisciplinary system including antibiotics administration and wasting management. ConclusionPneumatoceles are serious complications after pneumonia. Pneumonia is common in children with marasmus. Children with marasmus are caused by various underlying factors. The progression begins in the womb and continues through the first 1000 days of life.

The Mothers, Infants, and Lactation Quality (MILQ) Study: A Multi-Center Collaboration.

ABSTRACTLittle valid information is available on human milk nutrient concentrations, especially for micronutrients (MNs), and there are no valid reference values (RVs) across lactation. In this multi-center collaborative study, RVs will be established for human milk nutrients across the first 8.5 mo postpartum. Well-nourished, unsupplemented women in Bangladesh, Brazil, Denmark, and The Gambia (n = 250/site) were recruited during the third trimester of pregnancy. Milk, blood, saliva, urine, and stool samples from mothers and their infants are collected identically at 3 visits (1–3.49, 3.5–5.99, 6.0–8.49 mo postpartum). Milk analyses include macronutrients, selected vitamins, trace elements and minerals, iodine, metabolomics, amino acids, human milk oligosaccharides, and bioactive peptides. We measure milk volume; maternal and infant diets, anthropometry, and morbidity; infant development, maternal genome, and the infant and maternal microbiome. RVs will be constructed based on methods for the WHO Child Growth Standards and the Intergrowth-21st Project. This trial was registered at clinical trials.gov as NCT03254329.