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Luyang Zhang,1,&ast; Li Wang,2,&ast; Jiewen Long,1 Yan Yin,1 Sandip Patil1 1Department of Haematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, Guangdong Province, 518000, People’s Republic of China; 2Department of Clinical Nutrition, Shenzhen Children’s Hospital, Shenzhen, Guangdong Province, 518000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Sandip Patil; Yan Yin, Department of Haematology and Oncology, Shenzhen Children’s Hospital, 7019 Yitian Road, Shenzhen, Guangdong Province, 518000, People’s Republic of China, Tel +86-755-83008283, Email sandippatil1309@yahoo.com; yinyan0915@sina.comObjective: This retrospective study evaluated nutritional status and body composition changes in paediatric β-thalassemia (β-TM) patients before and after hematopoietic stem cell transplantation (HSCT), using bioelectrical impedance analysis (BIA), and explored their relationship with HSCT outcomes.Methods: A cohort of 40 paediatric β-TM patients undergoing allogeneic HSCT was assessed for their nutritional status, anthropometric parameters, including body mass index (BMI), weight, and height, and body composition parameters pre-and post-HSCT, focusing on BIA measurements, including intracellular water (ICW), extracellular water (ECW), fat mass (FAT), fat-free mass (FFM), Skeletal Muscle Mass (SMM), soft Lean Mass (SLM), percent body fat (PBF), Body Cell Mass (BCM), Phase angle (PA) and muscle balance pre- and post-HSCT. Post-HSCT clinical outcomes, including acute graft-vs-host disease (aGVHD), engraftment time, oral mucositis (OM), sinusoidal obstruction syndrome (SOS), and diarrhoea in relation to nutrition status after HSCT were analysed.Results: After HSCT, 28.21% experienced diminished nutritional status, with 71.43% of those who were wasting before HSCT showing diminished nutritional status, significantly higher than the normal group (18.75%, P = 0.012). Anthropometric changes included significant weight reduction (87.5%, 22.15 ± 7.46 vs 20.74 ± 6.57, P < 0.001) and BMI decrease (90%, 15.19 ± 1.70 vs 14.05 ± 1.48, P < 0.001). Body composition parameters, which are FFM, SMM, SLM, ICW, ECW, BCM, and PA (18.26 ± 5.71 vs 17.27 ± 5.19, 8.68 ± 3.30 vs 7.93 ± 3.02, 17.11 ± 5.28 vs 16.06 ± 4.84, 8.19 ± 2.54 vs 7.62 ± 2.31, 5.15 ± 1.58 vs 4.94 ± 1.47, 11.74 ± 3.63 vs 10.92 ± 3.32, 4.42 ± 0.50 vs 3.90 ± 0.57, respectively, P < 0.001) analysis revealed significant decreases. No significant differences in clinical outcomes were observed based on nutritional status.Conclusion: Paediatric β-TM patients undergoing HSCT exhibit significant changes in nutrition status and body composition, emphasizing the need for focused attention on malnourished children who are more prone to diminished nutritional status. Comprehensive BIA aids in understanding the impact, urging consideration for extended follow-up and larger cohorts in future research.Keywords: paediatric β-thalassemia, hematopoietic stem cell transplantation, HSCT, bioelectrical impedance analysis, BIA, nutritional status, malnourished children

Childhood malnutrition is a metabolic condition that affects the physical and mental well‐being of children and leads to resultant disorders in maturity. The development of childhood malnutrition is influenced by a number of physiological and environmental factors including metabolic stress, infections, diet, genetic variables, and gut microbiota. The imbalanced gut microbiota is one of the main environmental risk factors that significantly influence host physiology and childhood malnutrition progression. In this review, we have evaluated the gut microbiota association with undernutrition and overnutrition in children, and then the quantitative and qualitative significance of gut dysbiosis in order to reveal the impact of gut microbiota modification using probiotics, prebiotics, synbiotics, postbiotics, fecal microbiota transplantation, and engineering biology methods as new therapeutic challenges in the management of disturbed energy homeostasis. Understanding the host–microbiota interaction and the remote regulation of other organs and pathways by gut microbiota can improve the effectiveness of new therapeutic approaches and mitigate the negative consequences of childhood malnutrition. [ABSTRACT FROM AUTHOR]

Pyoderma gangrenosum (PG) is an extremely rare case of sterile necrotic ulcerative disease associated with malnutrition as a predisposition factor. It is unclear, though, whether dilated cardiomyopathy, which affects blood flow and results in stenosis in the arteries, could play a role as an etiology. In this study, a case of pyoderma gangrenosum in a 10-year-old boy complicated by dilated cardiomyopathy, a previous history of cerebrovascular disease, and a malnourished condition were reported. The patient was reported to have exudative necrotic lesions in both legs. Lesions began as small, multiple, itchy lesions on both legs, which later became blisters and scuffed, and progressed into painful, peeled-off lesions with pus, bleeding, redness around lesions, and maggots within a month. A high fever was an accompanying symptom. The multidisciplinary team was involved to provide a comprehensive treatment for this patient. Antibiotics and necrotomy debridement were performed several times. Anticoagulant treatment was indicated as the coagulation markers were increased and echocardiography suggested thrombus in the left ventricle. The underlying condition that increases the risk of pyoderma gangrenosum should be corrected. The patient was discharged after a clinical improvement, although the continuation of outpatient monitoring was required. Our report suggests that a chronic condition of dilated cardiomyopathy that affects normal blood flow leads to malnutrition, the formation of thrombus, and stenosis of a peripheral artery, all of which contributed to pyoderma gangrenosum. Therefore, early surgical treatment, antibiotic administration, and anticoagulant treatment were recommended.

Abstract Childhood malnutrition is a metabolic condition that affects the physical and mental well‐being of children and leads to resultant disorders in maturity. The development of childhood malnutrition is influenced by a number of physiological and environmental factors including metabolic stress, infections, diet, genetic variables, and gut microbiota. The imbalanced gut microbiota is one of the main environmental risk factors that significantly influence host physiology and childhood malnutrition progression. In this review, we have evaluated the gut microbiota association with undernutrition and overnutrition in children, and then the quantitative and qualitative significance of gut dysbiosis in order to reveal the impact of gut microbiota modification using probiotics, prebiotics, synbiotics, postbiotics, fecal microbiota transplantation, and engineering biology methods as new therapeutic challenges in the management of disturbed energy homeostasis. Understanding the host–microbiota interaction and the remote regulation of other organs and pathways by gut microbiota can improve the effectiveness of new therapeutic approaches and mitigate the negative consequences of childhood malnutrition.

Background: Eswatini is one of the countries affected by malnutrition and tuberculosis (TB) and some cases remained untreated. These two conditions are major public health problems. Aim: This study aimed to explore and describe caregivers’ experiences and practices of children’s nutrition during treatment. Setting: Baylor College of Nursing Children’s Foundation – Eswatini (BCMCF-SD). Methods: A qualitative study following a narrative design used purposive sampling to identify 12 caregivers of malnourished children and informed consent obtained. In-depth interview used semi-structured interview guide and digital voice recorder. Field notes were taken, transcribed, translated and analysed using NVivo version 11. Results: Two themes emerged as home’s nutritional situation and health facility’s nutritional support. The study found that most of the caregivers gave children unbalanced diet, while those less than a year were mixed-fed. Some caregivers reported experience of lost breadwinners, unemployment and high number of children than what the family could afford. The caregivers’ practices around food by prescription included inadequate supply of the ready-to-use therapeutic food and sharing of prescribed food supplies with other healthy children. Conclusion: During treatment, children’s caregivers need short health education and support. The Ministry of Health in Eswatini should consider using some comic books to guide that. Moreover, upscale vocational training promotes entrepreneurship and agricultural activities. Contribution: Association of malnutrition and TB outcomes has provided evidence-based information for more comprehensive integration between nutrition programmes and tuberculosis programmes. The study’s findings contributed to the growing body of knowledge about the association between malnutrition and diagnosed drug-susceptible TB among children aged from 0 – 15 years.

Children with Severe Acute Malnutrition (SAM) are at risk of developmental problems. Psychosocial stimulation can improve the developmental outcomes of hospitalised children with SAM. However, the intervention has remained underutilised in health facilities in resource-poor settings. Moreover, there is limited evidence on the acceptability and feasibility of the intervention. We conducted a qualitative study to explore the acceptability and feasibility of integrating psychosocial stimulation interventions in the inpatient care of children with SAM in selected areas in the Silti Zone, Central Ethiopia. Nine focus group discussions and 15 key informant interviews were conducted with parents, health workers, and other stakeholders. The data were transcribed, translated, and analysed using a thematic approach. Caregivers and health workers had positive attitudes toward the intervention and perceived it beneficial for the children’s development, recovery, and bonding with the mothers. Health workers reported barriers such as lack of materials, time, and space, capacity building training, and supervision for the effective implementation of the intervention. At the household level, gendered factors such as the housework burden of mothers and the inadequate engagement of fathers in childcare were the main challenges to the implementation of the intervention. Overall, psychosocial stimulation intervention was found to be acceptable and feasible for routine implementation with inpatient care provided for children with SAM. The study recommends supporting health facilities, health workers, and partners with the necessary resources and skills to promote the implementation of stimulation interventions along with the existing care provided in health facilities in resource-poor settings.

Ready-to-Use Therapeutic Food (RUTF) or Ready-to-Use Supplementary Food (RUSF) has been widely used in home-based treatment for severely and moderately acute malnourished children. These programs showed positive results in short term nutritional recovery in children, which were reported in some research settings. Nowadays, the RUTF/RUSF formulation has been improved using a variety of RUTF/RUSF from locally available food ingredients. This paper aims to review the essential aspects of the development and provision of RUTF/RUSF made from local food resources and monitor program effectiveness that warrants the program’s sustainability. The modified recipes of RUTF/RUSF were developed following the international dietary guidelines for the rehabilitation of severely and moderately acute malnourished children. The local production of RUTF/RUSF provided some benefits that include empowering the local community, consideration of the common eating pattern, promoting the diversification of food consumption, strengthening food security, as well as supporting the sustainability of RUTF/RUSF production. Results of the PRISMA-based systematic literature review revealed various ingredient developments and processing techniques which could improve the product characteristics and sensory evaluation. RUTF/RUSF in local food production provided different food carriers (e.g., biscuits, wafers) and seemed to be more readily accepted by the children. Furthermore, the program sustainability of RUTF/RUSF depends on a continuous ingredients supply and support from the local government. The findings presented the importance of development of such food supplements based on the local food resources and with improved technology for prevention and rehabilitation of malnourished children.

This study aims to determine the effect of educational socialization using animation media on the level of understanding of the characteristics of malnourished children in the residents of Cigugur Girang Village, Parongpong, Indonesia. The study was conducted on 20 residents of the village of Cigugur Girang Parongpong, Indonesia. The age range of the respondents is 20-60 years. Respondents consisted of 3 men and 17 women. The research was conducted in 3 stages, namely (i) pre-test; (ii) education through animation media; and (iii) post-test. The results showed that the average pretest score was 73.5 and the post-test average was 94.75. The results of the comparison of the pretest and posttest showed an increase in respondents' knowledge after the action was taken. The results of the N-Gain calculation show that the average N-Gain value is 21% (N-Gain < 40%) indicating that animation media as a way of educating the characteristics of malnourished children is not effectively used in the community. This is because the community's pre-test scores are quite good, so it can be seen that the knowledge of characteristics of malnourished children is already known by the community. As for the results of the calculation of the t-test, it is known that the t-count (-8.213) < t-table (2.086) means that the post-test score of the students increased not significantly. With the completion of this research, it is hoped that more people will know about the characteristics of malnourished children. Thus, the phenomenon of malnourished children can be tackled earlier.

BackgroundChildhood malnutrition could have adverse impacts on the growth of child and eventually on fertility and general economic growth, and still, this issue remains a worldwide priority and a concern. This study aimed to evaluate the effectiveness of the national nutritional interventions program on the improvement and nutritional status of malnourished children children aged 6–59 months.MethodsThis community-based intervention study was conducted with 1288 acute and moderately malnourished children aged 6–59 months referred to health centers. Children received combined nutritional education and counseling with the provision of affordable complementary food for 10 months. Anthropometric measurements were assessed monthly according to the standard protocols.ResultsOur results showed the reduction in the risk of malnutrition among children after nutritional interventions for weight-for-height (WHZ) (P < 0.001), height-for-age (HAZ) (P < 0.001), and weight-for-age (WAZ) (P = 0.008). Total malnourished children indicated improvement in HAZ (

Résumé Introduction. La malnutrition est un problème de santé publique chez les en-fants en Guinée. Objectif. Contribuer à l’évaluation du soin des enfants de 6 à 59 mois souffrant de malnutrition aigüe modérée dans les Foyers d’Apprentissage et de Réha-bilitation Nutritionnelle (FARN) de la préfecture de Kouroussa. Matériel et méthodes. Une étude transversale de type descriptif, menée du 1er août au 30 novembre 2017, avait concerné 322 enfants malnutris modérés, identifiés par la mesure du poids/taille et du périmètre brachial. Sept recettes de bouillies enrichies, préparées dans les FARN, à partir d’aliments locaux et des conseils sur les bonnes pratiques d’alimentation et d’hygiène ont été utilisées pendant 12 jours. Résultats. Il ressort de l’étude que la tran-che d’âge majoritaire était celle de 6 à 17 mois, soit 63%. Plus de la moitié (79%) des en-fants ont eu un rattrapage de croissance ≥ 400g. Le gain pondéral moyen journalier était bon, soit 8g/kg/j. L’analyse des indicateurs de soin des enfants malnutris modérés a don-né des valeurs conformes aux recommandations du protocole national, montrant, ainsi, les côtés positifs des FARN de Kouroussa pour le soin des enfants malnutris modérés. L’analyse des macronutriments a permis de calculer les valeurs nutritionnelles des bouillies. Cependant, les analyses microbiologiques et physico-chimiques des recettes n’ont pu être réalisées. Conclusion. Cette étude montre que les FARN restent une solution rapide et durable pour la prise en charge des enfants malnutris modérés. [Abstract Introduction. Malnutrition is a public health problem for children in Guinea. Objectives. To contribute to the care assessment of children, aged 6 to 59 months suffe-ring from moderate acute malnutrition, in the Learning and Nutritional Rehabilitation Homes (LNRH), in Kouroussa prefecture. Material and methods. A descriptive cross-sectional study, from august 1st to november 30th 2017, involved 322 moderately malnourished children, identified by weight/height, and mid upper arm circumference measurement. Seven recipes of enriched porridges, made in the LNRH, from local foods, with counseling on good practices of feeding, and hygiene for young children were used during 12 days. Results. The study showed that the majority age group of children was 6 to 17 months i.e. 63%. More than half (79%) of the children had catch-up growth (≥400g). The average daily weight gain was good, at 8g/kg/d. The global analysis of the care indicators, for moderately malnourished children, showed that the values were in accordance with the recommendations of national protocol, thus showing the positive aspects of the children management, in Kouroussa LNRH. The macronutrients analysis was permitted to determine the nutritional values of the different recipes. However, microbiological, and physicochemical analyzes of the recipes were not realized. Conclusion. This study shows that the LNRH remain a fast and sustainable solution for the moderately malnourished children care.]

This study investigated the phagocytic cell response in malnourished children after oral feeding of a fermented product containing clinically proven probiotic strains of Lactobacillus acidophilus, LBKV-3. The bacterial strain is used as a probiotic for humans to test its effect on immune cell activity in undernourished children below 8 years of age. To study the immune cell activity, implantation abilities of the culture in the GI tract of malnourished children, forty-five children of 6–7 and 7–8 years were randomly selected and distributed in three groups, each comprising 15 children in each of the age group. The test group of the children was receiving 100 g product volunteers/day of freshly prepared probiotic acidophilus milk containing 107 cfu/g of culture. The control group was receiving 100 g freshly prepared "dahi" containing 107 cfu/g of the LAB while the blank group of the volunteers was receiving thermal processed (85° C/30 min) buffalo milk containing 5% fat and 10% SNF at the rate of 100 ml/day/volunteer. Feeding trial was continued for 12 weeks. Blood samples were collected at W2, W4, W8, and W12. The blood serum samples were analyzed for monocytes, neutrophils, basophils, and lymphocytes by BC-3000 + Auto Hematology Analyzer. In conclusion, consumption of PAM increased the proportion of immune cells, including monocytes, neutrophils, basophils, and lymphocytes, as well as their phagocytic activity in all age groups but proportion was significant in the test group of 7–8 years. The effects were higher during W12 compared to W2, W4, and W8, which suggest regulation of the immune system. [ABSTRACT FROM AUTHOR]

Background: There is a paucity of evidence on improvement in malnutrition status after follow-up intervention among malnourished under-five children. Objective: The objective of the study is to assess the effect of community-based follow-up health education intervention on the awareness level of mothers, calorie intake, protein intake, and weight gain of malnourished children. Methods: This intervention study was conducted from December 2012 to October 2014 in three phases at rural Puducherry, coastal South India. The intervention group (57 mothers of 64 children) and control group (60 mothers of 64 children) included moderate and severely malnourished children aged 13–60 months. Children in the control group were taken from different areas and matched for age (±6 months) and sex. Health education intervention and follow-up supervision for 15 months were given to the mothers. Results: Awareness level in all domains increased significantly in the intervention group. In the intervention group, 81% (52) of malnourished children turned out to normal, whereas in the control group, 64% (41) of them became normal. There was a statistically significant difference between the mean changes in the protein intake among boys (15.34 g to 19.91 g in the intervention group against 13.6 g to 16.24 g in the control group) and girls (15.09 g to 19.57 g in the intervention group against 13.36 g to 16.51 g in the control group) and calorie intake among girls (993.86 kcal to 1116.55 kcal in the intervention group against 992.65 kcal to 1078.75 kcal in the control group) between the two groups. Conclusion: There was comparatively marginal increase in protein intake, calories' intake, and weight gain in the intervention group.

Introduction: Prevalence of malnourished children in Putrajaya was unexpectedly high in 2016. This paper describes the study protocol for a case-control study conducted to identify the associated factors of malnutrition among children under 5 years old in Putrajaya. Methods: This study involved two phases. Phase I was 'screening' where all children aged 6-59 months in 118 preschools and four government health clinics were measured for their weight and height. The World Health Organization Anthro software was used to determine the nutritional status of these children. Phase II was the 'interview' where children from screening were sampled into four pairs of case and control. The optimum sample size for the case of stunted, wasted, underweight, and overweight were 380, 335, 318, and 308, respectively. The same number of controls were recruited. Parents/caregivers of selected children were approached to obtain data on parental factors, children factors, food intake factors, and environmental factors that contributed to malnutrition. Data analysis was performed by multiple logistic regression in SPSS version 26. Results: Screening phase successfully measured 8,261 (50.1%) children from an estimated 16,500 children under 5 years old in Putrajaya. The number of children who were stunted, wasted, underweight, and overweight were 2,105 (25.5%), 512 (6.2%), 1,516 (18.4%), and 248 (3.0%), respectively. As overweight was undersampled, the number of controls for overweight was doubled to increase the power of the study. Parents/caregivers of selected cases and controls were interviewed in their household or any other venues at their convenience. Conclusion: This protocol promises beneficial outputs to stakeholders and policy makers that can be used for combating malnutrition in children. [ABSTRACT FROM AUTHOR]

Background: The risk factors and adverse outcomes related to maternal depression and child malnutrition are a leading cause of morbidity and mortality in low and middle-income countries (LMIC) including Pakistan. Above 25% of women suffer from maternal depression. Up to 50% children are under-nourished which contributes to 35% of all under-5 deaths in the country.Aim: To determine the efficacy of Learning through Play Plus Thinking Healthy Program (LTP Plus) intervention to reduce maternal depression in mothers with undernourished children.Methods: In this randomised controlled trial, all eligible mothers presenting to the paediatric departments were invited to participate in the study. Out of the total 256 mothers screened, 107 were included, 54 of those were randomly allocated to LTP Plus group and 53 to treatment as usual (TAU). Edinburgh Postnatal Depression Scale (EPDS) was used to screen for depression. Hamilton Depression Rating Scale (HDRS), Maternal Attachment Inventory (MAI), Social Support Scale (OSLO-3) and the Euro-QoL (EQ-5D) were used to measure the severity of depression, mother-child attachment, level of support and health related quality of life dimensions. Assessments were completed at baseline, end of intervention (3 months from baseline) and at 6 months from baseline.Results: Mothers in the LTP Plus group significantly showed improvements in depression (p<0.001), social support (p = 0.02) and quality of life (p<0.001) at the end of the intervention (LTP Plus), as compared to the TAU group, which were sustained up to 6 months after baseline.Conclusion: The outcomes of LTP Plus intervention for mothers of malnourished children show promising results in reducing maternal depression and improving child outcomes. A full trial with longer-term outcomes and cost-effectiveness needs to be conducted. [ABSTRACT FROM AUTHOR]

Background: Eswatini is one of the countries affected by malnutrition and tuberculosis (TB) and some cases remained untreated. These two conditions are major public health problems., Aim: This study aimed to explore and describe caregivers' experiences and practices of children's nutrition during treatment., Setting: Baylor College of Nursing Children's Foundation - Eswatini (BCMCF-SD)., Methods: A qualitative study following a narrative design used purposive sampling to identify 12 caregivers of malnourished children and informed consent obtained. In-depth interview used semi-structured interview guide and digital voice recorder. Field notes were taken, transcribed, translated and analysed using NVivo version 11., Results: Two themes emerged as home's nutritional situation and health facility's nutritional support. The study found that most of the caregivers gave children unbalanced diet, while those less than a year were mixed-fed. Some caregivers reported experience of lost breadwinners, unemployment and high number of children than what the family could afford. The caregivers' practices around food by prescription included inadequate supply of the ready-to-use therapeutic food and sharing of prescribed food supplies with other healthy children., Conclusion: During treatment, children's caregivers need short health education and support. The Ministry of Health in Eswatini should consider using some comic books to guide that. Moreover, upscale vocational training promotes entrepreneurship and agricultural activities., Contribution: Association of malnutrition and TB outcomes has provided evidence-based information for more comprehensive integration between nutrition programmes and tuberculosis programmes. The study's findings contributed to the growing body of knowledge about the association between malnutrition and diagnosed drug-susceptible TB among children aged from 0 - 15 years., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article., (© 2024. The Authors.)

Background: The community management for acute malnutrition (CMAM) was started in 2012 with the aim to impact the lives of a large number of children suffering from acute malnutrition without any cost. Objective: The study aimed at evaluating the effectiveness of the CMAM program on severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) treatment. Methods: Children aged 6 to 59 months were screened for malnutrition in a complementary compulsory screening program. Acutely malnourished children underwent free medical and nutritional treatment. Evaluation of the CMAM program implementation was performed by comparison with paid services by collecting data from malnourished children's parents. Results: From the 64458 screened children, 835 were diagnosed as new acutely malnourished cases and referred to health centers for treatment. The anthropometric parameters (MUAC, weight, height) have significantly improved from the time of admission to the end of treatment. Performance indicators using the Sphere standards were above the expected level for outpatient treatment but for inpatient treatment, it failed to meet the expected standard. Poverty and the use of traditional medicine to treat malnutrition, distance, availability, and cost of transportation to the health center were significant barriers to the continuation of healthcare services. Conclusion: The CMAM program is effective. It covered and allowed the treatment of several children presenting the number of pathologies reducing children's morbidity and mortality. In order to increase children's nutritional status, it will be helpful to work with traditional healers. [ABSTRACT FROM AUTHOR]

Introduction: Under five children are prone to many preventable life-threatening diseases. These diseases contribute to high mortality of under five children among which malnutrition is the major cause. Objective: 1)To identify 1-5 years children with malnutrition. 2) To asess the feeding practices of malnourished children, Dhanas, UT Chandigarh. Methodology: Descriptive design was used to conduct the study. Ethical approval was obtained from Institute Ethics Committee, PGIMER, Chandigarh and written informed consent was obtained from mothers. Total 152 children were enrolled by using purposive sampling technique. A list of malnourished children was taken from Anganwadi centers and they were enrolled in the study. Data was collected in August-November 2017. Assessment of feeding practices was done by using interview schedule and nutritional status was assessed by using weight for age chart. Mothers were interviewed in their home setting as per interview schedule. Results: Feeding practices revealed that all the children were not eating their meals in a separate plate, most of the children were consuming junk foods, most of the mothers were either giving junk food before meals or in place of food and only half of the children were started complementary feeding at 6 months, Half of them either started complementary feeding early or late. Conclusion: Children having malnutrition were consuming more junk food. Breast feeding and complementary feeding practices were not appropriate. Hence it is recommended that nurses and other community health workers should use the strategies to combat malnutrition which are applicable at local levels. [ABSTRACT FROM AUTHOR]

Childhood malnutrition is a metabolic condition that affects the physical and mental well-being of children and leads to resultant disorders in maturity. The development of childhood malnutrition is influenced by a number of physiological and environmental factors including metabolic stress, infections, diet, genetic variables, and gut microbiota. The imbalanced gut microbiota is one of the main environmental risk factors that significantly influence host physiology and childhood malnutrition progression. In this review, we have evaluated the gut microbiota association with undernutrition and overnutrition in children, and then the quantitative and qualitative significance of gut dysbiosis in order to reveal the impact of gut microbiota modification using probiotics, prebiotics, synbiotics, postbiotics, fecal microbiota transplantation, and engineering biology methods as new therapeutic challenges in the management of disturbed energy homeostasis. Understanding the host-microbiota interaction and the remote regulation of other organs and pathways by gut microbiota can improve the effectiveness of new therapeutic approaches and mitigate the negative consequences of childhood malnutrition., Competing Interests: The authors declare no conflicts of interest., (© 2023 The Authors. Engineering in Life Sciences published by Wiley‐VCH GmbH.)

Background Malnutrition is one of the most common serious diseases in the world, in which it carry high morbidity and mortality rates. and most of those children commonly exposed to anemic, for many reasons like low iron, folic acid,vit B12 in the food, also impaired absorption due to presence of chronic illnesses or parasitic infestations. Anemia most commonly measured as grams of hemoglobin per liter of blood. Cutoffs to define anemia are 11 gram per dl for children 6-59 months . Aim: To find the types of anemia using blood film examination in malnourished children Patients and Methods: A case control study was done in Tikrit Teaching Hospital and Aldour city during the period from thirteen of june 2013 to first of October 2013.,The total number of cases was (100) diagnosed as malnutrition ,70 of them was anemic . Another 100 normal weight children of same age was taken as control ,54 of them was anemic. The age of the children included in this study was between (2) months and (5) years. Blood film examination was done to all children included in this study (malnourished and control cases ). Also the clinical signs and symptoms of malnutrition was assessed for each child ,which include the mid upper arm circumference, weight per height ,weight per age, height per age and occipito-frontal circumference Results: The study revealed that there was a significant relation between the age of children and the malnutrition in which most of cases were under six months of age in malnourished cases(48,6% ), and there was significant relation between the types of feeding and malnutrition in which most of cases were on mixed feeding in malnourished cases(37,1%) versus (9,3%)in control cases, and there was a significant relation between the(mid upper arm circumference, occipito-frontal circumference) and malnutrition Conclusion: There was a significant relation between the the level of MCV,MCH and MCHC in malnourished cases in comparison to control cases. [ABSTRACT FROM AUTHOR]

Interaction between toxic and essential elements is of particular interest, because the deficiency of essential element can dramatically increase the absorption rate of toxic metals inside the body. This study was conducted to evaluate the possible correlation of lead (Pb) with calcium (Ca), iron (Fe), and zinc (Zn) in biological samples (whole blood and scalp hair) of malnourished children (MNC). For comparative purposes, age-matched, well-nourished children (WNC) were selected. The concentrations of understudy elements were analyzed by atomic absorption spectrophotometry after microwave acid digestion. The accuracy of the methodology, as well as its its validity and efficiency, was checked through certified reference material of whole blood and scalp hair. The result indicates that the MNC have a twofold higher level of Pb, while the levels of essential elements (Ca, Fe, and Zn) were onefold to twofold lower as compared to the WNC (p < 0.05). Significant negative correlations of Pb with Ca, Fe, and Zn were found in the studied malnourished population at p < 0.05. Further research studies are required to elucidate the role of these metals and the mechanism of interaction inside the body. [ABSTRACT FROM AUTHOR]

Introduction: malnutrition is one of the most common health problems among children in underdeveloped countries, including Mexico. Previous studies have indicated increased genetic damage in malnourished humans and animal models, but the essential mechanisms remain unclear. In the present study, we assessed the effects of malnutrition on the frequency of micronucleus (MN) in reticulocytes (RET) from the peripheral blood of well-nourished uninfected (WN), well-nourished infected (WNI), moderately malnourished infected (UNM) and severely malnourished infected (UNS) children. Moreover, lipid peroxidation and the antioxidant status were evaluated to investigate the role of oxidative processes in malnutrition-associated genotoxicity.Methods: the antioxidant status of the study population was determined by measuring superoxide dismutase (SOD) in the red blood cells and glutathione peroxidase (GPX) in whole blood.Results: the UNS and UNM groups have increased percentages of MN-RET compared to the WNI group. Moreover, the data showed a significant increase in lipid peroxidation and a decrease in erythrocyte SOD activity and GPX activity in the malnourished group compared to the well-nourished infected children.Conclusion: the data suggest that the antioxidant system was impaired in the cells of malnourished children and that oxidative stress causes a significant increase in DNA damage, as evaluated by the MN-RET frequency. [ABSTRACT FROM AUTHOR]

Clinically provenLactobacillus acidophilusstrain LBKV-3 intended as probiotic for humans was used to test its effect on fecal residual lactase activity in undernourished children below 10 years of age. The children were selected from malnutrition-declared area of Maharashtra (India). One of the major causes of malnutrition is lactose intolerance which leads to diarrhea. The basic consideration in selecting the probiotic strain ofL. acidophilus(LBKV-3) in this investigation was the fact that the organism is isolated from human vaginal surface swab and it was found extensively studied for probiotic characteristic. LBKB3is tested by several workers as probiotic for hypocholesterolemic activity, implantation ability, therapeutic effects on gastrointestinal (GI) and related ailments. The results of present investigation have shown that the fecal residual lactase activity significantly increased than its initial value (which was almost zero). It appeared that the fecal residual β-galactosidase activity is an indication of positive implementation abilities of the cultures under investigation. These trends were compared with the control and blank group of children receivingDahiand buffalo milk (BM). It was observed that both these products failed to exert any significant impact on increase in residual lactase activity. [ABSTRACT FROM AUTHOR]

Objective: : To evaluate vitamin D levels/deficiency among malnourished children <5 years admitted at a tertiary care center, the Muhimbili National Hospital, Dar es Salaam, Tanzania. Children with malnutrition may have co-existing vitamin D deficiency (VDD), which may be severe.Methods: : Serum vitamin D and alkaline phosphatase were evaluated, and X-ray of the wrist was carried out on 134 children.Results: : VDD was found in 41 of 134 children (30.6%). The mean vitamin D level was 74.8 nmol/l. The mean alkaline phosphatase level was 176.6 U/l. Sixty-four (48%) children were found to have severe stunting, of whom 20 (31.2%) were vitamin D deficient. Marasmic children had higher odds of VDD compared with other forms of malnutrition.Conclusion: : The high prevalence of VDD in malnourished children underlines the need for active surveillance and aggressive management. [ABSTRACT FROM AUTHOR]

Objective: To evaluate causes of lactation failure in children less than six months of age with severe acute malnutrition. Study Design: A cross section at descriptive study. Place and Duration: 1st January 2015 to 1st June 2015 at Nutritional Stabilization Center for Malnourished Children, Children Hospital Complex and Institute of Child Health Multan. Methodology: Malnourished children both male and females, that were not receiving exclusive breastfeeding or was on top feeding were included in this study. Mothers were questioned regarding feeding practices of their child, whether the child was breastfed or on top feed, reasons for introducing top feed, neonatal admission and maternal perception of milk production and myths regarding breast feeding and their answers were recorded. Results: Total 100 children were enrolled for study out of which only 20% babies were partially breastfed and 80% were totally bottle fed. The commonest cause of lactation failure was baby's hospital admission at the time of birth due to Neonatal illness (45%) followed by maternal perception of insufficient milk production (40%). Among these, 45% babies were delivered in home while 55% were born via hospital deliveries. Almost 85% of the mothers were illiterate. Conclusion: The neonatal admissions, morbidity rates and lack of education to mothers regarding breastfeeding are contributing factors in the lactation failure. [ABSTRACT FROM AUTHOR]

Serum iron, total iron binding capacity and plasma protein of severely malnourished children of 12-59 months of age were compared with that of normal healthy children. Mean serum total protein and albumin level in normal children were 76.33 ± 0.51, 43.50 ± 0.38 gm/l respectively which was significantly higher (p

Purpose – The purpose of this paper is threefold: first, to measure the health inequalities among malnourished children; second, to decompose the health inequalities to identify key socioeconomic predictors for child malnutrition; and third, to assess the change in the proportional contribution of key predictors over time. Design/methodology/approach – The study has used data of National Family Health Survey (NFHS) conducted in 1992-1993, 1998-1999 and 2005-2006. The information on anthropometric indicators for children below three years of age is provided; however the study is restricted to “weight-for-age,” as it is considered to be a comprehensive indicator of child nutritional status. In the first stage of analysis, health inequalities are measured among malnourished children using concentration indices (CI) for each round of NFHS. In second stage, the inequalities are decomposed to estimate the proportional contribution of socioeconomic predictors. In the third stage, change in the relative contribution of socioeconomic predictors over three rounds is assessed to suggest target-specific policies and programs. Findings – The results highlight a slow decline of only seven percentage points in the proportion of malnourished children in India during 1992-2006. The increasing values of CIs from −0.13 (1992) to −0.18 (2006) demonstrates the concomitant rise in economic inequalities among malnourished children. The results of decomposition analysis point toward household poor economic status and mother’s illiteracy as the major contributor of inequalities during 1992-2006. During the study period, the economic status explained 50, 65 and 59 percent of inequalities, whereas mother’s illiteracy explained 40, 30 and 29 percent of inequalities, respectively. Overall, the contributors to health inequalities remained the same over time with a change in their relative contribution. Research limitations/implications – The present study is focussed on three rounds of NFHS data conducted at different time period and so it has certain limitations which should be kept in mind while interpreting the results. The study has revealed mother’s education and economic status of the household as the major contributory factors toward child health inequalities. However, one should not forget that the level and quality of education has undergone tremendous change from 1992 to 2006 which the authors could not capture considering the availability of data in the form of years of schooling. Second, since the NFHS-1 has collected the information about the caste groups in only three categories, i.e. schedule caste, schedule tribe and others; the authors have to pool the other backward caste groups with the general caste groups. Third, the authors have used the broad classification of place of residence, i.e. rural and urban area to analyze the inequalities assuming the uniform level of development across the urban regions; however there exists huge disparities within urban areas which leave scope for further research. Fourth, though, the authors have estimated the wealth based inequalities, but NFHS does not provide the absolute level of wealth and so the authors have computed the proxy measure for wealth based on the household assets which has been extensively used in the field of research. Despite these limitations, the authors however believe that the present research work has appropriately decomposed the inequalities among malnourished children and have revealed the changes in the proportional contribution of socioeconomic factors over time. Practical implications – The decomposition analysis brought into light that average health indicators are insufficient for determining the right approach to health intervention programs. Health policy interventions have to focus ideally on both health averages and within and between group inequalities based on varying contributions of socioeconomic determinants. Social implications – Concentrated efforts along with the inter-sectoral concurrence, good nutrition governance, effective investment and unequal distribution of resources are pre-requisites to ameliorate the level and existing inequalities in child malnutrition in India. Originality/value – The distinctiveness of this study can be primarily found in the use of all three rounds of NFHS data to estimate health inequalities among underweight children. The study has also decomposed the health inequalities to estimate and analyze the change in relative contribution of socioeconomic predictors for each round to facilitate the formulation of target-specific policies and programs. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to develop and standardize nutrient dense, easily digestible and affordable ready-to-eat supplementary foods from locally available ingredients for malnourished children and to assess their nutritional composition. Design/methodology/approach – To develop supplementary foods, wheat and green gram were germinated, dried and made into flour. Potatoes of “Kufri Pukhraj” variety procured from university were washed, peeled, sliced, boiled, dipped in potassium metabisulphite solution, dried and grounded into flour. Spinach leaves were washed, dried and made into powder. Five wholesome ready-to-eat supplementary foods, namely, panjiri, mathi, seviyan, biscuits and pinni, were developed from germinated cereal, pulse and potato flour and spinach leaves powder. The products were standardized with potato flour and spinach leaves powder. The developed products were analyzed for proximate composition by standardized methods. Findings – One-way analysis of variance and Tukey’s test was used to obtain differences in organoleptic scores within different levels of treatments. All five supplementary foods were acceptable at 30 per cent level of potato flour and 2.5 per cent level of spinach leaves powder. Mean scores of panjiri, mathi, seviyan, biscuits and pinni were significantly different (p < 0.05). Significant (p < 0.05) difference was observed in terms of moisture, crude protein, crude fat, crude fibre and ash content among the developed products. Practical implications – The developed ready-to-eat supplementary foods can be recommended for supplementary feeding programmes running in the country. Originality/value – The paper aims at the development of high energy protein supplementary foods for malnourished children. The developed complementary food blend is made up of variety of food groups like cereal, pulse, root and tuber and green leafy vegetables to provide wholesome nutrition to children. This is different to originally provided supplementary foods to children made up of only cereal. The developed products also add a variety to supplementary foods given to malnourished children in supplementary feeding programmes. [ABSTRACT FROM AUTHOR]

Highlights: [•] We investigate the neuropsychological effects of the Omega-3 in children. [•] We evaluate improvements after three months of intervention. [•] More than 50% of children supplemented had greater improvement. [•] Shown improvements in 11 of the 18 neuropsychological variables studied. [•] The improvements are clinically significant. [Copyright &y& Elsevier]

Background: Hospital malnutrition is an underestimated problem and as many as half of malnourished patients do not receive appropriate treatment. In order to extend the management of malnutrition in health care facilities, multidisciplinary teams focusing on clinical nutrition were established in France. The establishment of such teams within hospital facilities remains nonetheless difficult. We have consequently developed a multifaceted intervention coordinated by a Nutritional Support Team (NST). Our study aims to evaluate the impact of this multifaceted intervention coordinated by a NST, in adherence to recommended practices for the care of malnourished children, among health care workers of a paediatric university hospital. Methods/design: We carried out 1) a six-month observational phase focusing on the medical care procedures relative to malnourished children followed by 2) a cluster randomised controlled trial phase to evaluate the impact of a multidisciplinary nutrition team over an 18 month time frame. Based on power analyses and assuming a conservative intracluster correlation coefficient, 1289 children were needed to detect a 25% difference in rates between the two groups of the cluster trial. The implementation of our intervention was coordinated by the NST and had three major components: a) access to a computerised malnutrition screening system associated with an automatic alert system, b) an awareness campaign directed toward the health care workers and c) a leadership based strategy. Main outcomes included the number of daily weighings during hospitalisation, the investigation of malnutrition etiology and the management of malnutrition by a dietician and/or the NST. Due to the clustered nature of the data with children nested in departments, a generalized estimated equations approach will be used to analyse the impact of the multifaceted intervention on primary and secondary outcomes. Discussion: Our results will provide an overall response regarding the effectiveness of our multifaceted intervention and we should be able to suggest an organization and mode of operation of NST. [ABSTRACT FROM AUTHOR]

Abstract: Malnutrition is a serious public health problem that affects approximately one third of all children. Developing countries have the highest incidence of malnourished children, and approximately 60% of deaths that occur in children under five are directly related to malnutrition and associated diseases. The relationship between malnutrition and genetic damage has been widely studied in humans and animal models. The micronucleus (MN) assay is useful in detecting chromosome damage induced by several factors. The aim of this study was to evaluate the effects of infection and malnutrition on the frequency of MN in erythrocytes from the peripheral blood of well-nourished, uninfected (WN) and well-nourished, infected (WNI) children, and moderately malnourished (UNM) and severely malnourished (UNS) children, both with infection, using a flow cytometric analysis technique. The percentage of reticulocytes (RETs) was significantly higher (1.5-fold) in WNI children than well-nourished controls. In addition, the UNS group had a 2.2-fold increase in the percentage of RETs compared to the WNI group. The frequency of micronucleated reticulocytes (MN-RETs) was 2.5 times greater, in WNI group compared to the WN group. These frequencies were significantly higher (1.7- and 2.1-fold) in UNM and UNS, respectively, compared to the WNI group. The results suggest that infection and malnutrition induce DNA damage in children. [Copyright &y& Elsevier]

The study employs mothers' counselling and participatory approach in ensuring quick recovery among malnourished children. Cohorts of sixty eligible mothers who have children diagnosed of malnutrition were considered for the study. The mothers and their children were grouped into test and control groups of thirty. The anthropometric measurements of the children were obtained before and after eight weeks of intervention. Mothers were involved in rehabilitating their own malnourished children by using local foods and knowledge. In addition to mothers counselling, growth monitoring was done for the malnourished children. The study showed a positive relationship between mothers counselling and the recovery rate of children suffering from acute malnutrition. During the eighth week of intensive counselling a change in the malnourished children in the test group became obvious: appetite returned, oedema disappeared, and the children began to run and play. These strategies of counselling mothers and a participatory approach can save cost of care, prevent malnutrition and improve the nutrition status of children. [ABSTRACT FROM AUTHOR]

OBJECTIVE:To determine the clinical pattern of infections in admitted malnourished children. METHODS:It is a cross-sectional study conducted at department of Paediatrics Dow University of Health Sciences and Civil Hospital Karachi from April 2008 to December 2009. Patients between 3 to 60 months of age admitted in the nutritional rehabilitation ward were graded for nutritional status according to WHO guidelines as mild (weight for height ratio between -1SD to -2SD), moderate (-2SD to -3SD) and severe malnourished (weight for height ratio <-3SD of NCHS/WHO reference values). These patients were clinically examined for weight, height/ length, sign and symptoms of infections and micronutrient deficiencies. Relevant investigations including CBC, Urine D/R, and Blood culture were done to confirm the clinical diagnosis. The collected data was analyzed and presented as frequencies and percentages. RESULTS:A total of 112 admitted malnourished children with various types of infections were included in the study. Majority of these patients (58%) were between 12 to 36 months of age, females were fifty nine and males were fifty three with male to female ratio of 1:1. There were hundred severely malnourished, eleven moderate and one case of mild malnutrition. Common infections found were acute gastroenteritis (44.6%), acute respiratory tract infections (24%), enteric protozoal and helminthic infections (23%) and sepsis (16%). Blood Culture was positive in 11.6% cases and common pathogens isolated were staphylococcus aureus (60.23%), gram negative organisms, including klebsiella pneumoniae (23%), E-coli (9.2%) and salmonella typhi in (7.6%) of cases whereas urine and stool culture revealed predominantly E-coli. Most of these organisms were sensitive to ciprofloxacin (100%), vancomycin (88.8%), co-amoxiclav (22.2%) and amikacin (33.3%) and showed resistant to most of the first line drugs including chloramphenicol ampicillin, gentamicin and co-trimaxazole. Co-existing micronutrient deficiencies were rickets (35.7%), vitamin A deficiency (18.7%) while (80%) children had iron deficiency anemia. CONCLUSION: Common infections found in malnourished children were acute gastroenteritis, acute respiratory tract infections, protozoal, helminthic infections and sepsis. Staphylococcus aureus and gram negative organisms were common pathogens found in blood, urine and stool cultures of malnourished children. These pathogens were sensitive to ciprofloxacin, co-amoxiclav, amikacin and 3rd generation cephalosporins but resistant to all first line drugs recommended by WHO including co-trimaxazole, gentamicin, penicillin, chloramphenicol. [ABSTRACT FROM AUTHOR]

To study the iron profile and find out an accurate diagnostic tool which reflects iron status in different types of infection in severely malnourished children aged 12 months to 71 months. Hundred and Eight (108) children of whom 72 children were infected and 36 non infected severely malnourished children according to WHO criteria in the age group of 12–71 months were interrogated. 36 healthy control in the same age group were also interrogated. Mean serum iron, total iron binding capacity (TIBC), ferritin concentration in normal children were significantly higher (P<0.001) than non-infected severely malnourished children. On the other hand mean serum ferritin concentration was significantly higher (P<0.001) in infected group than non-infected group but still lower than normal. Mean serum TIBC concentration significantly reduced in severely malnourished children than normal children but no significant difference was observed between non-infected and infected group. Mean serum iron, and transferrin saturation were significantly reduced (P<0.05) in parasitic infestation. Severely malnourished children had reduced mean serum iron profile. Parasitic infestation influenced the marked reduction of mean serum iron concentration and transferrin saturation level. Mean serum iron concentration was reduced in acute respiratory infection(ARI) and parasitic infestation than other infections. Serum ferritin concentration was elevated in all types of infection as acute phase protein but still lower than normal. So Iron, TIBC and Transferin saturation <16% constitute good evidence for iron deficiency in both infected and non-infected severely malnourished children. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the human immunodeficiency virus (HIV) seropositivity in severely malnourished children. Three hundred severely malnourished children (defined as of weight for height <70% according to WHO classification) were subjected to enzyme linked immunosorbent assay for detection of HIV antibodies. All the severely malnourished children who were screened for HIV antibodies were found to be negative. The seropositivity in severely malnourished children was found to be zero. Hence, severe malnutrition cannot be an indication for routine testing for HIV in this part of country. However, children with multiple risk factors may be screened for HIV infection in a resource poor country like India. [ABSTRACT FROM AUTHOR]

Background: Childhood malnutrition could have adverse impacts on the growth of child and eventually on fertility and general economic growth, and still, this issue remains a worldwide priority and a concern. This study aimed to evaluate the effectiveness of the national nutritional interventions program on the improvement and nutritional status of malnourished children children aged 6-59 months., Methods: This community-based intervention study was conducted with 1288 acute and moderately malnourished children aged 6-59 months referred to health centers. Children received combined nutritional education and counseling with the provision of affordable complementary food for 10 months. Anthropometric measurements were assessed monthly according to the standard protocols., Results: Our results showed the reduction in the risk of malnutrition among children after nutritional interventions for weight-for-height (WHZ) ( P < 0.001), height-for-age (HAZ) ( P < 0.001), and weight-for-age (WAZ) ( P = 0.008). Total malnourished children indicated improvement in HAZ (<-3 SD: OR = 1.10, P = 0.026), WAZ (<-2SD: OR = 1.21, P < 0.001; <-3SD: OR = 1.60, P < 0.001), and WHZ (<-3SD: OR = 1.10, P = 0.030). Controlling potential confounders (socioeconomic status, childrens' birth supine length, and weight) showed a significant amelioration in HAZ (<-2 SD: OR = 6.20, P = 0.020; <-3 SD: OR = 9, P = 0.003) and WAZ (<-2 SD: OR = 5.85, P = 0.010; <-3 SD: OR = 7.50, P = 0.004). In urban areas, significant amelioration was observed in HAZ (<-3 SD: OR = 1.22, P = 0.010) and WAZ (<-2 SD: OR = 1.24, P = 0.003; <-3 SD: OR = 1.64, P < 0.001). In rural, considerable amelioration was observed in WAZ (<-2 SD: OR = 1.20, P = 0.010; <-3 SD: OR = 1.50, P < 0.001) and WHZ (<-3 SD: OR = 1.20, P = 0.020)., Conclusion: Nutritional training and counseling as well as complementary food intervention among the malnourished children significantly improved the nutritional status of children. So community-based intervention is recommended to reduce the malnutrition among children., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Shenavar, Sajjadi, Farmani, Zarmehrparirouy and Azadbakht.)

Pediatric populations from lower-income countries may experience a higher incidence of zinc deficiency, which may cause physical and neurological dysfunctions. This case control study aims to assess different levels of zinc between malnourished and well-nourished children. Our study included 108 participants, all children less than 12 years of age. Out of the 108, 54 were malnourished children (cases), while 54 were well nourished (control group) and were screened for zinc deficiencies. Zinc deficiencies were 4 times more common in malnourished cases than in controls (OR: 3.89 95% CI: 1.1-14.9) with median value of zinc in cases being 91.69 and that of controls was 117.6. Our findings indicate significant deficiencies in malnourished children as compared to well-nourished children. Additionally, our findings support literature surveyed that suggest dietary changes alone would not be able to replenish zinc levels in children., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)