Z-score Of Weight For Age Research Articles

Growth Pattern of Preterm Neonates with Fetal Growth Restriction: A Prospective Cohort Study.

To compare the growth of preterm neonates with fetal growth restriction (FGR) and preterm neonates born appropriate-for-gestational-age (AGA) from birth to 12-18 mo of corrected age (CA). In this prospective cohort study, 85 preterm neonates with FGR and 85 gestation- and gender-matched AGA neonates were followed up from birth till 12-18 mo corrected age. Anthropometric indices were compared at specific time points and the risk factors for underweight status were analyzed. Mean gestational age of the cohort was 32.8 ± 2.1 wk. Mean birth weight was 1414 ± 248g in the FGR and 1806 ± 416g in AGA neonates. At 12-18 mo of corrected age, a significantly greater proportion of FGR infants were wasted (24.3% vs. 7.2%, P = 0.005). A greater proportion of FGR infants were underweight (27% vs. 17.4%, P = 0.11), stunted (41.9% vs. 36.2%, P = 0.30), and microcephalic (27% vs. 23.1%, P = 0.36), although the differences were not statistically significant. Significant catch-up growth from 40 wk postmenstrual age (PMA) to 12-18 mo corrected age in weight (52.8% vs. 13.1%, P <0.001) and length (37.9% vs. 8.7%, P <0.001) was observed in the FGR neonates. The z-score of weight for age at 3 mo (adjusted OR 0.65, 95% CI: 0.52-0.8; P <0.001), the median time to full feeds (aOR: 1.10, 95% CI: 1.04-1.15; P = 0.001), and hypothyroidism (aOR 2.44, 95% CI: 1.46-4.08; P = 0.001), were independent predictors of underweight status at 12-18 mo. At 12-18 mo of corrected age, a significantly greater proportion of preterm FGR neonates were wasted compared to AGA ones. The former also exhibited significantly greater catch-up growth than the latter.

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

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

Undernutrition and 60-day mortality in critically ill children with respiratory failure: a prospective cohort study

BackgroundTo determine whether undernutrition affects 60-day mortality in pediatric acute respiratory failure.MethodsSubjects with acute respiratory failure aged between two months and 13 years were included in the study. The Z-scores were calculated on admission and children were categorized into two groups of undernutrition and normal nutrition. The nutritional intake of the children was measured daily. The outcome was 60-day mortality.ResultsA total of 126 patients met the inclusion criteria; 41% were undernourished based on the Z-score of BMI and weight for height, 50% based on the Z-score of height and length for age and 45% based on the Z-score of weight for age. Overall, the 60-day mortality rate was 27.8%. The Cox regression analysis adjusted with PIM2, age and gender, showed that undernutrition has a significant relationship with 60-day mortality based on the weight for age Z-score (HR = 2.33; CI: 1.175–4.638). In addition, undernutrition has a significant relationship with 60-day mortality based on the BMI for age (HR = 3.04; CI:1.070–8.639) and weight for height (HR = 2.62; CI: 1.605–6.658) Z-scores. The mean calorie and protein intake of 72% of the children was less than 80% of their calorie needs. The time to start feeding in 63% of the children was more than 48 h. There was no relationship between the time of starting nutrition and nutritional intake during PICU admission and mortality.ConclusionUndernutrition is prevalent in mechanically ventilated children in the PICU and may be associated with 60-day mortality.

Cross-sectional nutrition assessment in a refugee camp in Gambella region, Ethiopia

Abstract Minors account for 20 percent of the world’s migrants, reaching 33 million in 2019. The prevalence of malnutrition has been reported between 17 and 21% among refugees. However, data about Sub-Saharan African refugees is lacking. The study evaluates the nutritional status of refugees in the Nguenyyiel camp in Gambella (Ethiopia). The retrospective cohort study included all children under five attending the first visit to the refugee camp’s health post between 01/06/2021 and 31/08/2021. Sociodemographic data, body weight, and upper arm circumference (MUAC) were recorded. The z-score of weight for age (WFA) and MUAC for age (MUACZ) were estimated using the R ‘anthro’ package developed by the World Health Organization (WHO). Children with WFA &amp;lt;-2 standard deviations (SD) were considered underweight, those &amp;gt;2SD overweight. A MUACZ &amp;lt;-2SD defined acute malnutrition. Among the 782 patients admitted, 415 (53%) were under five. Females were 195 (47%). The mean age was 2.1 years (SD 1.6). The mean body weight was 11kg (SD 5). Considering the WFA, 200 (48%) children were within +2 SD. Children with WFA &amp;lt;-2SD were 92 (29%), those &amp;gt; 2SD were 28 (9%). The frequency of children with WFA &amp;lt;-2SD was higher in boys (p = 0.049). There were no differences in the frequency of children with WFA &amp;gt;2SD based on sex (p = 0.998). WFA decreased as age increased (p = 0.048). MUAC was recorded for 273 (66%) children. The mean MUAC was 14.2mm (SD 2.4). Children with MUAC z-scores within +2SD were 245 (77%). Children &amp;lt;-2SD were 92 (8%). The frequency of children with MUACZ &amp;lt;-2SD was not significantly different based on sex or age (p = 0.125, p = 0.324). The prevalence of malnutrition was moderate in the Nguenyyiel camp. At the same time, the frequency of underweight children was high, particularly among boys (34%) and with increasing age. Key messages • Nutrition remains a problem in refugee camp settings, especially in children. • Ensuring the health of refugees, as vulnerable population, should be a priority for both governments and international organizations.

Intestinal Helminth Infection, Anemia, Undernutrition and Academic Performance among School Children in Northwestern Ethiopia.

This study examined the prevalence and intensity of intestinal helminth infections and their association with anemia, undernutrition, and academic performance among school children in Maksegnit, northwestern Ethiopia. A total of 1205 school children, who attended Maksegnit Number Two Elementary School between May and July 2021, participated in this study. To determine helminth infection status, two thick Kato–Katz slides were examined for each child. Hemoglobin level was measured using a HemoCue machine. Academic performance was assessed using the mean score of all subjects children have taken for the Spring 2020/2021 academic term. Out of 1205 children examined, 45.4% were infected with at least one helminth species, 7.9% were anemic, and 35.8% were undernourished. The means for hemoglobin level and z-scores of weight for age, height for age, body mass index for age, and academic scores were lower among helminth-infected children than the uninfected. Children infected with intestinal helminths showed higher odds of anemia than those uninfected with helminths. In conclusion, there was a moderate prevalence of intestinal helminth infection and undernutrition among school children in Maksegnit. Intestinal helminth infection could increase the risk of anemia, undernutrition, and poor academic performance.

Tracking Weight-for-Age of Infants Using Home Based Newborn Care Plus by ASHA Workers

Malnutrition in all its forms remains a serious global concern, particularly affecting children, a highly vulnerable population group. Home visits during the first year of life using the community worker platform is an unexplored opportunity for making improvements in nutritional status. To analyze the nutritional status (weight for age) of a cohort of infants between 3 and 12 months of age. Tracking weight for age of infants by ASHA workers. 13 districts in the states of Bihar, Madhya Pradesh, Odisha and Rajasthan. Home visits under a home-based newborn care program, home-based newborn care plus (HBNC+). Norway India Partnership Initiative (NIPI) project supported implementation of HBNC+, in 13 districts across four states in India. A descriptive analysis of infants based on retrospective record based program data was done. The nutritional status (weight-for-age) of the cohort was analyzed. Categories were defined based on the z-scores of weight for age (≤-3 SD; ≤-2 SD and > -3 SD; and > -2 SD). Trend of malnutrition and proportions of children in each category at 3, 6, 9 and 12 months were assessed. At 3 months of age, out of 3,50,986 infants provided home visits, 1,82,049 (51.97%) were underweight as per WHO definition with weight for age z-score ≤- 2 SD; this reduced to 11.1% at 12 months of age. Difference of means at 3 months and 12 months significantly different for weight for age z-score (P<0.001). There was a decline in the proportion of children in severe and moderate malnutrition categories by 15% and 26%, respectively. Catch-up growth in terms of weight-for-age among malnourished children is possible within one year of age. Frequent contacts with the health care functionaries may result in this improvement, though it is difficult to conclude in the absence of an appropriate control.

Nighttime Light Intensity and Child Health Outcomes in Bangladesh

This study examines the impact of nighttime light intensity on child health outcomes in Bangladesh. We use nighttime light intensity as a proxy measure of urbanization and argue that the higher intensity of nighttime light, the higher is the degree of urbanization, which positively affects child health outcomes. In econometric estimation, we employ a methodology that combines parametric and non-parametric approaches using the Gradient Boosting Machine (GBM), K-Nearest Neighbors (KNN), and Bootstrap Aggregating that originate from machine learning algorithms. Based on our benchmark estimates, findings show that one standard deviation increase of nighttime light intensity is associated with a 1.515 rise of Z-score of weight for age after controlling for several control variables. The maximum increase of weight for height and height for age score range from 5.35 to 7.18 units. To further understand our benchmark estimates, generalized additive models also provide a robust positive relationship between nighttime light intensity and children's health outcomes. Finally, we develop an economic model that supports the empirical findings of this study that the marginal effect of urbanization on children's nutritional outcomes is strictly positive.

Gender and age differences in the relationship between calorie, macronutrients intake and growth status of school-aged Aboriginal children at Labu, Negeri Sembilan

PurposeThis study aimed to determine the relationship between calorie and macronutrients intake and the growth status of Aboriginal children based on gender and age group.Design/methodology/approachThis was a cross-sectional study participated by 85 school-aged Aboriginal children at Labu, Negeri Sembilan. The dietary intake and socioeconomic status data were collected from the parents using an interviewer administrated structured-questionnaire and 24-hour dietary recall. WHO AnthroPlus software was used to determine the z-score of weight for age (WAZ), height for age (HAZ) and body mass index (BMI) for age (BAZ).FindingsThe mean fat intake was significantly higher among younger children (i.e. 7–9 years old) as compared to elder children (i.e. 10–12 years old) (40.7 ± 17.3 g vs 32.0 ± 13.8 g; t = 2.496, p = 0.015) but not for the mean intake of calorie (1816.1 ± 979.9 kcal vs 1566.3 ± 808.7 kcal; t = 1.248, p = 0.216), protein (50.13 ± 20.08 g vs 44.94 ± 16.45 g; t = 1.269, p = 0.208) and carbohydrates (198.0 ± 63.0 g vs 190.8 ± 66.1 g; t = 0.513, p = 0.609). The majority of the respondents did not meet recommended nutrient intake (RNI) for the calorie (65.9%) and fat (75.3%). A significantly higher proportion of elder children did not meet RNI for fat as compared to younger children (88.8% vs 65.3%; X2 = 6.21, p = 0.021). The HAZ showed that 28.2% (n = 24) of the Aboriginal children were stunted, while WAZ showed that 14.8% (n = 9) of the Aboriginal students were underweight, and 8.2% of them were overweight. Based on BAZ classification, 15.4% (n = 6) of boys and 2.2% (n = 1) of girls were overweight. There is no significant correlation between calories and macronutrients and growth status of the children.Originality/valueAlthough the under-nutrition status among Aboriginal children is still a highlighted issue, the few over-nutrition statuses among Aborigines should be taken into count, especially in term of energy and macronutrient intake.

The Relationship Between Food Insecurity and Anthropometric Measures at Birth in Low Income Households

Background: Food security is one of the important factors that influence health and well-being throughout the life cycle. Objectives: This study aimed to determine the relationship between household (HH) food security status and anthropometric indices at birth and before 6-years-of age among children in a low income community in Mashhad city. Methods: In this cross-sectional study, 240 Iranian HHs which had at least one under 6-year old child were selected through systematic cluster sampling. Height and weight of children were measured. Also, their length and weight at birth were collected from their vaccination certificate. Anthropometric status (based on z-scores) of children were evaluated by WHO Anthro-Plus software. Results: Severe, moderate, and mild food insecurity was observed in 7.1, 20, and 34.2 of the HHs, respectively. A significant association was observed between HH food insecurity and average height of their under 6-year-old children. There was no association between HH food insecurity and children’s measurements at birth (P > 0.05). Comparison of anthropometric status at birth and between 1 to 6 years of age in food secure and insecure groups based on Wilcoxon test, showed a significant difference between z-scores of weight for age (WAZ) and body mass index (BMI) for age (BAZ) in children from food insecure HHs. Conclusions: The results suggest that children in food insecure HHs do not necessarily have abnormal weight and length at birth, but growing up in a food insecure HH may lead to abnormal anthropometric status. Proper strategies to ensure food security in low income HHs may help to prevent child undernutrition. © 2019, Author(s).

Tolerability and Effects of the Use of Energy-Enriched Infant Formula After Congenital Heart Surgery: A Randomized Controlled Trial.

Undernutrition is a common problem among children with congenital heart disease (CHD) and may lead to poorer surgical outcomes. A higher intake of energy during the postoperative period of CHD surgery seems to be associated with better outcomes. This study aimed to investigate the effect of the use of energy-enriched formula (EE-formula) compared with normocaloric formula during 30 days after CHD surgery. A randomized controlled trial with patients undergoing heart surgery in a tertiary hospital in southern Brazil from March 2017 to December 2017 was performed. The intervention group received EE-formula (1 kcal/mL), and the control group received normocaloric formula (0.67kcal/mL). The researcher in charge of anthropometric evaluation was blinded to the randomization. Fifty-nine patients were included; 30 in control group and 29 in intervention group. There were no statistically significant differences between groups regarding age, gender, anthropometry, and surgical risk classification after randomization. A statistically significant difference in z-score of weight for age and in weight gain variation rate between groups after intervention was observed. Antibiotic use was less frequent in the intervention group, and hospital length of stay was shorter. General gastrointestinal side effects were similar between groups, whereas diarrhea was more frequent in the intervention group. However, this side effect was limited and had spontaneous resolution in 4 out of 6 cases. This study demonstrates that EE-formula use after heart surgery of patients with CHD is well tolerated and may improve short-term nutrition outcome, decrease hospital stay, and reduce antibiotic use.

Growth Indices of Exclusively Breastfed Until 6 Months Age and Formula-Fed Infants in Southwest of Iran.

Background:Formula milk is prepared as a nutritional substitution for human breast milk, but because of biologic and constituent differences, it might cause obesity and growth disorders in infants. In this study, we compared the growth pattern of formula-fed and breastfed infants living in Yasuj, southwest of Iran.Methods:Infants 7–14 months of age in southwest of Iran were classified as exclusively breastfed (n = 200) and formula-fed (n = 200) in their first 6 months of life. Growth velocity and Z-scores of weight for age, length for age, weight for length, and head circumference were estimated using WHO Anthro Plus software (2010) and SPSS Version 19 (SPSS Inc., Chicago, IL, USA) using World Health Organization reference for growth data.Results:The study showed that Z-score of length for age and head circumference for age at the birth were significantly lower in formula-fed group than exclusively breastfed group (P < 0.05), but the Z-score of weight for length did not differ significantly. At the sixth month of age, Z-score of weight for length was significantly higher in formula-fed group (P < 0.05), but Z-score of length for age had no significant difference and Z-score of head circumference was higher in exclusively breastfed group yet (P < 0.05). Growth velocity, prevalence of obesity, wasting, underweight, and stunting did not differ between two groups.Conclusions:Our findings suggest that formula feeding can lead to greater weight gain and may help the catch up of length, but evidences are not convincing enough to suggest the formula as an obesogenic feeding in the studied area. To make a conclusion, we suggest comparing the privileged and unprivileged areas and controlling for confounding variables including family hygiene and infant feeding practices between formula-fed and breastfed infants.

The Relationship between Nutritional Status and Anthropometric Indices among 2-5 Year Old Children in Tehran

Background: Malnutrition in children including lower nutrient intakes or high density food intakes is of recent world concerns; therefore, determining a simple index that reveals the diet adequacy might be an advantage. Methods: This cross-sectional study was done among 233 children aged 2-5 years old. A 24-hour dietary questionnaire was used to calculate mean adequacy ratio (MAR), naturally nutrient rich (NNR) and energy density (ED) via related formula. Results: A significant negative trend was observed for the relationship between the MAR and the Z-score of height for age. Significant positive relations were observed between the Z-score of body mass index (BMI) for age and the Z-score of weight for height as well as the Z-score of weight for age and the Z-score of height for age. In contrast, a significant negative correlation was between the energy density and MAR (all P &lt; 0.05). Conclusion: According to the Z-score based on the NNR, MAR and ED, these three indices might be widely used to determine the adequacy of food intakes especially among children.

Assessment of Nutritional Status of Infants Living in Arsenic-Contaminated Areas in Bangladesh and Its Association with Arsenic Exposure.

Data is scarce on early life exposure to arsenic and its association with malnutrition during infancy. This study followed the nutritional status of a cohort of 120 infants from birth to 9 months of age in an arsenic contaminated area in Bangladesh. Anthropometric data was collected at 3, 6 and 9 months of the infant’s age for nutritional assessment whereas arsenic exposure level was assessed via tube well drinking water arsenic concentration at the initiation of the study. Weight and height measurements were converted to Z-scores of weight for age (WAZ-underweight), height for age (HAZ-stunting), weight for height (WHZ-wasting) for children by comparing with WHO growth standard. Arsenic exposure levels were categorized as <50 μg/L and ≥50 μg/L. Stunting rates (<−2 SD) were 10% at 3 months and 44% at both 6 and 9 months. Wasting rates (<−2 SD) were 23.3% at 3 months and underweight rates (<−2 SD) were 25% and 10% at 3 and 6 months of age, respectively. There was a significant association of stunting with household drinking water arsenic exposure ≥50 μg/L at age of 9 months (p = 0.009). Except for stunting at 9 months of age, we did not find any significant changes in other nutritional indices over time or with levels of household arsenic exposure in this study. Our study suggests no association between household arsenic exposure and under-nutrition during infancy; with limiting factors being small sample size and short follow-up. Difference in stunting at 9 months by arsenic exposure at ≥50 μg/L might be a statistical incongruity. Further longitudinal studies are warranted to establish any association.

DAMPAK INTERVENSI PENDIDIKAN "GI-PSI-SEHAT" BAGI IBU TERHADAP KONSUMSI PANGAN DAN STATUS GIZI ANAK USIA DINI

THE IMPACT OF EDUCATION MODEL “GI-PSI-SEHAT” (NUTRITIONPSYCHOSOSIAL-HEALTH) FOR MOTHER ON FOOD CONSUMPTION AND NUTRITIONAL STATUS OF CHILDREN UNDER TWO YEAR The objective of this study is to develop and to analyze the education wholistic model (NutritionPsychosocial-Health) in order to build good food consumption pattern for children through the improvement of mother’s behaviour. A quasi experiment, nonrandomized control group pretest -posttest design study, of the impact of the education model “GI-PSI-SEHAT” (NutritionPsychosocial-Health) has been carried out at urban area in Bogor, West Java. The total of respondent are 131 primiparous mothers of children of 0-11 months, who are selected by purposive sampling technique, which consist of 66 mothers in control group and 65 mothers in intervention group, who participated in the intervention programme. During five months, education model “GI-PSI-SEHAT” was conducted by face to face method, in groups or individually, with combination of teaching techniques i.e. speech, discussion, simulation, practical and home visit. Teaching aids i.e. booklets, flip-chart, food-models, and real things was used in order to increase the effectiveness of the programme. The study reveals that the intervention of “GI-PSI-SEHAT” improves food consumption pattern, whether in punctuality, food diversification, or the frequency of food consumption. In eight months time, the intervention enable the increase of the Mean Adequacy Ratio (MAR) as an overall measure of the nutrient adequacy. The impact of the intervention of “GI-PSI-SEHAT” is decrease of z-score of weight-for-age and height-for-age of the intervention group is lower than the control group, especially for children under 12 month. Classification and regression tree statistical analysis demonstrated that independent variables have strong association with response variables. Nutritional status of mother based on Body Mass Index (BMI) is the dominant variable associated with nutritional status of children based on z-score of weight for age, on the other hand Mean Adequacy Ratio (MAR) is the dominant variable associated with nutritional status of children based on z-score of height for age. Wholistic education model “GI-PSI-SEHAT” for mothers with some modification may applicable at another area, especially for community with low education level. Keywords : nutrition education, children under two years, complementary feeding, food consumption pattern, nutritional status.

Clinical predictors and outcome of hypoxaemia among under‐five diarrhoeal children with or without pneumonia in an urban hospital, Dhaka, Bangladesh

To explore the predictors and outcome of hypoxaemia in children under 5 years of age who were hospitalized for the management of diarrhoea in Dhaka, where comorbidities are common. In a prospective cohort study, we enrolled all children <5 years of age admitted to the special care ward (SCW) of the Dhaka Hospital of ICDDR,B from September to December 2007. Those who presented with hypoxaemia (SpO(2) < 90%) constituted the study group, and those without hypoxaemia formed the comparison group. A total of 258 children were enrolled, all had diarrhoea. Of the total, 198 (77%) had pneumonia and 106 (41%) had severe malnutrition (<-3 Z-score of weight for age of the median of the National Centre for Health Statistics), 119 (46%) had hypoxaemia and 138 children did not have hypoxaemia at the time of admission. Children with hypoxaemia had a higher probability of a fatal outcome (21%vs. 4%; P < 0.001). Using logistic regression analysis, the independent predictors of hypoxaemia at the time of presentation were lower chest wall indrawing [OR 6.91, 95% confidence intervals (CI) 3.66-13.08, P < 0.001], nasal flaring (OR 3.22, 95% CI 1.45-7.17, P = 0.004) and severe sepsis (OR 4.48, 95% CI 1.62-12.42, P = 0.004). In this seriously ill population of children with diarrhoea and comorbidities, hypoxaemia was associated with high case-fatality rates. Independent clinical predictors of hypoxaemia in this population, identifiable at the time of admission, were lower chest wall indrawing, nasal flaring and the clinical syndrome of severe sepsis.

Nutritional status according to sensitized food allergens in children with atopic dermatitis.

PurposeFood allergies can affect the growth and nutritional status of children with atopic dermatitis (AD). This study was conducted to determine the association between the number of sensitized food allergens and the growth and nutritional status of infants and young children with AD.MethodsWe studied 165 children with AD, aged 5 to 47 months, and who visited the Atopy Clinic of the Seoul Medical Center. We recorded the birth weight, time at which food weaning began, scoring of atopic dermatitis (SCORAD) index, eosinophil counts in peripheral blood, and total serum IgE and specific IgE to six major allergens (egg white, cow's milk, soybean, peanut, wheat, and fish). The height and weight for age and weight for height were converted to z-scores to evaluate their effects on growth and nutritional status. Specific IgE levels ≥0.7 kUA/L, measured via the CAP assay, were considered positive.ResultsAs the number of sensitized food allergens increased, the mean z-scores of weight and height for age decreased (P=0.006 and 0.018, respectively). The number directly correlated with the SCORAD index (r=0.308), time at which food weaning began (r=0.332), eosinophil counts in peripheral blood (r=0.266), and total serum IgE (r=0.394). Inverse correlations were observed with the z-scores of weight for age (r=-0.358), height for age (r=-0.278), and weight for height (r=-0.224).ConclusionsA higher number of sensitized food allergens was associated with negative effects on the growth and nutritional status of infants and young children with AD. Therefore, a thorough evaluation of both growth and nutritional status, combined with adequate patient management, is crucial in pediatric AD patients presenting with numerous sensitized food allergies.

Nutritional status of children living in a community with high HIV prevalence in rural Uganda: a cross-sectional population-based survey

To assess the nutritional status of children in a rural community with high HIV prevalence in rural Uganda and to examine the impact of HIV infection at the individual and population level. Methods Cross-sectional population-based survey of children aged 0-12 in a cohort comprising the residents of 25 neighbouring villages in rural southwest Uganda. Anthropometric indicators of nutritional status (height for age, weight for age and weight for height) were assessed in relation to children's HIV serostatus, maternal HIV serostatus and maternal vital status. Children with a Z score of <-2 were defined as undernourished, with a Z score <-2 for weight for age defining underweight, for height for age defining stunting and for weight for height defining wasting. Of 5951 children surveyed, 91% underwent anthropometric measurement: 30% were underweight, 42% stunted and 10% wasted. HIV seroprevalence among children aged 2-12 was 0.7%. The prevalence of underweight was significantly higher in HIV-positive than in HIV-negative children (52%vs. 30%), as was the prevalence of stunting (68%vs. 42%), but there was no significant difference in the prevalence of wasting (4%vs. 9%). There were no significant differences in the prevalences of indicators of undernutrition in children classified by maternal HIV and vital status. Chronic childhood undernutrition is common in this rural community. HIV infection had a direct effect in worsening children's nutritional status, but no indirect effect in terms of maternal HIV infection or maternal death. The population-level impact of childhood HIV infection on nutritional status is limited on account of the low HIV prevalence in children. The response to undernutrition in children in Africa requires action on many fronts: not only delivering community-wide HIV and nutritional interventions but also addressing the many interacting factors that contributed to childhood undernutrition before the HIV era and still do so now.

P64: A School-based Nutrition Intervention Pilot Project, 2004-2005

Objects of this study are to evaluate the impact of a school-based nutrition intervention on nutritional status, educational achievement, school attendance, nutrition knowledge, eating habits and behaviors of children at fourth grade (8-11 years old). Three components are a nutrition education (group 1), a milk supplement (group 2), and control group (group 3). The subjects are mostly from low-income to middle-income families in three suburban elementary schools in Ho Chi Minh City. After 8 months of intervention, the results show that while means of z-score of weight for age (WAZ) in group 1 and group 2 had almost unchanged (P = .293 and P = .367, respectively), it had gone down significantly in group 3 (P = .001).

Prevalence of infant Vitamin A deficiency and undernutrition in the Republic of Congo

Objectives A representative sample of 5722 pre-school children living in rural and urban areas of the Congo was examined between July and September 1999 for assessing Vitamin A deficiency. Methods Using a randomized two-level cluster sampling method, 190 clusters of 30 children aged from 6 months to 6 years were selected in order to assess the prevalence of active xerophthalmia (night blindness and/or Bitot spots). Concurrently, the children's height and weight were determined. A semi-quantitative seven-day dietary questionnaire was applied to the mothers of 5722 children to estimate the latter's consumption of Vitamin A rich foodstuffs. The prevalence of biochemical deficiency was assessed based on the serum retinol concentrations analyzed in dried blood spots from a sub-sample of 300 children living in the Pointe-Noire area. Results Among the 5722 children studied, 0.7% were found to suffer from night blindness and 7.7% had Bitot spots. The weekly intake of Vitamin A rich foods was estimated in 5722 children. Our data suggest that Vitamin A rich food consumption was lower in rural zones than in urban area according to the food frequency method threshold values. The serum retinol levels were lower than 10 μg/dl in 18% (95% confidence interval [C.I.]: 13.7, 22.3) [8.04 ± 2.87 μg/dl] and less than 20 μg/dl in 49% (95% C.I.: 43.4, 54.6) [15.05 ± 2.76 μg/dl] of the 300 studied children. We have established a significant relation between mean serum retinol levels and high rate of Vitamin A food intake (chi-square = 59.64, 2 d.d.l., p < 0.05) in the sample studied. The mean serum retinol concentrations did not differ significantly between the various Z-scores of weight for age ( W/ A) and height for age ( H/ A) patterns. But children with a weight for height ( W/ H) ratio below −2 standard deviation (S.D.) had significantly lower serum retinol values [9.33 ± 1.3 μg/dl] than those with a W/ H ratio greater than or equal to −2S.D. [10.82 ± 4.84 μg/dl]. Conclusion These data suggest that Vitamin A deficiency is still a serious public health problem in rural areas of the Congo in which this study was carried out.

Z‐score of weight for age of infants with atopic dermatitis and cow's milk allergy fed with a rice‐hydrolysate formula during the first two years of life

Recently, rice-based formulas have been widely used in hypoallergenic diets, but data on nutritional values are scarce. To evaluate the growth of infants fed with a rice-based hydrolysate formula, compared to those infants fed with a soy formula or an extensively hydrolysed casein formula, in the first 2 y of life. A total of 88 infants were enrolled between March 2002 and March 2004. Fifty-eight infants with atopic dermatitis (AD) and cow's milk allergy (CMA), confirmed by open challenge, were enrolled as study group: 15 were fed with a rice-based hydrolysate formula (RHF), 17 with a soy-based formula (SF) and 26 with an extensively hydrolysed casein formula (eHCF). Thirty infants with AD without cow's milk allergy were recruited as a control group (CG) and fed with a free diet. Weight was recorded on enrolment and at 3-monthly intervals in the first year of life, and at 6-monthly intervals in the second year. Infants were weighed naked, before feeding, by means of an electronic integrating scale. The z-scores of weight for age were calculated. One-way analysis of variance and Student's t-test were used for statistical comparison. Significance was set at p<0.05. No significant differences between the RHF, SF and eHCF groups were observed for the z-score of weight for age during the first 2 y of life, but a significantly lower difference was seen in the RHF group compared to the control group in the intervals 9 mo-1 y (p=0.025) and 1-1.5 y (p=0.020) of age. In contrast, the SF and eHCF groups were comparable to the control group, but the eHCF group was significantly lower (p=0) in the first trimester of life. Even if our findings show no significant difference between RHF and control, low weight observed in infants fed with RHF raises doubts about the nutritional adequacy of rice-hydrolysate formulas.