1,510 results
Search Results
2. Stunting and its associated factors in children aged 6–59 months in Ilubabor zone, Southwest Ethiopia
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Zewdie, Asrat, Negash, Efrem, and Tsegaye, Dereje
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- 2022
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3. Exploring dietary diversity, nutritional status of adolescents among farm households in Nigeria: do higher commercialization levels translate to better nutrition?
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Otekunrin, Olutosin Ademola and Otekunrin, Oluwaseun Aramide
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- 2023
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4. Factors associated with early literacy and numeracy development among children under five years in Bangladesh: multivariate two-level mixed effect approach
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Hossain, Md. Ismail, Haq, Iqramul, Hossain, Md. Sanwar, Habib, Md. Jakaria, Islam, Fiza Binta, Roy, Sutopa, and Rahman, Mofasser
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- 2023
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5. Gender differentials in feeding practices, health care utilization and nutritional status of children in Northern India
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Singh, Abhishek and Patel, Sangram Kishor
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- 2017
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6. Impact of nutrition education intervention on nutritional status of undernourished children (6-24 months) in East Mamprusi district of Ghana
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Awuuh, Vincent Adocta, Appiah, Collins Afriyie, and Mensah, Faustina O.
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- 2019
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7. KEARIFAN LOKAL DALAM PAWON URIP UNTUK PENCEGAHAN STUNTING DI KABUPATEN LUMAJANG JAWA TIMUR.
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Ghaffar, Muhammad Luthfi Abdul, Riyanto, Edi Dwi, Nadhiroh, Siti Rahayu, Fatah, Mohammad Zainal, Nurmala, Ira, and Hadi, Mochamad Irfan
- Abstract
Copyright of National Nutrition Journal / Media Gizi Indonesia is the property of Universitas Airlangga and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2022
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8. The effect of additional egg supplementation on vitamin and mineral fortification program on growth, cognitive development and hemoglobin in Indonesian underweight and stunting children
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Sudargo, Toto, Muhammad, Harry Freitag Luglio, Kandarina, Istiti, Putri, Nurul, Irianto, Sugeng Eko, Pranoto, Yosephin Anandati, and Paramastri, Rathi
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- 2018
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9. Analysing the drivers of stunting reduction in twelve sub-saharan African countries using the RIF decomposition approach.
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Olakunle, Abibatou Agbéké
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Background: This study examines how significant is the changes in child stunting in Sub-Saharan African countries (SSA). Then, it investigates factors that contributed to the reduction in child stunting in those countries. For each country, we distinguish the contribution of compositional effects and structural effect. Methods: This paper uses data from Demographic and Health Surveys of 12 sub-Saharan African countries conducted between 2000 and 2020. The z-test to compare two independent proportions was used to assess changes in child stunting and explanatory variables over the period. Recentred influence function (RIF) decomposition method was used to decompose changes in stunting over the year in each country, and to determine the contribution of each variable to the changes. Results: The prevalence of child stunting declines significantly in 11 countries over the year. The decline varies from 6.8% in Cameroun to 19% in Mali. The average year of education of the child's mother and father, and the proportion of households with access to an improved drinking water source have contributed to the reduction in child stunting. This result was found in all the countries. Improvements in living standards, child vaccination, antenatal care attendance, delivery to health care centres, maternal education, improved drinking water sources, and improved sanitation make the largest contribution to the composition component, hence reducing child stunting. Conclusions: This study sheds light on what has contributed to the achieved improvement in child nutritional status and suggests how to possibly accelerate the reduction in undernutrition in countries that lag. [ABSTRACT FROM AUTHOR]
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- 2024
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10. Impact of COVID-19 on child malnutrition, obesity in women and household food insecurity in underserved urban settlements in Sri Lanka: a prospective follow-up study
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Himali P Herath, Thulasika T Dayaratne, Amila G. Perera, Nawmali D De Alwis, Renuka Jayatissa, and Hiyare Palliyage Laksiri K Nanayakkara
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Male ,Population ,Psychological intervention ,Medicine (miscellaneous) ,Overweight ,Child Nutrition Disorders ,Environmental health ,Humans ,Medicine ,Obesity ,Prospective Studies ,education ,Pandemics ,Wasting ,Sri Lanka ,Family Characteristics ,Stunting ,education.field_of_study ,Nutrition and Dietetics ,Food security ,business.industry ,Urban Health ,Public Health, Environmental and Occupational Health ,COVID-19 ,Infant ,medicine.disease ,Food Insecurity ,Malnutrition ,Child, Preschool ,Cohort ,Female ,medicine.symptom ,business ,Follow-Up Studies ,Research Paper - Abstract
Objectives:To determine changes and factors associated with child malnutrition, obesity in women and household food insecurity before and after the first wave of COVID-19 pandemic.Design:A prospective follow-up study.Setting:In 2019, the baseline Urban Health and Nutrition Study 2019 (UHNS-2019) was conducted in 603 households, which were selected randomly from 30 clusters to represent underserved urban settlements in Colombo. In the present study, 35 % of households from the UHNS-2019 cohort were randomly selected for repeat interviews, 1 year after the baseline study and 6 months after COVID-19 pandemic in Sri Lanka. Height/length and weight of children and women were re-measured, household food insecurity was reassessed, and associated factors were gathered through interviewer-administered questionnaires. Differences in measurements at baseline and follow-up studies were compared.Participants:A total of 207 households, comprising 127 women and 109 children were included.Results:The current prevalence of children with wasting and overweight was higher in the follow-up study than at baseline UHNS-2019 (18·3 % v. 13·7 %; P = 0·26 and 8·3 % v. 3·7 %; P = 0·12, respectively). There was a decrease in prevalence of child stunting (14·7 % v. 11·9 %; P = 0·37). A change was not observed in overall obesity in women, which was about 30·7 %. Repeated lockdown was associated with a significant reduction in food security from 57 % in UHNS-2019 to 30 % in the current study (P < 0·001).Conclusions:There was an increase in wasting and overweight among children while women had a persistent high prevalence of obesity. This population needs suitable interventions to improve nutrition status of children and women to minimise susceptibility to COVID-19.
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- 2021
11. Stunting Convergence Management Framework through System Integration Based on Regional Service Governance.
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Prasetyo, Andjar, Noviana, Nana, Rosdiana, Weni, Anwar, M. Arief, Hartiningsih, Hendrixon, Harwijayanti, Bekti Putri, and Fahlevi, Mochammad
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The acceleration of stunting reduction in Indonesia is one of the priority agendas in the health sector, its implementation being through various regional and tiered approaches. This paper aims to manage management using an integrated system framework approach at the regional level and to support the acceleration of stunting reduction nationally. It takes a quantitative description approach that uses secondary data sourced from the Directorate General of Regional Development, Ministry of Home Affairs, the Republic of Indonesia in 2019–2021. The locus of papers is in five provinces, North Kalimantan, South Kalimantan, Central Kalimantan, West Kalimantan, and East Kalimantan, Indonesia. The data collection and processing consisted of twenty stunting convergence coverage referring to regulations in Indonesia. The analysis used is an integrated framework based on five dimensions. Management based on an integrated framework in a regional-based system for stunting convergence can be a solution to accelerating stunting reduction. This paper provides an option to accelerate the handling of stunting through the Integration of Service Governance-Based Systems in Districts/Cities, considering the achievements in the last three years that have not been maximally carried out in every district/city in five provinces in Kalimantan, Indonesia. This study explains that the local government needs to socialize and disseminate the commitment to stunting reduction results to reaffirm commitment and encourage all parties to actively contribute to integrated stunting reduction efforts. This paper has limitations in the implementation of dimensions that can develop in a context that is correlated with several perspectives, such as regional planning, budgetary capacity, and regional capacity. [ABSTRACT FROM AUTHOR]
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- 2023
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12. Prevalence thresholds for wasting, overweight and stunting in children under 5 years
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Rafael Flores-Ayala, Mary Arimond, Patrick Webb, Chika Hayashi, Elaine Borghi, Luz Maria De-Regil, Faith Thuita, Kuntal K. Saha, Trevor Croft, Mercedes de Onis, Rebecca Heidkamp, and Julia Krasevec
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Male ,0301 basic medicine ,HOT TOPIC: Child/Adolescent Nutrition ,Psychological intervention ,Medicine (miscellaneous) ,Distribution (economics) ,Overweight ,Child Nutrition Disorders ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,Prevalence ,medicine ,Humans ,030212 general & internal medicine ,Child growth ,Children ,Wasting ,Growth Disorders ,Stunting ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Anthropometry ,Wasting Syndrome ,business.industry ,Malnutrition ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Infant ,Reference Standards ,Nutrition Surveys ,medicine.disease ,Child, Preschool ,Normative ,Female ,medicine.symptom ,business ,Research Paper - Abstract
ObjectivePrevalence ranges to classify levels of wasting and stunting have been used since the 1990s for global monitoring of malnutrition. Recent developments prompted a re-examination of existing ranges and development of new ones for childhood overweight. The present paper reports from the WHO–UNICEF Technical Expert Advisory Group on Nutrition Monitoring.DesignThresholds were developed in relation tosdof the normative WHO Child Growth Standards. The international definition of ‘normal’ (2sdbelow/above the WHO standards median) defines the first threshold, which includes 2·3 % of the area under the normalized distribution. Multipliers of this ‘very low’ level (rounded to 2·5 %) set the basis to establish subsequent thresholds. Country groupings using the thresholds were produced using the most recent set of national surveys.SettingOne hundred and thirty-four countries.SubjectsChildren under 5 years.ResultsFor wasting and overweight, thresholds are: ‘very low’ (≈6 times 2·5 %). For stunting, thresholds are: ‘very low’ (≈12 times 2·5 %).ConclusionsThe proposed thresholds minimize changes and keep coherence across anthropometric indicators. They can be used for descriptive purposes to map countries according to severity levels; by donors and global actors to identify priority countries for action; and by governments to trigger action and target programmes aimed at achieving ‘low’ or ‘very low’ levels. Harmonized terminology will help avoid confusion and promote appropriate interventions.
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- 2018
13. Relationship between Stunting, Wasting, Underweight and Geophagy and Cognitive Function of Children
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Achille Massougbodji, Michael O. Mireku, Florence Bodeau-Livinec, and Michel Cot
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Male ,Pediatrics ,medicine.medical_specialty ,Cachexia ,wasting ,030231 tropical medicine ,Gross motor skill ,B400 Nutrition ,Logistic regression ,03 medical and health sciences ,C841 Health Psychology ,Cognition ,0302 clinical medicine ,Thinness ,Pregnancy ,geophagy ,Prevalence ,Benin ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Pica (disorder) ,C820 Developmental Psychology ,Wasting ,Growth Disorders ,child development ,business.industry ,pica ,stunting ,Infant, Newborn ,Infant ,Anthropometry ,medicine.disease ,Original Papers ,Child development ,Infectious Diseases ,Pediatrics, Perinatology and Child Health ,Pica ,Female ,medicine.symptom ,Underweight ,business - Abstract
Objectives The aim of this study was to investigate the relationship between anthropometric characteristics and both geophagy and cognitive function of children. Study design The study prospectively followed singleton children whose mothers participated in the MiPPAD clinical trial in Allada, Benin, from birth to age 12 months. Anthropometric measurements were taken at birth and 9 and 12 months. Wasting, stunting and underweight were defined as weight-for-length, length-for-age and weight-for-age Z-scores less than −2, respectively. Cognitive and motor functions were assessed using the Mullen Scales of Early Learning. Parent-reported geophageous habits of children were collected when the children were 12 months. Multiple linear and logistic regressions were used to analyse the data. Results A total of 632 children (49.7% girls) were involved in the study. Stunting, wasting and underweight were observed in 14.1%, 13.6% and 17.7%, respectively, at 9 months and 17.3%, 12.7% and 17.2%, respectively, at 12 months. The prevalence of geophagy among the children was 48.2%. Impaired growth at 9 and 12 months was consistently associated with low cognitive and gross motor (GM) score. Children stunted at 9 months had lower GM scores at 12 months compared with their non-stunted peers (β = −3.48, 95% confidence interval −6.62 to −0.35). Conclusions Stunting, wasting and underweight are associated with cognitive and GM deficits in infants. In this setting, impaired growth was not associated with geophagy. Further research evaluating geophagy and growth prospectively and concurrently from birth to 36 months is needed.
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- 2020
14. The intergenerational impact of electoral violence on height and human capital.
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Gutiérrez-Romero, Roxana
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FOOD prices , *HUMAN capital , *VIOLENCE , *STUNTED growth , *SPATIAL variation , *CONSUMPTION (Economics) - Abstract
• The paper analyzes long-term impacts of electoral violence on health and education. • Areas exposed to violence in Kenya suffer inflation and fall in annual consumption. • Children and adolescents exposed to violence have stunted height as adults. • The sons of those exposed to violence during growing age also have stunted growth. • No long-term impact on education is found as violence peaks during school holidays. This paper examines whether prenatal, childhood, and teenage exposure to electoral violence has any long-term effects on height and human capital in Kenya. First, using the difference-in-difference estimator, we show that areas impacted by electoral violence see increases in local food prices and a decrease in annual nightlight, suggesting important local consumption shocks. We then identify people exposed to such violence using a nationally representative survey and take advantage of the temporal and spatial variation of electoral violence in Kenya between 1992 and 2013. Using coarsened exact matching, we find that exposure to electoral violence between prenatal and the age of sixteen reduces adult height. Previous research has demonstrated that protracted, large-scale armed conflicts can cause significant nutritional shocks and pass down stunting effects to descendants. In line with these studies, we find that the low-scale but recurrent electoral violence in Kenya has impacted the height-for-age of children whose parents were exposed to such violence while they were growing up. Only boys exhibit this intergenerational effect, possibly due to their increased susceptibility to malnutrition and stunting in Sub-Saharan Africa. The fact that most electoral violence in Kenya occurs over the school holidays may help explain why, in contrast to previous studies on large-scale conflicts, childhood exposure to electoral violence has no lasting impact on educational attainment. [ABSTRACT FROM AUTHOR]
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- 2024
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15. Extent and spread of malnutrition among children under five in Indian states.
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Varghese, Nisha
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Children are the most vulnerable victims of undernutrition. Undernutrition increases a child's risk of contracting common infections and also increases the frequency and severity of these illnesses in undernourished children. It is responsible for over half of all fatalities in children under the age of five. Inspite of being one of the fastest growing economies of the world, India ranks only 107th among 121 countries in terms of the global hunger index, 2022. This paper aims at estimating the relative position of various Indian states in terms of child malnutrition. For this purpose, a composite index for malnutrition was worked out for all the states on the basis of state-wise prevalence of stunting, wasting, anemia and low birth weight among children under five. The states were then ranked on the basis of malnutrition index and then classified as those having low, medium or high malnutrition. Maharashtra, Jharkhand, Bihar and Gujarat have high incidence of child malnutrition. The northeastern states of Manipur, Mizoram, Sikkim and Arunachal Pradesh and the southern state of Kerala are the best performing states. [ABSTRACT FROM AUTHOR]
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- 2024
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16. Aflatoxin exposure was not associated with childhood stunting: results from a birth cohort study in a resource-poor setting of Dhaka, Bangladesh
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Mohammed Ashraful Alam, Subhasish Das, John D. Groopman, M Munirul Islam, Muttaquina Hossain, S. M. Tafsir Hasan, Tahmeed Ahmed, Amran Gazi, Patricia A. Egner, Shah Mohammad Fahim, Mustafa Mahfuz, Tampere University, and Clinical Medicine
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0301 basic medicine ,Aflatoxin ,Aflatoxin B1 ,Medicine (miscellaneous) ,Aflatoxin B1-lysine adduct ,Logistic regression ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Aflatoxins ,3123 Gynaecology and paediatrics ,Environmental health ,medicine ,Nutritional Epidemiology ,Humans ,030212 general & internal medicine ,Child ,Children ,Growth Disorders ,Peroxidase ,Resource poor ,Stunting ,Bangladesh ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Plasma samples ,business.industry ,Public Health, Environmental and Occupational Health ,food and beverages ,Anthropometry ,3141 Health care science ,Low birth weight ,medicine.symptom ,Linear growth ,Birth cohort ,business ,Research Paper - Abstract
Objective:Chronic aflatoxin exposure has been associated with childhood stunting (length-for-age/height-for-age < –2 sd), while data lacks for Bangladesh, a country with substantial burden of childhood stunting. This paper examined the association between aflatoxin exposure and childhood stunting in a slum setting of Dhaka city.Design:In this MAL-ED aflatoxin birth cohort study, plasma samples were assayed for aflatoxin B1-lysine adduct (AFB1-lys) by MS at 7, 15, 24 and 36 months of age for 208, 196, 173 and 167 children to assess chronic aflatoxin exposure. Relationship between aflatoxin exposure and anthropometric measures was examined by mixed-effects logistic regression models.Setting and participants:The study was conducted in Mirpur, Dhaka, where children were followed from birth to 36 months.Results:Prevalence of stunting increased from 21 % at 7 months to 49 % at 36 months of age. Mean AFB1-lys concentrations at 7, 15, 24 and 36 months were 1·30 (range 0·09–5·79), 1·52 (range 0·06–6·35), 3·43 (range 0·15–65·60) and 3·70 (range 0·09–126·54) pg/mg albumin, respectively, and the percentage of children with detectable AFB1-lys was 10, 21, 18 and 62 %, respectively. No association was observed between aflatoxin exposure and stunting in multivariable analyses. Factors associated with childhood stunting were age, low birth weight, maternal height, stool myeloperoxidase and number of people sleeping in one room.Conclusions:A relatively lower exposure to aflatoxin may not influence the linear growth of children. This finding indicates a threshold level of exposure for linear growth deficit and further investigation in other areas where higher concentrations of aflatoxin exposure exist.
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- 2020
17. Use of Technology to Access Health Information/Services and Subsequent Association With WASH (Water Access, Sanitation, and Hygiene) Knowledge and Behaviors Among Women With Children Under 2 Years of Age in Indonesia: Cross-sectional Study
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Cut Novianti Rachmi, Cougar Hall, Emmalene Beckstead, Hafizah Jusril, Heidi Jane Niedfeldt, Benjamin T. Crookston, Emily Chahalis, Joshua H. West, Scott Torres, Mindy Jensen, and Britton Reher
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medicine.medical_specialty ,Health Knowledge, Attitudes, Practice ,Sanitation ,Cross-sectional study ,media_common.quotation_subject ,Health Informatics ,handwashing ,010501 environmental sciences ,01 natural sciences ,defecation ,03 medical and health sciences ,0302 clinical medicine ,WASH ,Hygiene ,Water Supply ,Environmental health ,medicine ,Humans ,Open defecation ,030212 general & internal medicine ,Growth Disorders ,0105 earth and related environmental sciences ,media_common ,Toilet ,Original Paper ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,stunting ,Infant ,Cross-Sectional Studies ,Indonesia ,technology ,Latrine ,Defecation ,Female ,Public aspects of medicine ,RA1-1270 ,business ,Medical Informatics - Abstract
Background Water access, sanitation, and hygiene (WASH) remain a public health concern in Indonesia. Proper WASH practices can decrease risk of stunting, wasting, and disease in children under the age of 2. Objective The purpose of our study is to examine if using technology to access health information and services among Indonesian women affects knowledge and behaviors regarding handwashing and defecation practices. Methods Our study is an interview-based cross-sectional survey. Participants included 1734 mothers of children under 2 years of age. These women were randomly selected and interviewed as part of a 3-stage cluster sampling technique. Our study uses data regarding WASH knowledge which includes benefits of handwashing with soap, 5 critical times of handwashing, risks of open defecation, media of disease transmission, defecation locations, and risks of open defecation. Data regarding WASH behaviors were also included: handwashing with soap, type of latrine used at home, and where defecation took place. This investigation used adjusted and unadjusted logistic and linear regression models to determine differences in WASH outcomes between those who use technology to access health information and services and those who did not. Results One result is that Indonesian women with children under 2 years of age who use technology to access health information and services are more likely to know the advantages of proper handwashing (odds ratio [OR] 2.603, 95% CI 1.666-4.067) and know the 5 critical times of handwashing (OR 1.217, 95% CI 0.969-1.528). Women who use technology to access health information are also more likely to know the risks of open defecation (OR 1.627, 95% CI 1.170-2.264) and use a type of toilet (such as a gooseneck or squat toilet) that limits risk (OR 3.858, 95% CI 2.628-5.665) compared to women who did not use technology to access health information. Conclusions Using technology to access health information and services was associated with an increase in handwashing and defecation knowledge. In the future, promoting mothers of children under 2 years of age to access health information through technology might be used to increase handwashing and defecation knowledge as well as safe defecation practices. However, further research should be done to determine how technology may increase the frequency of recommended handwashing behaviors.
- Published
- 2021
18. Mapping of variations in child stunting, wasting and underweight within the states of India: the Global Burden of Disease Study 2000-2017
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Michael Collison, Rajkumar Hemalatha, Anamika Pandey, Anju Sinha, Laishram Ladusingh, R S Sharma, Joy K Chakma, Rakhi Dandona, Chris M Varghese, Subodh S Gupta, Ajay Khera, Rinu P Krishnankutty, Anura V Kurpad, Ridhima Malhotra, Stephen S Lim, Arlappa Nimmathota, Manorama Purwar, Damaris K. Kinyoki, V. Sreenivas, Soumya Swaminathan, Rajni Kant, K. V. Radhakrishna, Joseph L. Mathew, Simon I. Hay, Parul Mutreja, Matthews Mathai, Elaine Borghi, Supriya Dwivedi, Siddarth Ramji, Megan F. Schipp, Anita Kar, Neena Raina, Rakesh Lodha, Helena Manguerra, Mahaveer Golechha, Raja Sriswan Mamidi, Lalit Dandona, Chander Shekhar, Zaozianlungliu Gonmei, Shally Awasthi, Suparna Ghosh Jerath, Deepika Saraf, Nicholas J Kassebaum, Priyanka Gupta Bansal, Christopher J L Murray, Mari Jeeva Sankar, Ashalata Pati, Avula Laxmaiah, K. Srinath Reddy, Hendrik J Bekedam, G Anil Kumar, Deepti Agrawal, and G S Toteja
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Burden of disease ,Research paper ,Inequality ,National Nutrition Mission ,media_common.quotation_subject ,Total fertility rate ,wa_395 ,01 natural sciences ,03 medical and health sciences ,0302 clinical medicine ,ws_115 ,medicine ,Prevalence ,030212 general & internal medicine ,Underweight ,0101 mathematics ,wd_100 ,Wasting ,media_common ,lcsh:R5-920 ,Stunting ,Under-five ,business.industry ,010102 general mathematics ,wa_900 ,ws_20 ,Child growth failure ,Geospatial mapping ,Time trends ,Undernutrition ,General Medicine ,Per capita income ,medicine.disease ,District-level ,wa_320 ,Malnutrition ,medicine.symptom ,WHO/UNICEF targets ,lcsh:Medicine (General) ,business ,Demography - Abstract
Background\ud To inform actions at the district level under the National Nutrition Mission (NNM), we assessed the prevalence trends of child growth failure (CGF) indicators for all districts in India and inequality between districts within the states.\ud \ud Methods\ud We assessed the trends of CGF indicators (stunting, wasting and underweight) from 2000 to 2017 across the districts of India, aggregated from 5 × 5 km grid estimates, using all accessible data from various surveys with subnational geographical information. The states were categorised into three groups using their Socio-demographic Index (SDI) levels calculated as part of the Global Burden of Disease Study based on per capita income, mean education and fertility rate in women younger than 25 years. Inequality between districts within the states was assessed using coefficient of variation (CV). We projected the prevalence of CGF indicators for the districts up to 2030 based on the trends from 2000 to 2017 to compare with the NNM 2022 targets for stunting and underweight, and the WHO/UNICEF 2030 targets for stunting and wasting. We assessed Pearson correlation coefficient between two major national surveys for district-level estimates of CGF indicators in the states.\ud \ud Findings\ud The prevalence of stunting ranged 3.8-fold from 16.4% (95% UI 15.2–17.8) to 62.8% (95% UI 61.5–64.0) among the 723 districts of India in 2017, wasting ranged 5.4-fold from 5.5% (95% UI 5.1–6.1) to 30.0% (95% UI 28.2–31.8), and underweight ranged 4.6-fold from 11.0% (95% UI 10.5–11.9) to 51.0% (95% UI 49.9–52.1). 36.1% of the districts in India had stunting prevalence 40% or more, with 67.0% districts in the low SDI states group and only 1.1% districts in the high SDI states with this level of stunting. The prevalence of stunting declined significantly from 2010 to 2017 in 98.5% of the districts with a maximum decline of 41.2% (95% UI 40.3–42.5), wasting in 61.3% with a maximum decline of 44.0% (95% UI 42.3–46.7), and underweight in 95.0% with a maximum decline of 53.9% (95% UI 52.8–55.4). The CV varied 7.4-fold for stunting, 12.2-fold for wasting, and 8.6-fold for underweight between the states in 2017; the CV increased for stunting in 28 out of 31 states, for wasting in 16 states, and for underweight in 20 states from 2000 to 2017. In order to reach the NNM 2022 targets for stunting and underweight individually, 82.6% and 98.5% of the districts in India would need a rate of improvement higher than they had up to 2017, respectively. To achieve the WHO/UNICEF 2030 target for wasting, all districts in India would need a rate of improvement higher than they had up to 2017. The correlation between the two national surveys for district-level estimates was poor, with Pearson correlation coefficient of 0.7 only in Odisha and four small north-eastern states out of the 27 states covered by these surveys.\ud \ud Interpretation\ud CGF indicators have improved in India, but there are substantial variations between the districts in their magnitude and rate of decline, and the inequality between districts has increased in a large proportion of the states. The poor correlation between the national surveys for CGF estimates highlights the need to standardise collection of anthropometric data in India. The district-level trends in this report provide a useful reference for targeting the efforts under NNM to reduce CGF across India and meet the Indian and global targets.\ud \ud Keywords\ud Child growth failureDistrict-levelGeospatial mappingInequalityNational Nutrition MissionPrevalenceStuntingTime trendsUnder-fiveUndernutritionUnderweightWastingWHO/UNICEF targets
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- 2020
19. Exploring the Nutritional Ecology of Stunting: New Approaches to an Old Problem
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Andrew A. Bremer and Daniel J Raiten
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0301 basic medicine ,Male ,Psychological intervention ,Ecological and Environmental Phenomena ,Nutritional Status ,lcsh:TX341-641 ,malnutrition ,Global Health ,03 medical and health sciences ,0302 clinical medicine ,Child Development ,children ,Environmental health ,Global health ,medicine ,Prevalence ,Humans ,Mass Screening ,030212 general & internal medicine ,Child ,Nutritional ecology ,Growth Disorders ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Mechanism (biology) ,stunting ,Infant ,Concept Paper ,Maternal Nutritional Physiological Phenomena ,medicine.disease ,Food insecurity ,Malnutrition ,Nutrition Assessment ,nutrition ,Child, Preschool ,Maternal nutrition during pregnancy ,Female ,Poor nutrition ,Child Nutritional Physiological Phenomena ,lcsh:Nutrition. Foods and food supply ,Food Science - Abstract
Despite a declining prevalence, stunting remains an elusive target for the global health community. The perception is that stunting represents chronic undernutrition (i.e., due to inadequate nutrient intake associated with food insecurity, low-quality diet, and suboptimal infant feeding practices in the first two years of life). However, other causes include maternal−fetal interactions leading to intrauterine growth retardation, poor maternal nutrition during pregnancy and lactation, and maternal and pediatric infections. Moreover, physical, economic, demographic, and social environments are major contributors to both food insecurity and conditions that limit linear growth. Overall, factors representing both the internal and external “nutritional ecologies” need to be considered in efforts to reduce stunting rates. Nutritional assessment requires better understanding of the mechanism and role of nutrition in growth, clear expectations about the sensitivity and specificity of the tools used, and inclusion of bio-indicators reflecting the extent and nature of the functional effect of poor nutrition and environmental factors contributing to human physical growth. We provide a perspective on current knowledge about: (i) the biology and contribution of nutrition to stunting/poor growth; (ii) our current nutritional assessment toolkit; (iii) the implications of current assessment approaches for clinical care and public interventions; and (iv) future directions for addressing these challenges in a changing global health environment.
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- 2020
20. Associations between enteric pathogen carriage and height-for-age, weight-for-age and weight-for-height in children under 5 years old in urban Dhaka, Bangladesh
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Joe Brown, Drew Capone, David A. Holcomb, David Berendes, Amy J. Pickering, Jackie Knee, and Sonia Sultana
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Male ,medicine.medical_specialty ,Urban Population ,Gastrointestinal Diseases ,Epidemiology ,Developmental Disabilities ,enteric infection ,medicine.disease_cause ,Communicable Diseases ,Feces ,Internal medicine ,Prevalence ,medicine ,Animals ,Humans ,Parasites ,Shigella ,Wasting ,Subclinical infection ,Bangladesh ,Original Paper ,Anthropometry ,Bacteria ,biology ,business.industry ,Giardia ,Body Weight ,Infant, Newborn ,stunting ,Infant ,biology.organism_classification ,Body Height ,Diarrhoea ,Cross-Sectional Studies ,Infectious Diseases ,Carriage ,Child, Preschool ,Carrier State ,Cohort ,Female ,Underweight ,medicine.symptom ,GIARDIA SPP ,business - Abstract
Nutritional factors and infectious agents may contribute to paediatric growth deficits in low- and middle-income countries; however, the contribution of enteric pathogens is only beginning to be understood. We analysed the stool from children Z-scores/Z-score cut-offs (−2 standard deviations (s.d.)) for height-for-age (HAZ/stunting), weight-for-age (WAZ/underweight) and weight-for-height (WHZ/wasting), adjusted for sociodemographic and trial-related factors, and measured caregiver-reported diarrhoea. Enteric pathogen prevalence in the stool was high (88% had ≥1 enteric pathogen, most commonly Giardia spp. (40%), Salmonella enterica (33%), enterotoxigenic E. coli (28%) and Shigella spp. (27%)) while reported 7-day diarrhoea prevalence was 6%, suggesting high subclinical infection rates. Many children were stunted (26%) or underweight (24%). Adjusted models suggested Giardia spp. detection was associated with lower HAZ (−0.22 s.d., 95% CI −0.44 to 0.00; prevalence ratio for stunting: 1.39, 95% CI 0.94–2.06) and potentially lower WAZ. No pathogens were associated with reported diarrhoea in adjusted models. Giardia spp. carriage may be associated with growth faltering, but not diarrhoea, in this and similar low-income settings. Stool-based enteric pathogen detection provides a direct indication of previous exposure that may be useful as a broader endpoint of trials of environmental interventions.
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- 2020
21. Trends and determinants of stunting among under-5s: evidence from the 1995, 2001, 2006 and 2011 Uganda Demographic and Health Surveys
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David Ngendahimana, Ying Ying Yang, Hope Barkoukis, Paul M. Bakaki, Ezekiel Mupere, Darcy A. Freedman, Gabriella Kaddu, and Yovani Moses Lubaale
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Male ,0301 basic medicine ,medicine.medical_specialty ,Secondary education ,Medicine (miscellaneous) ,Odds ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Prevalence ,medicine ,Humans ,Uganda ,030212 general & internal medicine ,Growth Disorders ,2. Zero hunger ,Stunting ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Nutrition Interventions ,business.industry ,Public health ,digestive, oral, and skin physiology ,1. No poverty ,Public Health, Environmental and Occupational Health ,food and beverages ,nutritional and metabolic diseases ,Undernutrition ,Demographic and Health Surveys ,Millennium Development Goals ,medicine.disease ,Health Surveys ,3. Good health ,Malnutrition ,Cross-Sectional Studies ,Sample size determination ,Child, Preschool ,Female ,Residence ,Trends ,business ,Research Paper ,Demography - Abstract
ObjectiveTo describe trends of childhood stunting among under-5s in Uganda and to assess the impact of maternal education, wealth and residence on stunting.DesignSerial and pooled cross-sectional analyses of data from Uganda Demographic and Health Surveys (UDHS) of 1995, 2001, 2006 and 2011. Prevalence of stunting and mean height-for-age Z-score were computed by maternal education, wealth index, region and other sociodemographic characteristics. Multivariable logistic and linear regression models were fitted to survey-specific and pooled data to estimate independent associations between covariates and stunting or Z-score. Sampling weights were applied in all analyses.SettingUganda.SubjectsChildren aged ResultsWeighted sample size was 14 747 children. Stunting prevalence decreased from 44·8% in 1995 to 33·2% in 2011. UDHS reported stunting as 38% in 1995, underestimating the decline because of transitioning from National Center for Health Statistics/Centers for Disease Control and Prevention standards to WHO standards. Nevertheless, one in three Ugandan children was still stunted by 2011. South Western, Mid Western, Kampala and East Central regions had highest odds of stunting. Being born in a poor or middle-income household, of a teen mother, without secondary education were associated with stunting. Other persistent stunting predictors included small birth size, male gender and age 2–3 years.ConclusionsSustained decrease in stunting suggests that child nutrition interventions have been successful; however, current prevalence does not meet Millennium Development Goals. Stunting remains a public health concern and must be addressed. Customizing established measures such as female education and wealth creation while targeting the most vulnerable groups may further reduce childhood stunting.
- Published
- 2018
22. Short-term nutrition and growth indicators in 6-month- to 6-year-old children are improved following implementation of a multidisciplinary community-based programme in a chronic conflict setting
- Author
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Karapet Davtyan, Himanshu A Gupte, Hambardzum Simonyan, Aelita Sargsyan, and Arin A. Balalian
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Male ,Child growth ,Medicine (miscellaneous) ,Nutritional Status ,Growth ,Health Promotion ,Multidisciplinary intervention ,Interdisciplinary research ,Malnutrition in children ,Logistic regression ,Child Nutrition Disorders ,Odds ,Child Development ,Multidisciplinary approach ,Intervention (counseling) ,Surveys and Questionnaires ,Prevalence ,Medicine ,Cycle of poverty ,Humans ,Community Health Services ,Child ,Evaluation ,Wasting ,Poverty ,Growth Disorders ,Interventions ,Human evolution ,Stunting ,Nutrition and Dietetics ,business.industry ,Malnutrition ,Public Health, Environmental and Occupational Health ,Infant ,Anemia ,Armenia ,medicine.disease ,Diet ,Breast Feeding ,Logistic Models ,Child, Preschool ,Female ,medicine.symptom ,business ,Demography ,Research Paper - Abstract
Objective:We investigated short- and long-term indicators of malnutrition and diet before and after the community-based ‘Breaking the Cycle of Poverty’ multidisciplinary intervention.Design:A historically and geographically controlled study using data collected in 2013 and 2016. We compared the prevalence of short-term indicators (anaemia, breast-feeding duration and minimum dietary diversity) and long-term indicators (stunting and wasting) in exposed communities at two time points. We then compared these factors in geographic areas exposed or not exposed to intervention. We conducted logistic regression analyses on the 2016 sample to measure associations between living in intervention communities and child growth indicators.Setting:Berd region, a chronic conflict zone near the north-eastern border of Armenia and Azerbaijan.Participants:Children aged 6 months to 6 years.Results:Analyses included data from 2013 comprising 382 children, and data from 2016 comprising 348 children living in communities where the programme was implemented, and 635 children from unexposed communities. Anaemia prevalence in exposed communities was significantly lower in 2016 v. 2013 (10·9 v. 19·1 %, P < 0·01). Minimum dietary diversity (79·0 v. 68·1 %, P < 0·001) and breast-feeding duration (13·0 v. 11·5 months, P < 0·002) were significantly improved in exposed communities. Prevalences of stunting (11·5 v. 10·2 %, P = 0·57) and wasting (4·8 v. 2·0 %, P = 0·07) were not significantly different. Odds of anaemia were significantly lower (OR = 0·24, 95 % CI 0·16, 0·36) in intervention communities.Conclusions:Exposure to a community-based multidisciplinary intervention reduced the rate of anaemia and improved dietary indicators.
- Published
- 2019
23. Birth seasons and heights among girls and boys below 12 years of age: lasting effects and catch-up growth among native Amazonians in Bolivia
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Abhishek Sharma, Ricardo Godoy, Mary E. Penny, Marek Brabec, Eduardo A. Undurraga, Edward Gibson, Susan Tanner, William R. Leonard, Celeste Kidd, Jere R. Behrman, Susan D. Emmett, and Steven Piantadosi
- Subjects
sex differences ,Male ,Aging ,Physiology ,Epidemiology ,birth month ,Bolivian amazon ,Child Development ,0302 clinical medicine ,Indians ,Dry season ,South American ,030212 general & internal medicine ,050207 economics ,Child growth ,Child ,Growth Disorders ,05 social sciences ,stunting ,Anatomy & Morphology ,Child, Preschool ,Female ,Seasons ,generalised additive model ,Research Paper ,Tsimane' ,Wet season ,Bolivia ,Biology ,Generalised additive model ,03 medical and health sciences ,0502 economics and business ,Genetics ,Humans ,Tsimane ,Preschool ,Indians, South American ,Puberty ,Birth Month ,Infant, Newborn ,Parturition ,Public Health, Environmental and Occupational Health ,Infant ,Newborn ,Late childhood ,Body Height ,Cross-Sectional Studies ,Biochemistry and Cell Biology ,Demography - Abstract
Background: Seasons affect many social, economic, and biological outcomes, particularly in low-resource settings, and some studies suggest that birth season affects child growth. Aim: To study a predictor of stunting that has received limited attention: birth season. Subjects and methods: This study uses cross-sectional data collected during 2008 in a low-resource society of horticulturists-foragers in the Bolivian Amazon, Tsimane’. It estimates the associations between birth months and height-for-age Z-scores (HAZ) for 562 girls and 546 boys separately, from birth until age 11 years or pre-puberty, which in this society occurs ∼13–14 years. Results: Children born during the rainy season (February–May) were shorter, while children born during the end of the dry season and the start of the rainy season (August–November) were taller, both compared with their age–sex peers born during the rest of the year. The correlations of birth season with HAZ were stronger for boys than for girls. Controlling for birth season, there is some evidence of eventual partial catch-up growth, with the HAZ of girls or boys worsening until ∼ age 4–5 years, but improving thereafter. By age 6 years, many girls and boys had ceased to be stunted, irrespective of birth season. Conclusion: The results suggest that redressing stunting will require attention to conditions in utero, infancy and late childhood.
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- 2018
24. Caregiver perceptions of children’s linear growth in Bangladesh: a qualitative analysis
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Gaelen Ritter, Donna M. Denno, Lauren Rice, Nurun Nahar Naila, Tahmeed Ahmed, Scott B. Ickes, Mustafa Mahfuz, Muttaquina Hossain, Baitun Nahar, Judd L. Walson, and Tasnia Zia
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0301 basic medicine ,Gerontology ,Adult ,Male ,Health Knowledge, Attitudes, Practice ,Adolescent ,media_common.quotation_subject ,Psychological intervention ,Medicine (miscellaneous) ,Mothers ,Nutritional Status ,Short stature ,Child Nutrition Disorders ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Child Development ,Perception ,medicine ,Humans ,030212 general & internal medicine ,Growth Disorders ,Qualitative Research ,media_common ,Child nutrition ,Nutritional Status and Body Composition ,Stunting ,Bangladesh ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Linear growth faltering ,Public Health, Environmental and Occupational Health ,Infant ,medicine.disease ,Focus group ,Research Papers ,Malnutrition ,Caregivers ,Maternal perceptions ,Child, Preschool ,Developmental Milestone ,Female ,medicine.symptom ,Linear growth ,Psychology ,Slum - Abstract
ObjectiveTo understand caregivers’ perceptions of children’s linear growth and to identify the cultural meanings and perceptions of risk associated with poor height attainment.DesignThree investigators from Bangladesh conducted twelve focus group discussions.SettingThe study was conducted in rural and slum settings in Bangladesh.SubjectsParticipants included mothers and alternative caregivers (n 81) who were recruited by household screening. No eligible, recruited subjects refused participation.ResultsCaregivers reported limited experience with growth monitoring services from the health system. Caregivers mainly use visual cues and developmental milestones to understand if children are growing properly, and recognize that children normally experience both weight gain and linear growth with age. Mothers expressed concern over children’s malnutrition and short stature, but did not discuss children’s failure to attain a ‘growth potential’ or distinguish inherited short stature from stunting. Caregivers interpret the consequences of poor height attainment as primarily social and economic and cite few health risks.ConclusionsLinear growth interpretation is determined more by community norms than by guidance from nutrition programming or the health system. Interventions to prevent or reduce linear growth failure may be perceived to have limited value where appropriate linear growth in children is determined by comparison to peers and siblings. Such perceptions may be significant barriers to programmes addressing stunting prevention in settings where many children are stunted. Efforts to raise awareness about the risks of linear growth faltering may need to consider delivering messages to caregivers that emphasize the social and economic consequences of stunting.
- Published
- 2018
25. PAthogen Transmission and Health Outcome Models of Enteric Disease (PATHOME)
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African Population and Health Research Center and Kelly K Baker, Associate Professor
- Published
- 2024
26. Unpacking the discourses of stunting in Indonesian early childhood education and parenting.
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Adriany, Vina and Tesar, Marek
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GOVERNMENT regulation ,POLICY science research ,PARENTING ,EARLY intervention (Education) ,RESEARCH funding ,DISCOURSE analysis ,TEACHERS ,GROWTH disorders ,NUTRITION policy ,SECONDARY analysis - Abstract
This paper interrogates the discourses of stunting in Indonesia and its links to early childhood education. Here, stunting is analysed via Foucault's work, with data stemming from a long‐term ethnography study and analysis of relevant policy documents in Indonesia. We argue the discourses of stunting have been regulating children, teachers and parents by acting as a form of biopower of governing rationalities. Focusing merely on the individual and nutrition aspects, the discourses overlook larger societal problems. In such a space, the children, teachers and parents become a site of the state's surveillance and are produced as docile bodies. [ABSTRACT FROM AUTHOR]
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- 2023
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27. Heterogeneity in potential impact and cost-effectiveness of ETEC and Shigella vaccination in four sub-Saharan African countries
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John D. Anderson, Thomas F. Wierzba, Farzana Muhib, and Richard Rheingans
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lcsh:Immunologic diseases. Allergy ,Sanitation ,Cost effectiveness ,Disparities ,medicine.disease_cause ,Environmental health ,Enterotoxigenic Escherichia coli ,parasitic diseases ,Medicine ,Shigella ,Shigella vaccine ,Disease burden ,health care economics and organizations ,Stunting ,Subnational ,General Veterinary ,General Immunology and Microbiology ,Sub-Saharan Africa ,business.industry ,ETEC ,Cost-effectiveness analysis ,Public Health, Environmental and Occupational Health ,Diarrhoea ,Vaccination ,Infectious Diseases ,Regular paper ,Molecular Medicine ,business ,lcsh:RC581-607 - Abstract
Diarrheal disease burden has become more heterogenous in low- and lower middle-income countries as access to clean water, sanitation and health care has increased in wealthier urban populations. Enterotoxigenic Escherichia coli (ETEC) and Shigella are among the top five causes of diarrheal mortality in children living in sub-Saharan Africa.Here, we explored how accounting for subnational and economic heterogeneity in ETEC and Shigella disease burden affects projected vaccine impact and cost-effectiveness of standalone ETEC and Shigella vaccines during the first decade after introduction in four sub-Saharan African countries. We developed dynamic models for provincial areas and socioeconomic subpopulations of children in the Democratic Republic of Congo (DRC), Kenya, Zambia, and Zimbabwe. We estimated deaths and morbidity due to ETEC and Shigella diarrhea plus additional deaths from other infectious diseases attributable to ETEC- and Shigella-induced stunting. We analyzed cost-effectiveness using Incremental Cost-Effectiveness Ratios (ICERs) with Disability-Adjusted Life Years (DALYs) and Moderate-and-Severe Diarrheal episodes (MSD) averted as denominators.Other infectious disease deaths due to induced stunting accounted for 9–28% and 9–32% of the total provincial level ETEC and Shigella disease burden, respectively, across these four countries from years 2025 to 2034. Our results indicated that the lowest and most cost-effective provincial DALYs averted ICERs were below $600 and $500/DALY averted for ETEC and Shigella vaccination, respectively in Zimbabwe. ICERs were the highest in Zambia and Kenya, where all provincial ICERs where above $2000/DALY. The highest national and provincial MSD averted ICERs were in DRC, while the lowest were in Kenya and Zimbabwe. Vaccinations were most cost-effective in averting DALYs in lower wealth subpopulations living in the highest burden provincial areas.Our approach focused on subnational heterogeneity in ETEC and Shigella burden and vaccination access found that impact and cost-effectiveness were more favorable if vaccinations reach the most vulnerable children in underserved provinces. Keywords: ETEC, Shigella, Sub-Saharan Africa, Disparities, Cost-effectiveness analysis, Subnational, Diarrhoea, Stunting
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- 2019
28. Potential impact and cost-effectiveness of future ETEC and Shigella vaccines in 79 low- and lower middle-income countries
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Richard Rheingans, Lindsey A. Laytner, John D. Anderson, Mirna Amaya, Farzana Muhib, Thomas F. Wierzba, Karoun H. Bagamian, and Ranju Baral
- Subjects
lcsh:Immunologic diseases. Allergy ,Diarrhea ,Cost effectiveness ,medicine.disease_cause ,Enterotoxigenic Escherichia coli ,Environmental health ,medicine ,Shigella ,Shigella vaccine ,Disease burden ,Stunting ,Vaccines ,General Veterinary ,General Immunology and Microbiology ,business.industry ,ETEC ,Public Health, Environmental and Occupational Health ,Vaccine efficacy ,Vaccination ,Infectious Diseases ,Regular paper ,Molecular Medicine ,Cost-effectiveness ,medicine.symptom ,business ,lcsh:RC581-607 - Abstract
While diarrhea mortality in children has declined over the last two decades, there has been a slower decline in diarrheal episodes. Repeated diarrheal episodes are associated with childhood stunting, which leads to increased mortality risk from infectious diseases. Vaccine candidates are under development for enterotoxigenic Escherichia coli [ETEC] and Shigella, important enteric pathogens in children in low income countries. These future vaccines could significantly reduce diarrheal burden, prevent ETEC- and Shigella-induced stunting, and stunting-associated mortality.We developed a cost-effectiveness model for two putative standalone ETEC and Shigella vaccine candidates to evaluate vaccine impact on mortality, morbidity, stunting, and stunting-associated deaths from other infectious diseases. We modeled impact over the first ten years after vaccine introduction in children under five years old living in 79 low and low-middle income countries.ETEC and Shigella diarrhea would cause an estimated 239,300 [95% UL: 179,700–309,800] and 340,300 [256,500–440,800] child deaths, respectively, from years 2025 to 2034. Most of these deaths would occur in AFRO countries. ETEC and Shigella moderate-to-severe diarrheal episodes would result in over 13.7 [8.4–19.0] and 21.4 [13.1–29.8] million stunted children, respectively. Introducing ETEC or Shigella vaccine each with 60% efficacy could prevent 92,000 [61,000–129,000] ETEC and 126,600 [84,000–179,000] Shigella direct deaths and 21,400 [11,300–34,800] ETEC- and 34,200 [18,000–56,000] Shigella-induced stunting deaths. ETEC ICERs ranged from $2172/DALY [1457–4369] in AFRO to $19,172/DALY [12,665–39,503] in EURO. Shigella ICERs ranged from $952/DALY [632–2001] in EMRO to $640,316/DALY [434,311–1,297,192] in EURO.Limitations of this analysis include uncertainty of vaccine efficacy, duration of protection, and vaccine price. Inclusion of other infectious disease mortality due to stunting provides a more accurate assessment of total ETEC and Shigella disease burden and increased the projected impact and cost-effectiveness of vaccination. Introducing vaccines only in high burden countries and regions could substantially reduce cost without substantially reducing impact. Keywords: ETEC, Shigella, Diarrhea, Stunting, Cost-effectiveness, Vaccines
- Published
- 2019
29. Improving screening for malnourished children at high risk of death: A study of children aged 6-59 months in rural Senegal - ERRATUM
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Mark Myatt, Tanya Khara, Carmel Dolan, Michel Garenne, and André Briend
- Subjects
Male ,Rural Population ,Medicine (miscellaneous) ,Child Nutrition Disorders ,Risk Assessment ,Cohort Studies ,Risk Factors ,Humans ,Mass Screening ,Nutritional Epidemiology ,Underweight ,Mortality ,Growth Disorders ,Stunting ,Nutrition and Dietetics ,Anthropometry ,Wasting Syndrome ,Body Weight ,Malnutrition ,Public Health, Environmental and Occupational Health ,Infant ,Therapeutic feeding ,Child survival ,Body Height ,Senegal ,Wasting ,Child, Preschool ,Arm ,Mid-upper arm circumference ,Female ,Erratum ,Research Paper - Abstract
Objective To investigate whether children with concurrent wasting and stunting require therapeutic feeding and to better understand whether multiple diagnostic criteria are needed to identify children with a high risk of death and in need of treatment. Design Community-based cohort study, following 5751 children through time. Each child was visited up to four times at 6-month intervals. Anthropometric measurements were taken at each visit. Survival was monitored using a demographic surveillance system operating in the study villages. Setting Niakhar, a rural area of the Fatick region of central Senegal. Participants Children aged 6–59 months living in thirty villages in the study area. Results Weight-for-age Z-score (WAZ) and mid-upper arm circumference (MUAC) were independently associated with near-term mortality. The lowest WAZ threshold that, in combination with MUAC, detected all deaths associated with severe wasting or concurrent wasting and stunting was WAZ
- Published
- 2019
30. Gender-specific disaggregated analysis of childhood undernutrition in Ethiopia: evidence from 2000–2016 nationwide survey.
- Author
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Sahiledengle, Biniyam, Mwanri, Lillian, Blumenberg, Cauane, and Agho, Kingsley Emwinyore
- Subjects
MALNUTRITION ,BIRTH size ,BIRTH order ,CHILDBIRTH ,DEMOGRAPHIC surveys - Abstract
Introduction: Childhood undernutrition has been investigated extensively in previous literature but gender inequality detailing the burden of undernutrition has not been adequately addressed in scientific papers, especially in Ethiopia, where undernutrition is known to be a public health problem of high significance, necessitating increased efforts to address it and reduce this inequality. This study was carried out to: (1) explore gender differences in the prevalence of stunting, wasting, and underweight, and (2) compare the factors associated with childhood undernutrition between boys and girls in Ethiopia. Methods: The study used a dataset of more than 33,564 children aged under 5 years (boys: 17,078 and girls: 16,486) who were included in the nationally representative Ethiopia Demographic and Health Survey (EDHS) from 2000 to 2016. The outcome variables were anthropometric indices: stunting (height-for-age < -2 standard deviations), wasting (weight-for-height < -2 standard deviations), and underweight (weight-for-age < -2 standard deviations). Gender-specific multilevel analyses were used to examine and compare the factors associated with child undernutrition. Results: The overall prevalence of stunting (49.1% for boys vs 45.3% for girls, p < 0.001), wasting (11.9% for boys vs 9.9% for girls, p < 0.001), and underweight (33.1% for boys vs 29.8% for girls, p < 0.001) higher among boys compared to girls. Boys significantly had higher odds of stunting (aOR: 1.31, 95%CI: 1.21–1.42), wasting (aOR: 1.35, 1.23–1.48), and underweight (aOR: 1.38, 95%CI: 1.26–1.50) than girls. The common factors associated with childhood undernutrition for male and female children were the child's age, perceived size of the child at birth, breastfeeding status, maternal stature, maternal education, toilet facility, wealth index, and place of residence. Boys who were perceived by their mothers to be average sized at birth and were born to uneducated mothers had a higher likelihood of experiencing wasting, in contrast to girls. Among boys, birth order (firstborn), household size (1–4), and place of residence (urban) were associated with lower odds of being underweight. Boys living in cities had lower odds of being stunted. While girls born to mothers with no education and worked in agriculture were at a higher odd of being stunted. Conclusion: Our study revealed that boys were more likely to be malnourished than girls, regardless of their age category, and there were variations in the factors determining undernutrition among boys and girls. The differences in the burden of undernutrition were significant and alarming, positioning Ethiopia to be questioned whether it will meet the set Sustainable Development Goals (SDGs), including SDG 2 of zero hunger by 2030. These findings call for more effort to address malnutrition as a significant public health issue in Ethiopia, and to urgently recognise the need for enhanced interventions that address the gender gap in childhood undernutrition. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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31. STUNTING IS NOT GENDER-NEUTRAL: A LITERATURE REVIEW.
- Author
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Rahmawati, Maulida and Putri, Nuzulul Kusuma
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DIVERSITY & inclusion policies ,SOCIAL determinants of health ,HEALTH services accessibility ,MIDDLE-income countries ,GENDER-neutral language ,SEX distribution ,INTERSECTIONALITY ,MALNUTRITION ,LOW-income countries ,SEX discrimination ,HEALTH equity ,GROWTH disorders ,DISEASE risk factors - Abstract
Background: Stunting is one of the undernutrition outcomes commonly reported in LMICs. It results from chronic or recurrent undernutrition and is associated with social determinants. Indonesia has promoted various programs to reduce and prevent stunting. The programs tend to not be gender-responsive with no existence of gender analysis on the programs. Purpose: To analyze the intersectionality of gender with other social determinants of stunting, transforming into any stunting program barriers within the health system. Methods: This narrative review was conducted using original research articles on the Scopus database. Two independent reviewers performed review selection and characterization. We grouped the identified gender intersectionality and constraints imposed on stunting programs based on three-levels of health systems. Results: There were 19 papers included in this literature review. Two main messages were identified. First, gender has a different impact on any health program. It interacted with other social determinants in shaping the risk of being stunted. Second, the gender intersectionality will be different for each level of health system. Conclusion: Gender intersects with different social determinants in each level of the health system. The impact of gender intersectionality with other stunting determinant stunting is identified. Hence, stunting is not gender neutral. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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32. Child diarrhoea and nutritional status in rural Rwanda: a cross‐sectional study to explore contributing environmental and demographic factors
- Author
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James Habyarimana, Karen A. Grépin, Leodomir Mfura, William Jack, Jeannine Condo, Zachary Clemence, Sophie Boisson, Wolf-Peter Schmidt, Ronald Wendt, Thomas Clasen, Erin Crossett, Kris Cox, and Sheela S. Sinharoy
- Subjects
medicine.medical_specialty ,Sanitation ,Cross-sectional study ,sanitation ,030231 tropical medicine ,Population ,diarrhée ,sanitaire ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,medicine ,030212 general & internal medicine ,eau potable ,Improved sanitation ,education ,Wasting ,education.field_of_study ,business.industry ,Public health ,drinking water ,Public Health, Environmental and Occupational Health ,stunting ,Anthropometry ,diarrhoea ,Diarrhea ,Infectious Diseases ,nutrition ,Parasitology ,Original Article ,medicine.symptom ,business ,Original Research Papers ,retard de croissance - Abstract
To explore associations of environmental and demographic factors with diarrhoea and nutritional status among children in Rusizi district, Rwanda. We obtained cross-sectional data from 8,847 households in May-August 2013 from a baseline survey conducted for an evaluation of an integrated health intervention. We collected data on diarrhoea, water quality, and environmental and demographic factors from households with children
- Published
- 2016
33. Droplet digital PCR quantifies host inflammatory transcripts in feces reliably and reproducibly
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M Isabel Ordiz, Jennifer L. Stauber, Nurmohammad Shaikh, Phillip I. Tarr, and Mark J. Manary
- Subjects
0301 basic medicine ,Analyte ,Malawi ,Human mRNA ,030231 tropical medicine ,Immunology ,Environmental enteric dysfunction ,Biology ,digestive system ,Polymerase Chain Reaction ,Sensitivity and Specificity ,law.invention ,03 medical and health sciences ,Feces ,Quantitative PCR ,0302 clinical medicine ,Intestinal mucosa ,law ,Gene expression ,Humans ,Digital polymerase chain reaction ,RNA, Messenger ,Intestinal Mucosa ,Polymerase chain reaction ,Gut inflammation ,Inflammation ,Stunting ,digestive, oral, and skin physiology ,Infant ,Reproducibility of Results ,Molecular biology ,030104 developmental biology ,Real-time polymerase chain reaction ,Stool ,Child, Preschool ,Nucleic acid ,Inflammation Mediators ,Research Paper - Abstract
Highlights • Direct measurement of gut epithelial immunology is difficult. • Fecal host transcript can measured using conservative transcript isolation and droplet digital PCR. • A new method to non-invasively elucidate gut immunology is described., The gut is the most extensive, interactive, and complex interface between the human host and the environment and therefore a critical site of immunological activity. Non-invasive methods to assess the host response in this organ are currently lacking. Feces are the available analyte which have been in proximity to the gut tissue. We applied a method of concentrating host transcripts from fecal specimens using a existing bead-based affinity separation method for nucleic acids and quantified transcripts using droplet digital PCR (ddPCR) to determine the copy numbers of a variety of key transcripts in the gut immune system. ddPCR compartmentalizes the reaction in a small aqueous droplet suspended in oil, and counts droplets as either fluorescent or non-fluorescent. Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) was used to normalize transcript concentration. This method was applied to 799 fecal samples from rural Malawian children, and over 20,000 transcript concentrations were quantified. Host mRNA was detected in >99% samples, a threshold for target detection was established at an average expression of 0.02 copies target/GAPDH, above which correlation coefficient between duplicate measurements is >0.95. Quantities of transcript detected using ddPCR were greater than standard qPCR. Fecal sample preservation at the time of collection did not require immediate freezing or the addition of buffers or enzymes. Measurements of transcripts encoding immunoactive proteins correlated with a measure of gut inflammation in the study children, thereby substantiating their relevance. This method allows investigators to interrogate gene expression in the gut.
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- 2016
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34. Stunting coexisting with overweight in 2·0–4·9-year-old Indonesian children: prevalence, trends and associated risk factors from repeated cross-sectional surveys
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Mu Li, Louise A. Baur, Kingsley E Agho, and Cut Novianti Rachmi
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Male ,0301 basic medicine ,Gerontology ,Double burden ,Cross-sectional study ,Nutritional Status ,Medicine (miscellaneous) ,Overweight ,Overweight/obesity ,03 medical and health sciences ,Risk Factors ,Surveys and Questionnaires ,Prevalence ,medicine ,Humans ,Obesity ,Children ,Growth Disorders ,Stunting ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Monitoring and Surveillance ,Public Health, Environmental and Occupational Health ,nutritional and metabolic diseases ,Infant ,Secondary data ,medicine.disease ,Research Papers ,Body Height ,Family life ,language.human_language ,Indonesian ,Malnutrition ,Cross-Sectional Studies ,Indonesia ,Child, Preschool ,language ,Female ,medicine.symptom ,business ,Demography - Abstract
ObjectiveThe persistence of undernutrition, along with overweight and obesity, constitute the double burden of malnutrition. The present study aimed to: (i) describe the prevalence and trends of concurrent stunting and overweight in Indonesian children; (ii) identify potentially associated risk factors; and (iii) determine whether stunted children are at greater risk of overweight compared with those of healthy height.DesignA secondary data analysis of children aged 2·0–4·9 years in four cross-sectional studies of the Indonesian Family Life Survey. Children’s height and BMI Z-scores were calculated based on the WHO Child Growth Standards (2006). We defined ‘concurrent stunting and overweight’ as height-for-age Z-score Z-score >+1. Multivariate generalised linear latent and mixed models were used to determine associated risk factors.SettingThirteen out of twenty-seven provinces in Indonesia.SubjectsChildren (n 4101) from four waves of the Indonesian Family Life Survey (1993–2007).ResultsThere were inconsistent trends in the prevalence of concurrent stunting and overweight from waves 1 to 4. Children were more likely to be stunted and overweight when they were in the youngest age group (2·0–2·9 years), were weaned after the age of 6 months, had short-statured mothers or lived in rural areas. Stunted children were significantly more likely to be overweight than healthy-height children (OR>1) but did not differ significantly different across each wave (OR=1·34–2·01).ConclusionsConcurrent stunting and overweight occurs in Indonesian children aged 2·0–4·9 years. Current policies and programmes need to be tailored for the management of this phenomenon.
- Published
- 2016
35. Factors Associated with Stunting among Pre-school Children in Southern Highlands of Tanzania
- Author
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George Mutembei Mutwiri, Debarati Guha-Sapir, Tefera Darge Delbiso, Regine Kopplow, Chiara Altare, and UCL - SSS/IRSS - Institut de recherche santé et société
- Subjects
Male ,0301 basic medicine ,Pediatrics ,Cross-sectional study ,Breastfeeding ,Growth ,Tanzania ,Food Supply ,0302 clinical medicine ,Risk Factors ,Surveys and Questionnaires ,diet diversity ,Prevalence ,030212 general & internal medicine ,Growth Disorders ,Stunting ,Family Characteristics ,stunting ,Original Papers ,Maternal support ,Infectious Diseases ,Family planning ,Child, Preschool ,Community Health ,Female ,medicine.medical_specialty ,growth ,Mothers ,Nutritional Status ,03 medical and health sciences ,Thinness ,maternal support ,medicine ,Humans ,Poverty ,child care ,Pregnancy ,030109 nutrition & dietetics ,business.industry ,Public health ,Infant ,Odds ratio ,medicine.disease ,Child care ,Health Surveys ,Confidence interval ,Diet ,Cross-Sectional Studies ,Socioeconomic Factors ,Pediatrics, Perinatology and Child Health ,Diet diversity ,business ,Breast feeding ,Demography - Abstract
Background: Stunting is a major public health problem in Africa and is associated with poor child survival and development. We investigate factors associated to child stunting in three Tanzanian regions. Methods: A cross-sectional two-stage cluster sampling survey was conducted among children aged 6-59 months. The sample included 1360 children aged 6-23 months and 1904 children aged 24-59 months. Descriptive statistics and binary and multivariate logistic regression analyses were used. Results: Our main results are: in the younger group, stunting was associated with male sex (adjusted odds ratio [AOR]: 2.17; confidence interval [CI]: 1.52-3.09), maternal absence (AOR: 1.93; CI: 1.21-3.07) and household diet diversity (AOR: 0.61; CI: 0.41-0.92). Among older children, stunting was associated with male sex (AOR: 1.28; CI: 1.00-1.64), age of 4 and 5 (AOR: 0.71; CI: 0.54-0.95; AOR: 0.60; CI: 0.44-0.83), access to improved water source (AOR: 0.70; CI: 0.52-0.93) and to a functioning water station (AOR: 0.63; CI: 0.40–0.98) and mother breastfeeding (AOR: 1.97; CI: 1.18-3.29). Conclusions: Interventions that increase household wealth and improve water and sanitation conditions should be implemented to reduce stunting. Family planning activities and programmes supporting mothers during pregnancy and lactation can positively affect both newborns and older siblings.
- Published
- 2016
36. Predictors of the risk of malnutrition among children under the age of 5 years in Somalia
- Author
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Abdisalan M. Noor, Ngianga-Bakwin Kandala, Grainne Moloney, James A. Berkley, and Damaris K. Kinyoki
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Male ,Gerontology ,Climate ,Medicine (miscellaneous) ,Prevalence ,Body Size ,Infant Nutritional Physiological Phenomena ,Wasting ,Growth Disorders ,2. Zero hunger ,Family Characteristics ,Stunting ,education.field_of_study ,Nutrition and Dietetics ,Food security ,1. No poverty ,Nutrition Surveys ,Research Papers ,3. Good health ,Child, Preschool ,Arm ,Mid-upper arm circumference ,Female ,medicine.symptom ,Child Nutritional Physiological Phenomena ,Risk ,medicine.medical_specialty ,Somalia ,Severe Acute Malnutrition ,Population ,Nutritional Status ,Developing country ,Dysentery ,Environmental health ,medicine ,Humans ,education ,Nutritional Status and Body Composition ,Waist-Height Ratio ,Poverty ,Wasting Syndrome ,business.industry ,Public health ,Malnutrition ,Public Health, Environmental and Occupational Health ,Infant ,medicine.disease ,Diet ,Cross-Sectional Studies ,Socioeconomic Factors ,business - Abstract
Malnutrition is a leading cause of childhood deaths in low- and middle-income countries( 1 ) and has permanent consequences for cognitive, physical and metabolic development( 2 ). The burden of acute malnutrition is often greatest in areas suffering complex emergencies such as drought or conflict( 3 ). Somalia has been without a nationally recognized central government since 1991 and is one of the most unsafe countries globally( 4 ). This long period of insecurity and political instability has affected all facets of human life and development( 5 ). Somalia is now ranked the fifth poorest country globally and has among the highest child and maternal mortality rates( 6 ). It is also ranked lowest on the food security index( 6 ) and currently is estimated to have the highest rate of acute malnutrition in the world( 4 ). In 2011, approximately 2·9 million Somalians, or 35 % of the population, experienced food crisis( 7 ). In the last two decades, international and local non-governmental organizations have supported essential public health services in Somalia. Primary health-care services are funded by several international organizations and donors, coordinated under the umbrella of the Somalia Support Secretariat, which was established under the auspices of a network including donors, UN agencies and international non-governmental organizations( 4 ). Interventions are often implemented under highly insecure conditions, especially in the southern parts of the country( 8 ). Interventions against food insecurity and malnutrition have been a major focus, including out-patient therapeutic feeding programmes for severe acute malnutrition and targeted supplementary feeding programmes for moderately malnourished children under the age of 5 years and pregnant or lactating women( 4 ). In 1994 the World Food Programme set up the Food Security Analysis Unit, later renamed the Food Security and Nutritional Analysis Unit (FSNAU), to provide timely information to monitor and inform interventions to mitigate food insecurity and malnutrition in Somalia( 4 , 9 ). Since 2011, the FSNAU has undertaken several random cluster nutritional surveys including demographic, household and anthropometric data. These surveys have been used to inform the nature and timing of nutritional interventions across the country and provide alerts for acute food insecurity. Data from these surveys provide an opportunity to identify the determinants of childhood malnutrition during the complex emergency situation in Somalia. Although inadequate nutritional intake is an obvious direct cause of malnutrition, many other factors are involved in causation, including poverty and access to health care, water and sanitation. These may be potential targets for interventions that could have a more sustained effect than reactive nutritional programmes( 10 – 14 ). Unravelling the determinants that are most important in this specific context can inform the efficient targeting of such interventions. The determinants of childhood nutritional status can be classified as either proximate or distal( 15 ). Proximate factors have been the focus of most published literature and are child specific, including age, sex, inadequate nutritional intake and infections( 2 , 16 , 17 ). Distal factors include features of the wider socio-cultural, economic, environmental, climatic and political context that affect household food security, personal security and access to economic opportunities, health care and education( 18 ). These factors are likely to vary spatially and temporally, depending on geographic and climatic conditions and anthropogenic factors, and analyses must account for these variations. In the present study, the first nationwide investigation of the predictors of malnutrition among children aged 6–59 months in Somalia is undertaken using the data from the FSNAU household cross-sectional nutritional surveys done from 2007 to 2010. Bayesian spatial-temporal regression models are applied to the data to account for the space and time effects on wasting, stunting and mid-upper arm circumference (MUAC).
- Published
- 2015
37. Maternal education and child malnutrition: evidence from selected West African countries
- Author
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Yorke, Frederick Richmond, Wahab, Samiratu, and Turkson, Danny
- Published
- 2023
- Full Text
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38. Minimum Wages around Birth and Child Health.
- Author
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Majid, Muhammad Farhan and Behrman, Jere R
- Subjects
MINIMUM wage ,CHILDBIRTH ,REAL wages ,FIXED effects model ,CHILDREN'S health - Abstract
This paper studies the effects of minimum wages in Indonesia around the time of birth on child height-for-age Z scores (HAZ) up to five years of age. Using variations in annual fluctuations in real minimum wages in different Indonesian provinces, it finds that children exposed to increases in minimum wages in their birth years have higher HAZ in the first five years of their lives. The estimated impacts are based on difference-in-differences models with biological-mother fixed effects and year-of-birth fixed effects and are robust to inclusion of multiple time-varying factors. The impacts are prominent particularly among male children. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
39. Birth registration and child undernutrition in sub-saharan Africa
- Author
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Stefano Cabras, Ornella Comandini, and Elisabetta Marini
- Subjects
Pediatrics ,medicine.medical_specialty ,media_common.quotation_subject ,Nutritional Status ,Medicine (miscellaneous) ,Estadística ,Logistic regression ,Child Nutrition Disorders ,03 medical and health sciences ,0302 clinical medicine ,Thinness ,Prevalence ,medicine ,Humans ,Registries ,030212 general & internal medicine ,Underweight ,Wasting ,Africa South of the Sahara ,Growth Disorders ,Selection Bias ,media_common ,Selection bias ,Stunting ,030505 public health ,Nutrition and Dietetics ,Multiple Indicator Cluster Surveys ,Anthropometry ,Wasting Syndrome ,business.industry ,Body Weight ,Malnutrition ,Public Health, Environmental and Occupational Health ,Demographic and health surveys ,medicine.disease ,Research Papers ,Multiple indicator cluster surveys ,Cross-Sectional Studies ,Negative relationship ,Birth Certificates ,Child, Preschool ,medicine.symptom ,0305 other medical science ,business ,Demography - Abstract
ObjectiveIn many countries of the world millions of people are not registered at birth. However, in order to assess children’s nutritional status it is necessary to have an exact knowledge of their age. In the present paper we discuss the effects of insufficient or imprecise age data on estimates of undernutrition prevalence.DesignBirth registration rates and levels of stunting, underweight and wasting were retrieved from Multiple Indicator Cluster Surveys and Demographic and Health Surveys of thirty-seven sub-Saharan African countries, considering the subdivision in wealth quintiles. The composition of the cross-sectional sample used for nutritional evaluation was analysed using a permutation test. Logistic regression was applied to analyse the relationship between birth registration and undernutrition. The 95 % probability intervals and Student’s t test were used to evaluate the effect of age bias and error.ResultsHeterogeneous sampling designs were detected among countries, with different percentages of children selected for anthropometry. Further, registered children were slightly more represented within samples used for nutritional analysis than in the total sample. A negative relationship between birth registration and undernutrition was recognized, with registered children showing a better nutritional status than unregistered ones, even within each wealth quintile. The over- or underestimation of undernutrition in the case of systematic over- or underestimation of age, respectively, the latter being more probable, was quantified up to 28 %. Age imprecision was shown to slightly overestimate undernutrition.ConclusionsSelection bias towards registered children and underestimation of children’s age can lead to an underestimation of the prevalence of undernutrition.
- Published
- 2016
40. Triple trouble: Understanding the burden of child undernutrition, micronutrient deficiencies, and overweight in East Asia and the Pacific.
- Author
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Blankenship, Jessica L., Rudert, Christiane, and Aguayo, Victor M.
- Subjects
MALNUTRITION ,FOOD quality ,MOTHERS ,NUTRITIONAL requirements ,OBESITY ,QUALITY of life ,MICRONUTRIENTS ,WASTING syndrome ,COVID-19 pandemic - Abstract
Young children in the East Asia and the Pacific region1 are failing to thrive, in large numbers, as indicated by stagnation in the decline of stunting, wasting, and micronutrient deficiencies and the fastest growing rates of overweight in the world. Eliminating the triple burden of malnutrition is essential to ensure that, as a matter of right, all children reach their full physical growth and development potential and actively contribute to equitable prosperity and the sustainable development of their communities and nations. Ending all forms of malnutrition will only be achieved through the implementation of effective policies and programmes soundly based on an understanding of the leading contextual drivers of child malnutrition. To address the lack of data on these drivers in the region, the UNICEF regional office for East Asia and the Pacific commissioned a series of papers in 2017–2019 to fill gaps in the current body of evidence on the triple burden of maternal and child malnutrition. This series includes analyses of the determinants of child malnutrition including maternal nutrition status, dietary quality of children, inequity, and poverty. Additionally, policy and programmatic actions associated with improved coverage and quality of nutrition interventions are reviewed. This overview paper summarizes the findings of these analyses and presents recommendations for the direction of future advocacy, policy, and programmatic actions to address the triple burden of malnutrition in East Asia and the Pacific. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
41. Assessing socioeconomic inequalities in the reduction of child stunting in sub-Saharan Africa.
- Author
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Asuman, Derek, Ackah, Charles Godfred, Fenny, Ama P., and Agyire-Tettey, Frank
- Subjects
GROWTH disorders ,REGRESSION analysis ,SOCIOECONOMIC factors ,CHILDREN - Abstract
Aim: Health and nutrition in early childhood are essential for survival, growth and adult life outcomes. As such, a number of global and national interventions have been pursued to improve early childhood health and nutrition. However, child malnutrition is pervasive and endemic across the sub Saharan Africa. This paper therefore assesses the nature and trends of socioeconomic inequalities in child stunting. The paper proceeds to decompose the causes of such socioeconomic-related inequalities over the period covered. Subjects and methods: We used data from Demographic and Health Surveys (DHSs) for ten sub-Saharan African countries conducted between 2000 and 2016. The study employs an extension to the concentration index for binary health outcomes to measure socioeconomic inequalities in stunting and decompose the causes of inequalities in stunting using a generalized decomposition technique based on recentered influence function regressions. Results: The results show substantial pro-rich inequalities in child stunting across sub-Saharan Africa. The incidence of stunting are concentrated among children living in households with low socioeconomic status. In spite of persistent declines in the prevalence of stunting among children under 5 years across the study countries since 2000, trends in socioeconomic inequalities in stunting are mixed. We find significant contributions of child, maternal, and household characteristics to inequalities in child stunting. Conclusion: The results suggest that there is the need to design and target nutrition-based interventions at children in low socioeconomic households. In addition, promoting female education and improving access to health and nutrition information will be key to improving child nutrition across the region. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
42. The prevalence and factors associated with stunting among infants aged 6 months in a peri-urban South African community
- Author
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Tonderayi M. Matsungo, Mieke Faber, Herculina S. Kruger, Marinel Rothman, Cornelius M. Smuts, 24420875 - Matsungo, Tonderayi Mathew, 10061568 - Kruger, Herculina Salome, and 20924445 - Smuts, Cornelius Mattheus
- Subjects
0301 basic medicine ,Male ,Urban Population ,Birth weight ,Medicine (miscellaneous) ,Mothers ,Complementary feeding ,Overweight ,Logistic regression ,03 medical and health sciences ,South Africa ,0302 clinical medicine ,Breast-feeding ,Sex Factors ,medicine ,Prevalence ,Birth Weight ,Humans ,030212 general & internal medicine ,Infant Nutritional Physiological Phenomena ,Wasting ,Growth Disorders ,Soluble transferrin receptor ,Stunting ,030109 nutrition & dietetics ,Nutrition and Dietetics ,biology ,business.industry ,Iron-deficiency anaemia ,Public Health, Environmental and Occupational Health ,Infant ,Research Papers ,Body Height ,Low birth weight ,Breast Feeding ,Cross-Sectional Studies ,Socioeconomic Factors ,biology.protein ,Female ,medicine.symptom ,Underweight ,business ,Breast feeding ,Demography - Abstract
ObjectiveTo determine the prevalence and factors associated with stunting in 6-month-old South African infants.DesignThis cross-sectional study was part of the baseline of a randomized controlled trial. Weight-for-length, length-for-age and weight-for-ageZ-scores were based on the WHO classification. Blood samples were analysed for Hb, plasma ferritin and soluble transferrin receptor (sTfR). Socio-economic, breast-feeding and complementary feeding practices were assessed by questionnaire.Setting/SubjectsInfants aged 6 months (n750) from a peri-urban area of Matlosana Municipality, North West Province of South Africa.ResultsStunting, underweight, wasting and overweight affected 28·5, 11·1, 1·7 and 10·1 % of infants, respectively. Exclusive breast-feeding to 6 months of age was reported in 5·9 % of the infants. Multivariable binary logistic regression showed that birth weight (OR=0·12; 95 % CI 0·07, 0·21,PP=0·001) were inversely associated with stunting; while male sex (OR=1·73; 95 % CI 1·10, 2·70,P=0·014) was associated with higher odds for stunting. Stunting was also associated with higher plasma sTfR (>8·3 mg/l) concentrations.ConclusionsThe association between stunting and lower birth weight, shorter maternal height and male sex reflects possibly the intergenerational origins of stunting. Therefore, interventions that focus on improving preconceptual and maternal nutritional status, combined with strategies to promote appropriate infant feeding practices, may be an important strategy to prevent stunting in vulnerable settings.
- Published
- 2017
43. Does household’s food and nutrient acquisition capacity predict linear growth in children? Analysis of longitudinal data from rural and small towns in Ethiopia
- Author
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Mekonnen, Daniel Ayalew
- Published
- 2024
- Full Text
- View/download PDF
44. Stagnant Stunting Rate Despite Rapid Economic Growth in Papua New Guinea : Factors Correlated with Malnutrition among Children under Five
- Author
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Hou, Xiaohui
- Subjects
VITAMINS ,HEALTH STATUS ,PROTEIN ,INFANTS ,INFANT FEEDING ,CHILDREN ,ECONOMIC GROWTH ,CALORIES ,CHILD HEALTH ,MINERALS ,FAMILIES ,SEVERE MALNUTRITION ,FOOD POLICY ,LOW BIRTH WEIGHT ,IMPLEMENTATION ,POPULATION ,ANEMIA PREVALENCE ,COMPLEMENTARY FOOD ,PRODUCTIVITY ,BREASTFEEDING ,STAPLE FOODS ,FOOD INSECURITY ,WORKERS ,EDUCATION ,INFECTIOUS DISEASES ,NUTRITIONAL STATUS ,MALNUTRITION ,GROWTH MONITORING ,POVERTY ,FOOD QUALITY ,DISEASES ,RISK FACTORS ,HEALTH OUTCOMES ,GROWTH ,HEALTH ,INTERVENTION ,IODIZATION ,SPATIAL VARIATIONS ,ORGANIZATIONS ,NUTRITIONAL PROGRAMS ,NUTRITION STATUS ,SOCIAL WORKERS ,SALT IODIZATION ,POLICY DISCUSSIONS ,IODINE ,CHILD DEVELOPMENT ,CAPACITY ,DEVELOPMENT ,MALARIA ,VITAMIN ,FOOD ,POVERTY ASSESSMENT ,VEGETABLES ,MORTALITY ,NUTRITION SURVEYS ,FOOD INTAKE ,NUTRITION OUTCOMES ,CHILD MALNUTRITION ,CONSUMPTION ,DEVELOPMENT POLICY ,DIETARY IMPROVEMENT ,REGIONAL LEVEL ,CHILD STUNTING ,VITAMIN A ,WASTED CHILDREN ,UNDERNUTRITION ,MICRONUTRIENTS ,NUTRITIONISTS ,HUNGER ,COMMUNICABLE DISEASES ,SURVEYS ,EARLY CHILD DEVELOPMENT ,ECONOMIC DEVELOPMENT ,NUTRIENT ,NUTRIENTS ,INFECTION ,EPIDEMIOLOGY ,DIABETES ,SOCIAL ECONOMIC STATUS ,NUTRITION EDUCATION ,ACCESS TO EDUCATION ,FOOD ACCESS ,HEALTH POLICY ,IRON ,NUTRITION POLICY ,ACCESS TO INFORMATION ,FOOD SECURITY ,IODINE DEFICIENCY ,CHILD NUTRITION ,POLICY ,REGIONS ,HEALTH WORKERS ,PREGNANCY ,HEALTH CARE ,OBESITY ,NUTRITIONAL OUTCOMES ,FOOD RESEARCH ,CHILD GROWTH ,NUTRITION ,PUBLIC HEALTH ,MALNUTRITION AMONG CHILDREN ,RURAL COMMUNITIES ,BIRTH ,UNDERWEIGHT RATES ,HOUSEHOLD INCOME ,FEEDING ,STUNTING ,POLICY RESEARCH ,REGION ,DIET ,MORBIDITY ,HUMAN NUTRITION ,WEIGHT GAIN ,SOCIOECONOMIC STATUS ,KNOWLEDGE ,RICE ,STRATEGY ,ANEMIA ,POLICY RESEARCH WORKING PAPER ,POORER FAMILIES ,HOUSEHOLD HEADS ,POVERTY LINE ,DIARRHEA ,HEALTH SERVICES ,PRESCHOOL CHILDREN ,ANIMAL PROTEIN ,CHILD MORTALITY ,ILLITERACY ,HOUSEHOLD HEAD ,WASTING ,WEIGHT ,CALORIC INTAKE ,MALNUTRITION RATES ,RURAL POPULATIONS - Abstract
Maternal and child undernutrition is a pervasive and detrimental condition in Papua New Guinea. Despite rapid economic growth during the past decade, the stunting rate for children under 5, one of the primary indicators for child undernutrition, was estimated at 46 percent in Papua New Guinea in 2010, stagnant from 44 percent in 2005. This paper analyzes the association between the demographic, socioeconomic, environmental, and health-related factors on nutritional status for children under age 5 years, using the 2009–10 Papua New Guinea Household Income and Expenditure Survey. Stunting and underweight rates sharply rise in the first 24 months. Even in the better-off quintiles, children suffer from suboptimal breastfeeding and complementary food in the first 24 months. In general, the regression results showed that household wealth and geographic location are crucial factors that contribute to children’s malnutrition. More importantly, food quality, measured by protein intake, has significant predicting power on child malnutrition. Broadly increasing socioeconomic status and improving the quantity and quality of caloric intake are general steps to improving health outcomes in Papua New Guinea. In addition, three key areas were identified as critical to alleviating the persistent and detrimental stunting rate in the country: (1) exclusive breastfeeding and complementary food; (2) interventions by health workers; and (3) nutrition education.
- Published
- 2015
45. Spatial Inequality in Undernutrition Among Under-Five Children in Zimbabwe
- Author
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Chari, Abigail
- Published
- 2024
- Full Text
- View/download PDF
46. First foods: Why improving young children's diets matter.
- Author
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Bégin, France and Aguayo, Víctor M.
- Subjects
GROWTH disorders ,CONFERENCES & conventions ,CHILD development ,CHILD nutrition ,DEVELOPING countries ,FOOD ,INFANTS ,INTERPROFESSIONAL relations ,NUTRITIONAL requirements ,QUALITY assurance ,SERIAL publications ,PREVENTION - Abstract
Globally, only 52% of children aged 6-23 months meet the minimum meal frequency and a mere 29% meet the minimum dietary diversity, with large disparities across and within regions. With most of the stunting occurring during the first thousand days-from conception to age 2 years-improving complementary feeding in children 6-23 months old is an urgent priority. With this evidence in mind, UNICEF collaborated with the governments of India and Maharashtra to convene a global meeting in Mumbai, India, under the theme: First Foods: A Global Meeting to Accelerate Progress on Complementary Feeding in Young Children (November 17-18, 2015). The global meeting provided a platform that aimed to (a) synthesize the biological and implementation science on complementary feeding; (b) review the practice and experience in improving access to nutritious complementary foods and good complementary feeding practices; and (c) consolidate a strong evidence base that can inform the development of strategies and approaches to improve complementary feeding that are fit to context. This overview paper summarizes the rationale on why improving complementary foods and feeding for infants and young children matters and what it takes to improve them. It builds on the papers presented at the First Foods Global Meeting and those commissioned as a follow on to it. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
47. Maternal postpartum depression in relation to child undernutrition in low- and middle-income countries: a systematic review and meta-analysis.
- Author
-
Asare, Hannah, Rosi, Alice, Scazzina, Francesca, Faber, Mieke, Smuts, Cornelius M., and Ricci, Cristian
- Subjects
CHILD development deviations -- Risk factors ,CINAHL database ,ONLINE information services ,POSTPARTUM depression ,MIDDLE-income countries ,META-analysis ,MEDICAL databases ,INFORMATION storage & retrieval systems ,MEDICAL information storage & retrieval systems ,CONFIDENCE intervals ,SYSTEMATIC reviews ,MOTHER-infant relationship ,RISK assessment ,MALNUTRITION ,LOW-income countries ,DESCRIPTIVE statistics ,MEDLINE ,MOTHER-child relationship ,DISEASE risk factors ,CHILDREN ,DEVELOPING countries - Abstract
Perinatal (antenatal and postpartum) depression is increasingly becoming a global public health problem. Studies have shown that the presence of depression during the perinatal period impact on a mother's ability to adequately provide nutritional care for herself and her infants and young children. This may thus negatively influence the nutritional status of these vulnerable children resulting in poor growth, such as stunting which is currently a public health problem in low- and middle-income countries (LMICs). The aim of this systematic review and meta-analysis was to determine the association between maternal postpartum depression and child growth in LMICs. Electronic databases were systematically reviewed by screening abstracts, titles, full text and additional data sources of eligible papers. Articles were eligible for inclusion if based on children aged 0 to 59 months, if reporting maternal postpartum depression as an exposure, if based on observational studies evaluating the relation between maternal postpartum depression and child growth, if reporting at least one physical growth indicator such as stunting as an outcome, and if published after 2000. Article selection was based on the PRISMA guidelines for reporting systematic reviews. Twelve articles were included in the quantitative synthesis (12 for stunting, 8 for underweight and 2 for wasting). Maternal postpartum depression was observed to be associated with an increased risk of child stunting (1.87 (95% CI: 1.52, 2.30; I
2 = 41.6%, p = 0.064)) and underweight (1.81 (95% Cl: 1.25, 2.62; I2 = 70.7%, p = 0.001)). These results were confirmed after influence analyses, with publication bias being negligible. Conclusion: Maternal depression is a risk factor for poor child growth in LMICs. This study contributes to the knowledge on this topic and calls on policymakers to improve on its understanding, screening and treatment to alleviate the potential negative impact on child growth. What is Known: • Maternal postpartum depression is currently a public health relevance in low- and middle-income countries (LMICs). • Maternal postpartum depression is a risk factor for poor nutritional status in children from LMICs. What is New: • Maternal postpartum depression is associated with an 80 to 90% increased risk of childhood stunting and underweight in LMICs. • The association between risk of childhood stunting and underweight with maternal postpartum depression is slightly influenced by geographical area, rural or urban location, by factors such as study design, study quality and sample size. [ABSTRACT FROM AUTHOR]- Published
- 2022
- Full Text
- View/download PDF
48. Nutrition in Nepal: Three decades of commitment to children and women.
- Author
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Chitekwe, Stanley, Torlesse, Harriet, and Aguayo, Victor M.
- Subjects
HEALTH policy ,CHILD nutrition ,NUTRITIONAL assessment ,HEALTH services accessibility ,FOLIC acid deficiency ,STAKEHOLDER analysis ,WORLD health ,DIET ,HEALTH status indicators ,INFANT nutrition ,DIETARY supplements ,VITAMIN A deficiency ,COMMITMENT (Psychology) ,MICRONUTRIENTS ,SUSTAINABLE development ,WOMEN'S health ,GROWTH disorders ,GOAL (Psychology) ,NUTRITION services ,IODINE deficiency - Abstract
South Asia has made significant progress in reducing child undernutrition. The prevalence of stunting declined by one third between 2000 and 2019; as a result, in 2019, there were 34 million fewer stunted children than in 2000, indicating that progress for child nutrition is possible and is happening at scale. However, no country in South Asia is on track for all nutrition targets of Sustainable Development Goal 2, and the region has the highest prevalence of stunting (33.2%) and wasting (14.8%) in the world. Nepal, the best performing country in the region, narrowly missed the Millennium Development Goal (MDG) target to half the prevalence of child underweight between 1990 and 2015 and achieved the fastest recorded reduction in stunting prevalence in the world between 2001 and 2011. In 2019, UNICEF Nepal completed a series of papers to examine Nepal's progress on maternal and child nutrition during the MDG era. The series explores the trends, distribution and disparities in stunting, micronutrient deficiencies and feeding practices in children under 5 years and anaemia in adolescents and women. Besides, it reviews national micronutrient programmes (vitamin A supplementation, iron and folic acid supplementation and universal salt iodization) and Nepal's first Multi‐Sector Nutrition Plan, to illuminate the success factors and enduring challenges in the policy and programme landscape for nutrition. This overview paper summarizes the evidence from these analyses and examines the implications for the direction of future advocacy, policy and programme actions to improve maternal and child nutrition in Nepal and other similar contexts. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
49. Development and Effectiveness of a Mobile Health-based Nutrition Education Intervention on Maternal, Infant and Young Child Nutrition to Prevent Stunting in Kelantan: A Study Protocol.
- Author
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Azimi, Norshafawati Abd, Abdul Hakim, Bibi Nabihah, Jan Mohamed, Hamid Jan, Tengku Ismail, Tengku Alina, Yusoff, Hafzan, Zabidi-Hussin, ZAMH, Yee Cheng Kueh, Sukeri, Surianti, and Mohamad, Puspawati
- Subjects
- *
CHILD nutrition , *NUTRITION education , *STUNTED growth , *INFANTS , *RESEARCH protocols , *TEENAGE pregnancy - Abstract
Introduction: The first "1000 days" is a critical period of opportunity for interventions to prevent stunting and other health problems. This paper describes a study protocol of a mobile phone-based nutrition education (MiNd) intervention on maternal, infant and young child nutrition. Methods: This is a six-months quasi-experimental intervention consisting of three phases; (i) Phase 1 - development of MiNd intervention modules, (ii) Phase 2 - evaluation of the effectiveness of MiNd intervention, and (iii) Phase 3 - a qualitative study exploring perceptions and experiences of the intervention. Discussion: Assessment of anthropometry, dietary intake, food security, mental health, knowledge, attitude, and practice (KAP) of food intake during pregnancy and breastfeeding will be evaluated during pre and post intervention. This is the first comprehensive mobile phone-based nutrition intervention study on pregnancy, lactation, and infant growth in Malaysia. The findings will be useful in modulating health intervention programme to prevent stunting and other health issues nationwide. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
50. Causal Pathways from Enteropathogens to Environmental Enteropathy: Findings from the MAL-ED Birth Cohort Study
- Author
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Margaret N, Kosek and Dixner Rengifo, Trigoso
- Subjects
Child health ,Stunting ,Malnutrition ,Child growth ,Infant ,Undernutrition ,Orosomucoid ,Models, Theoretical ,Neopterin ,Lactulose ,Cohort Studies ,Feces ,Intestinal Diseases ,alpha 1-Antitrypsin ,Humans ,Mannitol ,Enteropathogen ,Biomarkers ,Enteropathy ,Peroxidase ,Research Paper - Abstract
Highlights • Children living in these settings had a high prevalence of enteropathogens, high levels of intestinal inflammation, abnormal intestinal permeability, high markers of systemic inflammation, and postnatal acquired linear growth deficits when compared to children living in the US or Europe • This study contributes empiric evidence to demonstrate that enteric infection alters both fecal markers of inflammation and permeability • Current markers of enteropathy fail to account for a large portion of the observed shortfalls in linear growth in these populations, and markers of systemic inflammation appear as the most promising predictive biomarkers for identifying linear growth failure in children Environmental enteropathy (EE) is hypothesized as a mediator of growth faltering, but few prospective studies have evaluated pathways linking enteropathogen exposure, intestinal inflammation and permeability, and growth. The MAL-ED study represents a novel analytical framework and explicitly evaluates multiple putative EE pathways in combination and using an unprecedented quantity of data. Despite evidence that gut inflammation and altered gut permeability are frequently present and that associations between enteropathogen exposure and gut dysfunction exist, the observed attributable effects of EE on growth faltering in young children were small., Background Environmental enteropathy (EE), the adverse impact of frequent and numerous enteric infections on the gut resulting in a state of persistent immune activation and altered permeability, has been proposed as a key determinant of growth failure in children in low- and middle-income populations. A theory-driven systems model to critically evaluate pathways through which enteropathogens, gut permeability, and intestinal and systemic inflammation affect child growth was conducted within the framework of the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) birth cohort study that included children from eight countries. Methods Non-diarrheal stool samples (N = 22,846) from 1253 children from multiple sites were evaluated for a panel of 40 enteropathogens and fecal concentrations of myeloperoxidase, alpha-1-antitrypsin, and neopterin. Among these same children, urinary lactulose:mannitol (L:M) (N = 6363) and plasma alpha-1-acid glycoprotein (AGP) (N = 2797) were also measured. The temporal sampling design was used to create a directed acyclic graph of proposed mechanistic pathways between enteropathogen detection in non-diarrheal stools, biomarkers of intestinal permeability and inflammation, systemic inflammation and change in length- and weight- for age in children 0–2 years of age. Findings Children in these populations had frequent enteric infections and high levels of both intestinal and systemic inflammation. Higher burdens of enteropathogens, especially those categorized as being enteroinvasive or causing mucosal disruption, were associated with elevated biomarker concentrations of gut and systemic inflammation and, via these associations, indirectly associated with both reduced linear and ponderal growth. Evidence for the association with reduced linear growth was stronger for systemic inflammation than for gut inflammation; the opposite was true of reduced ponderal growth. Although Giardia was associated with reduced growth, the association was not mediated by any of the biomarkers evaluated. Interpretation The large quantity of empirical evidence contributing to this analysis supports the conceptual model of EE. The effects of EE on growth faltering in young children were small, but multiple mechanistic pathways underlying the attribution of growth failure to asymptomatic enteric infections had statistical support in the analysis. The strongest evidence for EE was the association between enteropathogens and linear growth mediated through systemic inflammation. Funding Bill & Melinda Gates Foundation.
- Published
- 2016
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