WHO Child Growth Research Articles

Nutritional status and concomitant factors of stunting among pre-school children in Malda, India: A micro-level study using a multilevel approach

BackgroundMalnutrition was the main cause of death among children below 5 years in every state of India in 2017. Despite several flagship programmes and schemes implemented by the Government of India, the latest edition of the Global Nutrition Report 2018 addressed that India tops in the number of stunted children, which is a matter of concern. Thus, a micro-level study was designed to know the level of nutritional status and to study this by various disaggregate levels, as well as to examine the risk factors of stunting among pre-school children aged 36–59 months in Malda.MethodA primary cross-sectional quantitative survey was conducted using structured questionnaires following a multi-stage, stratified simple random sampling procedure in 2018. A sum of 731 mothers with at least one eligible child aged 36–59 months were the study participants. Anthropometric measures of children were collected following the WHO child growth standard. Children were classified as stunted, wasted, and underweight if their HAZ, WHZ, and WAZ scores, respectively, were less than −2SD. The random intercept multilevel logistic regression model has been employed to estimate the effects of possible risk factors on childhood stunting.ResultsThe prevalence of stunting in the study area is 40% among children aged 36–59 months, which is a very high prevalence as per the WHO’s cut-off values (≥40%) for public health significance. Results of the multilevel analysis revealed that preceding birth interval, low birth weight, duration of breastfeeding, mother’s age at birth, mother’s education, and occupation are the associated risk factors of stunting. Among them, low birth weight (OR 2.22, 95% CI: 1.44–3.41) and bidi worker as mothers’ occupation (OR 1.92, 95% CI: 1.18–3.12) are the most influencing factors of stunting. Further, about 14 and 86% variation in stunting lie at community and child/household level, respectively.ConclusionSpecial attention needs to be placed on the modifiable risk factors of childhood stunting. Policy interventions should direct community health workers to encourage women as well as their male partners to increase birth interval using various family planning practices, provide extra care for low birth weight baby, that can help to reduce childhood stunting.

Safety and Tolerance of a Novel Anti-Regurgitation Formula: A Double-Blind, Randomized, Controlled Trial.

ABSTRACTObjectives:A novel anti-regurgitation (AR) formula has been designed to support gut health and improve gastrointestinal (GI) symptoms beyond regurgitation. This study assessed the tolerance and safety of this new AR formula.Methods:This was a 4-week double-blind, randomized, controlled trial with a 4-week extension in formula-fed infants with regurgitation. The new AR (Test) formula contained 0.4 g/100 mL locust bean gum (LBG) as thickener, partly fermented formula with postbiotics, and short-chain galacto-oligosaccharides (scGOS) and long-chain fructo-oligosaccharides (lcFOS) (0.4 g/100 mL, ratio 9:1). The Control AR formula contained LBG (0.4 g/100 mL) with postbiotics and has a history of safe use. The primary outcome was the Infant Gastrointestinal Symptom Questionnaire (IGSQ) sum score including stooling, spitting-up/vomiting, crying, fussiness and flatulence.Results:All 182 infants screened were enrolled in the study. The primary analysis showed the equivalence of the IGSQ sum scores at Week 4 between groups. IGSQ sum scores improved significantly within 1 week (Mixed Model Repeated Measurement [MMRM], P < 0.001). Post-hoc analyses showed a bigger improvement of the IGSQ score in the Test (n = 38) versus Control (n = 44) group (MMRM, P = 0.008) in infants with more severe gastrointestinal (GI) symptoms (IGSQ score ≥35). Stool characteristics were comparable between groups. Growth related z scores were in line with the WHO child growth standards and both groups showed improvement of regurgitation. Adverse events did not show any safety concerns.Conclusions:The novel AR formula combining LBG, scGOS/lcFOS and postbiotics is well-tolerated, safe and supports adequate growth during the intervention. Post-hoc analyses suggest that the formula results in more improvement of GI symptom burden in infants with more severe symptoms.

Growth and development of children under 5\xa0years of age with tetralogy of Fallot in a Chinese population

Congenital Heart Defects (CHDs) are associated with different patterns of malnutrition and growth retardation, which may vary worldwide and need to be evaluated according to local conditions. Although tetralogy of Fallot (TOF) is one of the first described CHDs, the etiology outcomes in growth and development of TOF in early age child is still unclear in most cases. This study was designed to investigate the growth retardation status of Chinese pediatric TOF patients under 5 years old. The body height, body weight and body mass index (BMI) of 262 pediatric patients (138 boys and 124 girls) who underwent corrective surgery for TOF between 2014 and 2018 were measured using conventional methods. The average body height, body weight and BMI of the patients were significantly lower than WHO Child Growth Standards, while the most affected was body height. Meanwhile, higher stunting frequency and greater deterioration of both the body height and weight happened in elder age (aged 13–60 months) rather than in infant stage (aged 0–12 months) among these patients. Our results confirmed that intervention should be given at early age to prevent the growth retardation of TOF patients getting severer.

Maternal complementary feeding practices and anthropometric status of children (6-23 months) in Abakaliki Nigeria, a facility based study

Sub-optimal complementary feeding practices among children aged 6-23 months is a major cause of under-nutrition in developing countries. This study was designed to assess the complementary feeding practices and nutritional status of children 6-23 months attending an immunization clinic at Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria. The study was descriptive and cross-sectional in design. A total of 320 children were selected using a two-stage sampling technique. WHO/PAHO/UNICEF recommendations and WHO Child Growth Standard charts were used to categorize their complementary feeding and anthropometric indices, respectively. Statistical analysis was performed using descriptive statistics and inferential statistics. Complementary feeding indicators such as timely complementary feed introduction (54.1%) and minimum dietary diversity (68.7%) were met by more than half of the respondents. But overall, complementary feeding practices were considerably poor. Low minimum meal frequency, minimum adequate diet and continued breastfeeding at one year were reported. Wasting, stunting and underweight prevalences were 12.5%, 11.3% and 8.3% respectively. Children who continued breastfeeding at one year (AOR = 0.34; CI= 0.15-0.76) or met minimum dietary diversity criteria (AOR = 0.43; CI= 0.17-1.05) were less likely to be stunted. Increased attention towards breastfeeding continuation and dietary diversity improvement using locally available/affordable food stuffs is needed.

Multilevel analysis of risk factors associated with severe underweight among children under 5 years: evidence from the 2014 Ghana Demographic and Health Survey

Background: Undernutrition among children &lt;5yr. is a global public health problem, especially in developing countries like Ghana. Undernutrition increases the risk of child morbidity and mortality. There is paucity of data on household-level effects on severe underweight and associated factors. Objective: The study investigated the risk factors associated with severe underweight among children &lt; 5yr.in Ghana and examined unobserved differences across households based on the 2014 Ghana Demographic and Health surveys (GDHS) data. Methods: Data from a population-based cross-sectional study was obtained from the 2014 Ghana Demographic and Health Survey. Data on 2720 children nested within 1972 households was extracted for analysis. Our regression analysis used data on 2716 children with complete data on the outcome and risk factors. Children with weight-for-age Z-score below -3 standard deviations were classified as severely underweight based on the 2006 WHO child growth standards. We applied random intercept multilevel logistic regression to examine whether severe underweight status in children differ across households while simultaneously identifying potential risk factors. Results: A total of 2720 children had valid weight-for-age z-score and 53 (1.95%) of them were identified as severely underweight. In the univariate model, child level variables such as multiple birth [odds ratio (OR), 4.03;95%confidence interval (CI): 1.85-8.76]and child born average (OR, 2.17;95%CI: 1.09-4.32) or small (OR, 4.08; 95%CI: 2.01-8.28) in size at birth are associated with increased odds of severe underweight. Maternal/household level variables such as increase in number of children below 5 yr. (OR, 1.61; 95%CI: 1.28-2.04), poorest households (OR, 4.85; 95%CI: 1.14-20.59) and increase in number of births in last 5 yr. (OR, 1.80, 95%CI: 1.24-2.60) were associated with increased odds of severe underweight. Increase in maternal years of education (OR, 0.89; 95%CI: 0.83-0.95) was associated with reduced odds of severe underweight. In the multilevel logistic model, only type of birth (OR, 1.61;95%CI: 1.28-2.04), size of child (average: OR, 2.12;95%CI: 1.04-4.33; small: OR, 3.87;95%CI: 1.80-8.33) at birth, and maternal education (OR, 0.92;95%CI: 0.84-1.00) were independently associated with severe underweight. There were no significant residual household-level variations in severe underweight status. Conclusion: Our findings suggest that improving maternal education, socioeconomic conditions of families, and family planning are critical in addressing severe underweight

HUBUNGAN TINGKAT PENDIDIKAN IBU DAN PEMBERIAN ASI EKSKLUSIF DENGAN KEJADIAN STUNTING PADA BALITA DI PUSKESMAS SUNGAI LEKOP KOTA BATAM

Stunting is impaired growth and development that children experience from a number of impacting factors with poor nutrition being one of them. 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 report of the Health Office of Batam in 2018, out of 20 puskesmas (community clinics) in the region, five of them recorded the highest prevalence of stunting among toddlers with Puskesmas Sei Lekop being the highest hitting 110 reported cases (0.89%). This research aims to discover the correlations between mother’s educational background and exclusive breastfeeding practice on the toddlerhood stunting prevalence in Puskesmas Sei Lekop, Batam, in 2019.The research design employs analytic method with cross-sectional approach. Conducted from April to August 2019, the research involves 97 respondents in total. The data analyzing technique employs chi-square. The findings reveal the correlations between mother’s educational background and the stunting prevalence among toddlers with ρ-value 0.01 < 0.05; and between exclusive breastfeeding practice and the stunting prevalence among toddlers with ρ-value 0.00 < 0.05. In conclusion, the findings confirm the correlations between mother’s educational background and exclusive breastfeeding practice on the stunting prevalence among toddlers. In suggestion, the following researchers who are interested in studying similar subject are expected to develop more detailed parametric variables and investigate other possible factors that may contribute or are related to stunting issues .

WHO Child Growth Standards in context: The Baby–bod Project - Observational study in Tasmania

ObjectiveThis research evaluated (1) differences in body size and composition of Tasmanian infants at birth and 3 and 6 months postpartum compared with WHO child growth standards and (2) body...

160-OR: Increased Adiposity and Low Height-for-Age in Early Childhood Is Associated with Later Metabolic Risk in American Indian Children and Adolescents

Background: Growth abnormalities in early childhood have been related to later metabolic risk, but little is known about these associations in populations at high risk of diabetes. Methods: We linked anthropometric data collected at ages 0-&amp;lt;5 y from 2928 routine clinical examinations conducted 1990-2000 to metabolic data from a longitudinal study in a southwestern American Indian population at high risk of diabetes. A total of 701 participants with ≥1 follow-up examination at ages 5-16 y were included. We derived age and sex-specific z-scores (from WHO Child Growth Standards) of weight-for-height (WHZ) and height-for-age (HAZ) at ages 0-&amp;lt;5 y. We selected the highest observed WHZ and the lowest HAZ and analyzed associations of categories of WHZ and HAZ with metabolic data at ages 5-9 y and 10-16 y. Linear mixed effects models were used to account for repeated measures. Results: In age and sex-adjusted models, overweight and obesity (WHZ &amp;gt; 2) at ages 0-&amp;lt;5 y was significantly associated with higher BMI and with greater height at ages 5-16 y relative to normal weight (WHZ ≤ 1). It was also associated with increased fasting glucose, 2-h glucose, fasting insulin, 2-hr insulin, total cholesterol, triglycerides, SBP, DPB and decreased HDL. For example, at ages 5-9 y 2-h glucose was 10.4 mg/dl higher (95% CI: 5.6, 15.3) and fasting insulin was 1.88 times higher (95% CI: 1.58, 2.24). Associations were attenuated and no longer significant when adjusted for BMI. Low height-for-age (HAZ&amp;lt; -2) at ages 0-&amp;lt;5 y was associated with lower BMI and lower height at ages 5-16 y relative to normal height (HAZ ≥ 0). With adjustment for BMI, low height-for-age was associated with 1.40 times higher 2-h insulin (95% CI: 1.05, 1.87) and 5.47 mg/dL lower HDL (95% CI: 2.68, 8.62) at ages 10-16 y. Conclusion: These analyses suggest that both overweight/obesity and low height-for-age in early childhood can influence subsequent metabolic risk in American Indian children and adolescents. Disclosure M. J. Ramirez-luzuriaga: None. S. Kobes: None. M. Sinha: None. W. C. Knowler: None. R. L. Hanson: None.

Micronutrient Status and Child Growth in Mexico: Results From the 2018 National Health and Nutrition Survey (ENSANUT)

ObjectivesTo examine the associations between micronutrient status and child growth, as part of the National Health and Nutrition Survey in Mexico. MethodsData from the National Health and Nutrition Survey (ENSANUT 2018) were analyzed to examine the association between micronutrient status and child growth in 1,656 children 36 to 59 months of age. Micronutrient biomarkers (serum ferritin (SF), vitamin B12, vitamin D, serum zinc) were measured in venous blood samples via immunoassays. Child weight and height were measured using standardized procedures, and indicators weight-for-age (WAZ), height-for-age (HAZ), weight-for-height (WHZ), and body mass index (BMI) Z-scores were calculated using the WHO Anthro V3.1 and categorized as per WHO Child Growth Standards. Micronutrient biomarkers were natural logarithmically transformed prior to analyses. Iron deficiency was defined as SF < 12.0 μg/L and iron insufficiency was defined as SF < 20.0 μg/L. Vitamin B12 deficiency and insufficiency were defined as < 148 and < 221 pmol/L, respectively. Vitamin D deficiency was defined as < 50 nmol/L, and zinc deficiency was defined as < 65μg/dL. Survey linear regression models were used to examine associations of micronutrient status with WHO Z-scores. ResultsSerum ferritin concentrations (β [SE]: 0.096 [0.001], p < 0.0001) and vitamin B12 (0.092 [0.003], p < 0.0001) concentrations were associated with higher WHZ. Vitamin B12 (0.171 [0.004], p < 0.0001), vitamin D (0.358 [0.007], p < 0.0001), and zinc (0.122 [0.006], p < 0.0001) concentrations were associated with higher HAZ. Iron deficiency (β [SE]: -0.469 [0.004], p < 0.0001) and zinc deficiency (-0.203 [0.01], p < 0.0001) were associated with lower WHZ, and vitamin B12 (-0.449 [0.002], p < 0.0001), vitamin D (-0.215 [0.001], p < 0.0001) and zinc (-0.216 [0.01], p < 0.0001) deficiencies were associated with lower HAZ. ConclusionsMicronutrient deficiencies of vitamin B12, vitamin D, and zinc were associated with lower linear growth in young children in Mexico. Funding SourcesENSANUT was funded by The Ministry of Health of Mexico.

Delivery mode and altered infant growth at 1 year of life in India

BackgroundCesarean section (C-section) delivered infants are more likely to be colonized by opportunistic pathogens, resulting in altered growth. We examined whether C-section (elective/emergency) vs vaginal delivery was associated with altered weight and linear growth at 1 year of life.MethodsA total of 638 mother–infant pairs were included from MAASTHI cohort 2016–2019. Information on delivery mode was obtained from medical records. Based on WHO child growth standards, body mass index-forage z-score (BMI z) and length-for-age z-score (length z) were derived. We ran multivariable linear and Poisson regression models before and after multiple imputation.ResultsThe rate of C-section was 43.4% (26.5%: emergency, 16.9%: elective). Percentage of infant overweight was 14.9%. Compared to vaginal delivery, elective C-section was associated with β = 0.57 (95% CI 0.20, 0.95) higher BMI z. Also infants born by elective C-section had RR = 2.44 (95% CI 1.35, 4.41) higher risk of being overweight; no such association was found for emergency C-section. Also, elective C-section delivery was associated with reduced linear growth at 1 year after multiple imputation (β = −0.38, 95% CI −0.76, −0.01).ConclusionsElective C-section delivery might contribute to excess weight and also possibly reduced linear growth at 1 year of age in children from low- and middle-income countries.ImpactOur study, in a low-income setting, suggests that elective, but not emergency, C-section is associated with excess infant BMI z at 1 year of age and elective C (C-section) was also associated with altered linear growth but only in multiple imputation analyses.Elective C-section was associated with a higher risk of being overweight at 1 year of age.Our results indicate that decreasing medically unnecessary elective C-section deliveries may help limit excess weight gain and stunted linear growth among infants.

A novel development indicator based on population-average height trajectories of children aged 0–5 years modelled using 145 surveys in 64 countries, 2000–2018

IntroductionChildren’s growth status is an important measure commonly used as a proxy indicator of advancements in a country’s health, human capital and economic development. We aimed to assess the feasibility...

Trimester-specific and sex-specific effects of prenatal exposure to di(2-ethylhexyl) phthalate on fetal growth, birth size, and early-childhood growth: A longitudinal prospective cohort study.

Prenatal exposure to di(2-ethylhexyl) phthalate (DEHP) may cause adverse health outcomes. However, trimester-specific impacts of DEHP exposure on offspring growth from fetal to early childhood stage have not been thoroughly evaluated. In this study, participants who provided a full series of urine specimens at three trimesters were selected from a birth cohort conducted at Wuhan, China from 2014 to 2015. 814 mother-offspring pairs were included in the study. Urinary concentrations of DEHP metabolites were determined using liquid chromatography-tandem mass spectrometry. Z-scores for ultrasound-measured fetal growth parameters at 14.0-18.9, 22.6-27.0, and 29.0-33.9weeks of gestation, were calculated. Weight, height, and body mass index (BMI) at 6, 12, and 24months were standardized to z-scores using sex-specific and age-specific WHO child growth standards. Linear regressions with generalized estimating equations were used to assess the relationships of DEHP levels per trimester to fetal growth, birth size, and growth at 6, 12, and 24months to explore the trimester-specific impacts of DEHP exposure on offspring development. Among males, the1st-trimester DEHP was negatively related to fetal growth (β<0, p<0.05), but positively related to 24-month BMI. The 2nd-trimester DEHP was negatively related to birth weight and birth length, but positively related to weight gain rates from birth to 24months old. The 3rd-trimester DEHP was positively (β>0, p<0.05) associated with birth weight and BMI at 6 and 12months. Among females, the 1st-trimester DEHP was associated with increased birth length, while the 2nd-trimester DEHP was negatively associated with BMI at 6 and 12months. A negative association between DEHP and weight gain rates at 6months was noted among females. This prospective cohort revealed the sex-specific and trimester-specific relationships of DEHP exposure to offspring growth from fetal to early-childhood stage.

Prevalence of early childhood caries, risk factors and nutritional status among 3-5-year-old preschool children in Kisarawe, Tanzania.

Early childhood dental caries (ECC), a serious public health problem lacks information on the association between ECC, risk factors and nutritional status among children in Tanzania. Therefore, this study aimed to determine the prevalence of ECC, risk factors and nutritional status among 3-5-year-old preschool children and to assess its correlation with the form, visible plaque scores in upper anterior teeth, total sugar exposure, anthropometric measures, and socio demographic attributes. This cross-sectional study was conducted on 831 children registered in public preschools in Kisarawe District. Assessment of ECC used the WHO (2013) criteria and anthropometric measures used the WHO Child Growth Standards (2006). Structured questionnaires were completed by children's parents through an interview. Collected information on socio-demographic attributes including oral hygiene and sugar exposure to their children was analyzed. Only 459 children (55.2%) were recognized as caries-free. Dental caries experience in terms of decayed, missing and filled teeth (dmft) index was 2.51. Children with visible plaque were the majority (56.1%). The dmft score index was negatively and significantly associated with weight-for-age z-score [Coefficient: -0.11 (95% CI: -0.76, -0.11)] and positively significantly associated with visible plaque score index [Coefficient: 0.16 (95% CI: 0.18, 0.52)] and total sugar exposure [Coefficient: 0.19 (95% CI: 0.15, 0.38)] in the adjusted model. The prevalence of underweight was 4.2% [95% CI: (3.0-5.8)] and severe underweight was 0.2% [95% CI: (0.1-0.9)] while prevalence of stunting was 1.6% [95% CI: (0.9-2.7)] and severe stunting was 0.4% [95% CI: (0.1-1.1)]. This study demonstrated a significant negative relationship between ECC and children's anthropometric measures indicated by weight-for-age, and positive relationship with sugar exposure and poor oral hygiene indicated by visible plaque on upper anterior teeth. Controlling risk factors will reduce the occurrence of ECC thereby catering for a healthy population of well-nourished children.

The Sex Specific Association Between Maternal Gestational Diabetes and Offspring Metabolic Status at 1 Year of Age.

Previous studies showed the association between maternal GDM and long-term effects of overweight in offspring. However, the nature of this association in the early postnatal period is still undetermined. The aim of this prospective cohort study was to evaluate whether maternal GDM is associated with overweight and obesity status in offspring at age 1 year. We studied 1167 infants born at a large obstetrical care hospital including 778 normal glucose tolerance (NGT) and 389 GDM pregnancies, matched in a 1:2 ratio according to offspring’s gender, during the years 2016–2017. Overweight and obesity status in offspring of both groups were evaluated at 1 year of age through questionnaires. Infant outcomes were defined according to the WHO Child Growth Standards based on the length-based BMI-for-age. Female offspring from the GDM group exhibited a higher mean BMI (17.2 vs. 16.6, p < 0.01), a higher rate of obesity (13.9% vs. 7.7%; p < 0.05), and overweight (33.1% vs. 23.5%; p < 0.05) as compared to the NGT female group. In the multivariable regression model, maternal GDM was found to be independently and significantly associated with overweight or obesity in 1-year aged female offspring only (OR 1.61, 95% CI 1.09–2.37, p < 0.05). We found a sex specific association between maternal GDM and the overweight risk only in female offspring at 1 year of age.

Effect of Different Complementary Feeding on Iron Deficiency Anemia and Growth in Breastfed Infants: Home-Made VS Commercial

After approximately 6 months of age, term breastfed infants are increasingly depend on other sources of iron to avoid iron deficiency anemia, due to the depletion of the low concentration of iron in human milk. The appropriate complementary feeding must include a balance composition of foods containing an adequate amount of macro- and micronutrients to avoid iron deficiency anemia. This study aimed to compare the risk of iron deficiency and growth in breastfeed infants receiving commercial fortified complementary foods or home-made. A cross-sectional study was held on April-June 2016 to evaluate infants aged 6-24 months with breast feeding intake for 6 month of life. Complementary feeding practices were determined by questionnaire; an unquantified food frequency and feeding practices questionnaire was used to determine usual food intake. Biochemical assessment of haemoglobin (Hb), serum ferritin (SF) and serum iron (SI) level were measured. Anthropometric were assessed using WHO Child Growth Standard 2005. Statistical analysis used were Chi-square Test. Thirty eight infants were enrolled, mean age of 16.2 (SD 10.5) months. 17 infants consumed commercial complementary foods and 21 infants use home-made. Infants with home-made had lower Hb level, SF and SI than those receiving commercial complementary food, and had higher risk of underweight, stunted and wasted. Infants with home-made complementary food had lower haemoglobin, serum feritin and serum iron levels than those in fortified complementary food CF; and a higher risk of stunted and wasted than children with commercial fortified CF.

Vitamin A Deficiency, Anemia, and Nutritional Status of under 5-Year Children from Northeast India.

Background:Vitamin A deficiency (VAD) and Anemia are important public health nutritional problems in India.Objective:To assess nutritional status and prevalence and correlates of undernutrition, anemia, and VAD among children.Materials and Methods:A community-based cross-sectional study was carried out adopting systematic random sampling. Information on socio-demographic particulars was collected and 20 μL blood was collected for hemoglobin and free-flowing drop on Whatman filter paper for Vitamin A estimation. Hemoglobin was estimated using indirect cyanmethemoglobin and Vitamin A by high-pressure liquid chromatography. Nutritional status was assessed using the WHO Child Growth Standard.Results:The overall prevalence of anemia and VAD was 68% and 59%, respectively, while underweight, stunting, and wasting was 30%, 55%, and 11%, respectively, among under 5 year children. Stepwise logistic regression analysis revealed no significant association of anemia and VAD with any sociodemographic variables, while the odd of stunting was four times higher among children of mothers engaged in labor and two times among children from low-income group, while underweight was two times higher among children from households not having sanitary latrine. Exclusive breastfeeding was observed to be associated with undernutrition among infants.Conclusions:Anemia, VAD, and stunting were high among children. Low intakes of green leafy vegetables and milk and milk product may be the reasons for the higher prevalence of anemia and VAD. There is a need to strengthen supplementation of iron and folic acid tablets and Vitamin A and also public distribution system.

Growth in Exclusively Breastfed and Non-exclusively Breastfed Children: Comparisons with WHO Child Growth Standards and Korean National Growth Charts.

BackgroundThis study examined the relationship of infant feeding with anthropometric indices of children during their first six years of life relative to the Korean National Growth Charts (KNGC) and the World Health Organization Child Growth Standards (WHO-CGS).MethodsThe study population consisted of 547,669 Korean infants and children who were 6 months-old to 6 years-old (born in 2008–2009) and participated in the National Health Screening Program for Infants and Children. Data on height, weight, and type of feeding during the first 6 months (exclusively breastfed [BF] vs. mixed- or formula-fed [FF]) were analyzed.ResultsBF boys and girls were significantly shorter and lighter than FF counterparts from the age of 6 months to 4 years, but these differences were not significant after the age of 4 years. BF boys and girls only had significantly lower body mass index at the age of 2 years. Under the age of 2 years 6 months, and especially under the age of 1 year, BF boys and girls were significantly taller and heavier than the 50th percentile values of the 50th percentile value of the WHO-CGS.ConclusionIn this study using large-scaled national data, Korean breastfed children are shorter and lighter by 3 years 6 months–4 years 6 months, but afterward, there is no significant difference from those who had mixed- or formula-feeding. Substantial disparities in the anthropometric indices of Korean infants under the age of 1 compared to KNCG and WHO-CGS were found, regardless of their infantile feeding types. Our results emphasize the importance of constructing a nationwide reference chart based on actual measurements of BF Korean infants.

Physical Growth of Primary School Children in Cambodia

Background: Following up children’s health at schools is crucial to ensuring their health and nutrition supply. Cambodia does not have a system for assessing the children’s growth. In this regard, WHO child growth reference might be used to assess child growth in this country. The present study aimed to compare Cambodian primary schoolchildren’s growth in three categories and assess their growth status by reference to the South-East Asian Nutrition Survey (SEANUTS) and WHO references. Methods: This is a case study of primary school children’s growth in Cambodia. Aichi University of Education in Japan conducted physical measurement in some primary schools in Cambodia in three categories: an urban school, a rural school with “school meals”, and a rural school without “school meals”. A total sample size of 9 487 primary schoolchildren was measured from 2015 to 2020. The data were analyzed by a computed formulation of LMS and SPSS statistics version 20. Results: Cambodian primary schoolchildren in the urban school were taller and heavier than those in the rural school with “school meals” and the rural school without “school meals”. The children in the rural school without “school meals” were the shortest and the lightest. The physical growth of the “schoolchildren” in Cambodia was similar to those of the pooled SEANUTS, but far below the WHO references. Conclusion: School meals have a positive influence on children’s growth. SEANUTS growth reference might be fitted to assess child growth in Cambodia, but the WHO reference is not fitted. National child growth curve and reference should be devised to accurately assess children’s growth in Cambodia.

Kejadian Stunting Pada Anak Usia Prasekolah (3-5 Tahun) Berdasarkan Status Sosial Ekonomi Dan Penyakit Infeksi

Background: Stunting is a length or height that is more than minus two standard deviations of the WHO child growth standard which starts in the development process of the fetus in the womb until the age of 2 years with both short and long term effects. Research Objectives: This study aims to analyze the relationship between socioeconomic status and infectious diseases with the incidence of stunting in preschool children in Sugihwaras District, Bojonegoro Regency. Methods: This study used a correlation analytic design with a retrospective cohort approach. The study was conducted in February-March 2020. The sample was taken by a random sampling technique. A sample of 36 preschool-aged stunting children. Data were analyzed using logistic regression. Results: showed a relationship between socioeconomic status (P = 0.000) and the incidence of stunting. there is an association of infectious diseases (P = 0.000) with the incidence of stunting. However, in the logistic regression test, it was found that there was a relationship between socioeconomic status (p = 0.012) and there was no relationship between infectious diseases (p = 0.071) and the incidence of stunting. Conclusions and Suggestions: Preschoolers with middle to lower socioeconomic status are 30,549 times more likely to experience stunting than preschool children with upper-class socioeconomic status. It is hoped that the research results can provide additional information to change the family mindset regarding the incidence of stunting.

Prevalence, risk factors and health consequences of soil-transmitted helminth infection on the Bijagos Islands, Guinea Bissau: A community-wide cross-sectional study.

Soil-transmitted helminths (STH) are endemic and widespread across Sub-Saharan Africa. A community wide soil-transmitted helminth (STH) prevalence survey was performed on the island of Bubaque in Guinea-Bissau using both Kato-katz microscopy and qPCR methodology. Predictors of infection and morbidity indicators were identified using multivariable logistic regression, and diagnostic methods were compared using k statistics. Among 396 participants, prevalence of STH by microscopy was 23.2%, hookworm was the only species identified by this method and the mean infection intensity was 312 eggs per gram. qPCR analysis revealed an overall prevalence of any STH infection of 47.3%, with the majority A. duodenale (32.3%), followed by N. americanus (15.01%) and S. stercoralis (13.2%). A. lumbricoides, and T. trichiura infections were negligible, with a prevalence of 0.25% each. Agreement between diagnostic tests was k = 0.22, interpreted as fair agreement, and infection intensity measured by both methods was only minimally correlated (Rs = -0.03). STH infection overall was more common in females and adults aged 31–40. STH infection was associated with open defaecation, low socio-economic status and further distance to a water-source. The prevalence of anaemia (defined as a binary outcome by the WHO standards for age and sex) was 69.1%, and 44.2% of children were malnourished according to WHO child growth standards. Hookworm infection intensity by faecal egg count showed no statistically significant association with age (Rs 0.06) but S. Stercoralis infection intensity by qPCR cycle threshold was higher in pre-school aged children (Rs = 0.30, p-value 0.03) There was no statistically significant association between STH infection and anaemia (OR 1.0 p = 0.8), stunting (OR 1.9, p-value 0.5) and wasting (OR 2.0, p-value 0.2) in children. This study reveals a persistent reservoir of STH infection across the community, with high rates of anaemia and malnutrition, despite high-coverage of mebendazole mass-drug administration in pre-school children. This reflects the need for a new strategy to soil-transmitted helminth control, to reduce infections and ultimately eliminate transmission.