Prevalence of undernutrition in Santal children of Puruliya district, West Bengal

This study was carried out to determine the prevalence of undernutrition among the Santal children of Puruliya district of West Bengal. 442 Santal children (216 boys and 226 girls) aged 5-12 years were taken from randomly selected schools of Balarampur and Baghmundi areas of Puruliya. Nutritional status was analyzed by Z-score values according to the height for age, weight for age and weight for height reference data of National Center for Health Statistics (NCHS). The prevalence of undernutrition among Santal children was as follows: stunting (17.9%), underweight (33.7%) and wasting (29.4%). Severe (below -3 Z-score) stunting, underweight and wasting were found in 4.98%, 7.92% and 9.51% of Santal children, respectively. In girls, prevalence of stunting (21.7%) and wasting (35.8%) was higher in comparison to boys (13.8% stunting and 22.7% wasting).     

Evaluation of the nutritional status of 1st-year school children in Campinas, Brazil.

We present findings from a study of nutritional status amongst 1st year primary school children in Brazil. The study was based on a 10% stratified random sample of children in Campinas, Sao Paulo State. The primary schools in the city were grouped into four socio-economic strata (high, medium, low and very low) based on the type of school maintenance (private or maintained by the local or by the State government) and the socio-economic characteristics of the school's catchment area. The nutritional status of 1942 children was assessed by looking at the distributions of z-scores of weight-for-age, height-for-age and weight-for-height in relation to growth charts of the National Center for Health Statistics reference population. In the overall population, 22% of the children were found to be stunted (z-score of height-for-age less than -1.0), 15% wasted (z-score of weight-for-height less than -1.0), 22% underweight (z-score of weight-for-age less than -1.0) and 5% overweight (z-score of weight-for-height greater than 2.0). These figures represent an excess of 6% of stunted children and also 6% of underweight children in comparison with the expected values in the NCHS reference population, and an excess of 2% overweight. The data were analysed by age, sex, ethnic group and socio-economic level. Both stunting and low weight-for-age were observed in 32% of children from the very low socio-economic level, with the highest percentages amongst the oldest children. A total of 11.6% of children from the high socio-economic stratum were obese. These results emphasize the need for different programmes to deal with nutritional problems in different groups of the population.     

Growth of normal urban black Southern African children aged 6-19 years

Height-for-age, weight-for-age, weight-for-height, and height gain were studied in two-thousand normal urban black Southern African schoolchildren from Umtata, Republic of Transkei, Southern Africa. The height-for-age data in the present study were less than those of the USA National Centre for Health Statistics (NCHS) data and the overall distribution of height for age was between the 3rd and 75th percentiles of NCHS. In boys, after the age of 13 years, the weight-for-age data in the present study were statistically less than NCHS and the overall distribution of weight-for-age data was between the 10th and 75th percentiles of NCHS. The weight for height in the present study was slightly greater than NCHS and the overall distribution of weight for height data was between 25th and 90th percentiles of NCHS. Adolescent growth spurt occurred in girls at the age of around 11 years, while in boys it occurred around 12 years. The mean duration of the pubertal period was 2 years for boys and girls. Peak height velocity (PHV) was 7.7 and 7.9 cm/year in boys and girls, respectively. The present study may be used a source of reference for urban black schoolchildren in Africa.     

Risk factors for protein–energy malnutrition in children under 5 years: Study from Luangprabang province, Laos

BACKGROUND: Laos is one of the poorest countries in which chronic malnutrition is highest. The aim of the present study was to determine the prevalence of and to identify risk factors associated with protein-energy malnutrition (PEM) in children under 5 years of age in Luangprabang province, Laos. METHODS: This cross-sectional study was undertaken from March to May 2004. Anthropometric measurements of 798 children were done and data were transformed into height-for-age, weight-for-age and weight-for-height ratios. Mothers were also interviewed with a semi-structured questionnaire. Anthropometric data were entered into Nutstat in Epi-Info 2000 and transferred to SPSS for analysis. RESULTS: There was a high prevalence of stunting, underweight and wasting, that is, 54.6%, 35%, and 6% respectively. It was also noted that children aged 12-23 months and Khmu ethnic children had a higher prevalence of stunting (65% and 66%) and underweight (45% and 40%), respectively. However, it was also found that boys were more prone to be stunted and underweight. Furthermore, restricted intake of meats, vegetables during illness, and low maternal education were main risk factors for child malnutrition in the study area. CONCLUSION: Socioeconomic-demographic factors, low maternal education, poor nutrition knowledge for mother and feeding practices for sick children are affecting children's health regarding stunting and underweight. It is recommended that an improvement in societal infrastructure, better maternal education and nutrition are needed to address the child malnutrition issue.     

Obesity and malnutrition in children: profile of a low-income community

OBJECTIVE: To establish the nutritional diagnosis of children living in a low-income community through anthropometric evaluation, detecting insufficient nutrition (low weight-for-age, wasting and stunting) and excessive nutrition (overweight and obesity). METHODS: A community-based survey identified children below 11 years living in a low-income community. Their weight and height (or lengths) were measured. The National Center for Health Statistics growth curve was used as reference. The cut-off points used were: low-weight-for-age z score of < -2 (weight-for-age), wasting (weight-for-height) and stunting (height-for-age); respective overweight and obesity z scores of +1 to +2 and of > +2, according to weight-for-height. RESULTS: Prevalence rates were 3.8% for low weight for age, and 24% for low-weight-for-age risk factors; 1.2% for wasting, and 21.6% for wasting risk factors; 5% for stunting, and 14.3% for stunting risk factors; 10.1% for overweight, and 4.6% for obesity. CONCLUSIONS: Main nutritional issues were present in children from that community, with simultaneous occurrence of chronic malnutrition and obesity.     

Height and weight of urban preschool children in relation to their mothers' educational levels and employment status in Rasht City, northern Iran

This study determined the relationship between anthropometric status of 3-5-year-old urban children and theirs mothers' educational levels and employment status in Rasht City, northern Iran. A total of 1319 children (638 girls and 681 boys) at the ages of 3 and 6 years in all day-care centres in Rasht City were studied, using a cross-sectional design. Height and weight of the children were measured, and data on mothers' educational levels, employment status and duration of any breastfeeding were collected. Height for age, weight for age and weight for height of the children were compared with the National Center for Health Statistics (NCHS) reference population of the United States, and z-values 12 years of schooling, OR = 1.87; 95% CI: 1.08-2.4) had higher relative risk for underweight than children of mothers with an intermediate level of education (5-12 years of schooling). Children of mothers with college education were also more at risk for development of stunting (OR = 1.41; 95% CI: 1.14-4.22). In addition, children of employed mothers were more likely to be underweight (OR = 1.52; 95% CI: 1.05-2.31), stunted (OR = 2.42; 95% CI: 1.21-6.35) and wasted (OR = 3.35; 95% CI: 1.21-5.58) than children of non-employed mothers. The relative risk for undernutrition was higher in the children of both less and highly educated mothers compared with children of mothers with an intermediate level of education. Mothers' employment was also negatively related to nutritional status of these children in day-care centres in Rasht City.     

The interrelationship of malnutrition and diarrhea in a periurban area outside Alexandria, Egypt

BACKGROUND: In the developing world, children are often observed to have both diarrhea and malnutrition. This observation has led many researchers to speculate that diarrhea may produce malnutrition and that malnutrition may predispose to diarrhea. In this study, the interrelationship between diarrhea and malnutrition was investigated among 143 Egyptian children less than 3 years of age. METHODS: For 22 months, children were followed for diarrhea at twice weekly home visits and measured for nutritional status at approximately 3-month intervals. Nutritional measurements were converted to z-scores based on the National Center for Health Statistics/World Health Organization (NCHS/WHO) reference population. RESULTS: Three hundred fifty-eight diarrheal episodes were reported with only 1% of episodes lasting 14 days or more. Stunting, wasting, and low weight-for-age were found in 19%, 3%, and 7%, of these children, respectively. When testing whether malnutrition predisposes to diarrhea, a weight-for-age z-score of <-2 standard deviations was associated with increased incidence of diarrhea (RR = 1.7, P < 0.01) but not height-for-age or weight-for-height. Diarrhea itself was associated with a subsequent attack of diarrhea (RR = 2.1, P < 0.001). During short intervals of follow-up (approximately 3 months), an association was detected between diarrhea episodes and growth faltering for height-for-age z-score (-0.16, P < 0.05). This association was reduced, however, when analyzed during 6-month intervals, if no diarrhea was reported in either the first or second half of this interval. CONCLUSIONS: In a population with moderate malnutrition, both low weight-for-age and diarrhea itself are associated with increased diarrhea risk. Diarrhea alone does not appear to contribute substantially to malnutrition when children have diarrhea-free time for catch-up growth.     

宁夏吴忠市7岁以下儿童生长状况及影响因素分析

目的：了解宁夏吴忠市7岁以下儿童生长状况及影响因素,为制定相关干预措施提供参考依据。方法：采用分层整群的抽样方法,对宁夏吴忠市两县区7岁以下儿童进行了调查,生长状况采用Z评分法评价。结果：7岁以下儿童生长迟缓、低体重、消瘦的发生率分别为12.58%、5.71%、5.55%。儿童年龄的身高Z评分(HAZ)、年龄的体重Z评分(WAZ)以及身高的体重Z评分(WHZ)均值分别为-0.26±2.50、0.29±4.54和0.65±3.02。不同民族儿童消瘦发生率差异有统计学意义（P＜0.05）,不同地区和不同年龄段儿童生长迟缓发生率、低体重的发生率差异有统计学意义（P＜0.05）。儿童生长迟缓的主要影响因素为地区（OR=0.369,P＜0.001）、民族（OR=1.694,P=0.027）、儿童年龄（OR=1.143,P=0.002）。低体重的主要影响因素为地区（OR=0.453,P=0.001）、儿童年龄（OR=1.204,P=0.002）。消瘦的主要影响因素为民族（OR=1.735,P=0.024）。结论：吴忠市7岁儿童生长水平欠佳,其生长水平与民族、地区、年龄等因素有关。     

Prevalence and correlates of stunting among children in rural Pakistan

BACKGROUND: Protein-energy malnutrition remains an important underlying cause of death among preschool children in Pakistan. The present study aimed to estimate the prevalence of stunting and its correlates and to explore the role of sex bias in remote rural villages of south Pakistan. METHODS: We selected 1878 children less than 3 years of age through stratified random sampling from 64 villages having the number of children enrolled proportionate to the size of each village, in rural Sindh, Pakistan. Trained investigators completed child physical measurements and a maternal interview. The Z-scores for the distribution of height-for-age (stunting) and weight-for-height (wasting) were estimated relative to those of the National Center for Health Statistics/Center for Disease Control (NCHS/CDC) reference population. RESULTS: A total of 483 (26%) of the 1878 children were wasted, 977 (55%) were stunted and 259 (15%) were both wasted and stunted. Mothers who were illiterate were more likely to have children who were stunted (odds ratio (OR) = 1.27, 95% confidence interval (CI) 1.11-1.61). Fathers who earn less than Rs. 1000 (US $20) per month (OR = 1.35, 95% CI 1.12-1.66) were more likely to have children who were stunted. Children living in an overcrowded house were more likely to be stunted (OR = 1.44, 95% CI 1.18-1.75). Male children compared to females were equally likely to be stunted (57 vs 55%, OR 1.03, 95% CI 0.86-1.25). CONCLUSIONS: In this region of lower Sindh, stunting is more common than wasting. Female illiteracy, poor household income and overcrowding are important risk factors for stunting. The prevalent belief that in rural Pakistan, parents pay attention to feeding male children at the cost of female children is not proven by these data.     

Nutritional status of low-birthweight ethnic minority infants in Backan province, Vietnam

BACKGROUND: Birthweight and length have been reported to be important determinants of infant growth and future nutritional status. The study aims to describe the weight and length growth patterns during the first year of life of low-birthweight (LBW) ethnic minority infants in the mountainous province Backan, Vietnam. METHODS: A total of 64 LBW and normal birthweight infants of ethnic minority mothers were recruited from 2001 to 2002 into a prospective cohort study. The weight and length of infants were measured monthly for 1 year. Data on nutritional status and feeding practices of the infants were collected from monthly health records and face-to-face interviews with mothers while their infants were 6 and 12 months of age. RESULTS: Most of the increase in weight, length and catch-up to the 10th percentile for LBW infants occurred during the first 3 and 6 months for boys and for girls, respectively. After these ages, the mean weight and length diverged from National Center for Health Statistics (NCHS) reference curves to below the 10th percentile. LBW infants' weight-for-age z-scores was below the NCHS standard at birth (-2.16 SD), caught up after birth, became sustainable by 4 months, fell rapidly from the sixth month, then decreased to -2 SD at 12 months of age. LBW infants' length-for-age z-scores increased in the first month after birth, decreased in the second month and sharply increased again until 5 months of age before decreasing. CONCLUSIONS: For LBW infants, it is difficult to achieve the same weight or length curves at 12 months of age as the NCHS standard.     

Prevalence and correlates of stunting among primary school children in rural areas of southern Pakistan

Protein-energy malnutrition is one of the leading causes of childhood morbidity and mortality in developing countries. The purpose of the present study was to measure the prevalence of stunting and its correlates among school children aged 6-12 years in the rural areas of southern Pakistan. We selected 1915 children aged 6-12 years enrolled in 32 primary schools in rural Sindh, Pakistan. Trained community health workers conducted child height and weight measurements and collected information from the parents. The Z-scores for the distribution of height-for-age, weight-for-age, and weight-for-height relative to those of National Center for Health Statistics/Center of Disease Control and prevention (NCHS/CDC) reference population were calculated. Out of 1915 children, 300 (16.5 per cent) were stunted. Female children compared to males were more likely to be stunted (prevalence ratio (PR) = 1.26; 95 per cent confidence interval (CI): 1.02-1.53). Children older than 7 years were more likely to be stunted (PR, 1.40; CI, 1.14-1.72). Fathers who were working as government employees (PR, 1.71; CI, 1.05-2.79), shopkeepers (PR, 2.00; CI, 1.22-3.26) and farmers (PR, 1.43; CI, 0.93-2.22) were more likely to have children who were stunted when compared to landlords. In rural areas of southern Pakistan, sex of child, age of the child, and father's occupation may be considered as important risk factors for stunting among school children aged 6-12 years.     

Dietary intake and growth pattern of children 9-36 months of age in an urban slum in Delhi

This investigation deals with the dietary intakes and growth in early childhood in poor communities. Five hundred and forty five children, 9-36 months of age, and their caretakers (mothers) were selected randomly and invited to participate in the study. The food and nutrient intake of children was assessed using a 10-item food frequency and amount questionnaire (FAQ). The anthropometric nutritional status was assessed by the indices height-for-age (H/A), weight-for-age (W/A), weight-for-height (Wt/Ht) and MUAC, according to Indian and NCHS standards. The results showed that the intake of cereals, pulses, roots, green leafy vegetables (GLVs), other vegetables, fruits, sugar, fats and oils among children was grossly inadequate. The nutrient intake for energy was 56% of the current RDA. Anthropometric analysis revealed that the children were grossly undernourished. Seventy five per cent children were underweight (<-2 SD), while 35% severely undernourished (<-3 SD). Approximately, 74% children were having short stature (chronic malnutrition) with 39% severely stunted. Nineteen per cent children were excessively thin (wasted). The data regarding the degree of malnutrition among children demonstrated that 9.6% girls in 9-36 months of age had severe malnutrition as compared to 6.5% males. The maximum prevalence of severe malnutrition was in the age 31-36 months (10%) followed by 9.6% in 13-18 months. The moderate degree of malnutrition was around 30 to 33% in age group 13-36 months. The evidence from the study provides a strong basis to suggest low food intake as the main cause of under/malnutrition and growth retardation (stunting) in early childhood in poor communities.     

Some determinants of nutritional status of one- to four-year-old children in low income urban areas in Tanzania.

Some socio-economic and demographic factors contributing to nutritional status (underweight and wasting) of children aged 1 to 4 years (n = 949) were studied in selected low income urban areas in Tanzania. Children were classified as either normal or malnourished and logistic regression was used in the analysis. Of the demographic variables studied, sex of the child was significant using both weight-for-age and weight-for-height indices. Males had better nutritional status than females. Mother's education level and age were significant risk factors using weight-for-age. Immunization status of the child and household density were also significant, but their effects became insignificant when morbidity and dietary variables were included in the analysis. Using weight-for-height the place of residence and number of children under 5 years in a household had significant effects on nutritional status through the latter was less significant when morbidity variables were incorporated. Children from big towns were significantly better off nutritionally than those from small towns. For dietary and morbidity variables frequency of feeding and diarrhoea were significant predictors of nutritional status (weight-for-age) while malaria was a significant predictor of weight-for-height.     

Changing patterns of under- and over-nutrition in South African children-future risks of non-communicable diseases

Under- and over-nutrition in children in KwaZulu-Natal, South Africa was investigated comparing data collected from primary school children in a rural district (643 children aged 8-11 years in 1994) with secondary data from the National Schools Study (16,179 children, 4-11 years in 1994), the Vitamin A Consultative Group Study (408 children, 2-5 years in 1994) and the Income Dynamics Study (1,593 children, 2-11 years in 1998). Stunting and wasting (WHO/NCHS guidelines) and overweight and obesity (International Obesity Task Force guidelines) were retrospectively analysed from these studies and compared in the children aged 4-5 and 8-11 years. There was moderate stunting in 10-25%, wasting in 1-6%, 5-24% were overweight and 1-10% obese. Girls in the National Schools Study (p<0.005) and in the primary datasets (p=0.02) had a significantly higher prevalence of overweight than boys; girls (1.4%) were also more obese than boys (0.9%) in the Schools Study (p=0.002), and the boys significantly more stunted (p<0.005) and wasted (p<0.005). An increasing prevalence of overweight and obesity was seen in both the 4-5- and 8-11-year age-groups. The finding that moderate stunting co-exists with overweight and obesity suggests that patterns of under- and over-nutrition in South African children are changing and might indicate the early stages of a complex nutritional transition. Action is required to prevent the future risk of non-communicable diseases.     

Is undernutrition a problem among Turkish school children?: Which factors have an influence on it?

Undernutrition is a frequent manifestation and an important health problem. The aim of this study was to analyse the variables of nutritional status among primary school children and to determine the risk factors associated with it. The study group was composed of 1576 students between 6 and 16 years of age. The prevalence of stunting, underweight, wasting were calculated according to WHO recommended cut-off points to define undernutrition. Chi-square tests, logistic regression analysis were used to investigate the relationship between the prevalence of undernutrition and the sociodemographic factors. The overall prevalence of stunting, underweight and wasting were found as 5.7, 4.6 and 1.0%, respectively. There were significant relationships between underweight and age, sex, number of family members, monthly family income. But, a significant correlation was found only between stunting and age. No correlation was found between wasting and sociodemographic factors. Undernutrition is still a common problem among primary school children in Istanbul. Identification of risk factors is essential for prevention of undernutrition.     

Prevalence and correlates of malnutrition among children in rural minority areas of China

BACKGROUND: Child growth retardation and malnutrition remain a matter of uttermost public concern in economically disadvantaged areas of China. The present study aimed to estimate the prevalence of protein-energy malnutrition with various anthropometric indices and examine its correlates in a large sample of poor rural minority children. METHODS: A total of 2019 children under 7 years of age belonging to the Hani, Yi, Hui, Miao ethnic minority groups and the Han major group were drawn from four poor rural minority counties in the Yunnan Province of China. Well-trained investigators completed child physical measurements and maternal interviews. Protein-energy malnutrition was defined as being underweight (weight for age), wasting (weight for height) and stunting (height for age) on the basis of reference data from the National Center of Health Statistics (NCHS)/World Health Organization (WHO). RESULTS: The respective prevalence of moderate and severe protein-energy malnutrition was 15.8 and 3.1% for underweight children, 31.8 and 19.2% for stunting and 0.9 and 0.5% for wasting. Stunting was most common in children aged 2 years. Boys were more likely to suffer from malnutrition. Logistic regression analyses showed that lower family income, lower parental height, belonging to the Miao, Yi and Hani ethnic groups compared with Han and poorer maternal child-rearing behavior significantly increased the risk for stunting of children. CONCLUSIONS: Protein-energy malnutrition is relatively high in the rural minority children of China. Chronic socioeconomic underdevelopment and genetic effects, rather than a severe or immediate lack of food, may lead to protein-energy malnutrition.     

Nutritional status of adolescent girls from an urban slum area in South India

Objective  To assess the nutritional status of adolescent girls in a slum community of Urban Health Center, Panangal. Methods  A community-based cross-sectional study was carried out over a period of two months. 223 adolescent girls of age 10–18 years were selected randomly. Data was collected by interviewing the adolescent girls using predesigned, pre tested, semi-structured schedule. Parents interview was taken whenever necessary. Anthropometric measurements were recorded using standardized methodology as recommended by World Health Organization (WHO). Standard operational definitions were used. Various statistical applications like percentiles, mean, standard deviation and proportions were used for analysis of the data. Results  Overall prevalence of stunting was found to be 47% and 28.3% as per NCHS and Indian standards respectively. Prevalence of underweight was 42.6% and 22.9% as per NCHS and Indian standards respectively. Prevalence of thinness was 20.6% as per Indian standards. Conclusion  It is concluded that there is a high prevalence of under nutrition among adolescent girls in this slum community. Health education and nutrition interventions are needed on priority basis.     

Tamil Nadu nutritional survey comparing children aged 0–3 years with the NCHS/CDC reference population

A cross-sectional nutritional survey of children belonging to Tamil Nadu State of India, aged 0–3 years was conducted on a representative sample of 2039 children. The collected data was analysed using the recommended indices of height-for-age and weight-for-height based on standard deviation (SD scores) and cross-classified using the SD scores. The nutritional status of these children was compared with the NCHS standard. Prevalence of stunting (27.6%), wasting (9.9%) and simultaneous wasting and stunting (10.7%) was high among the children studied:     

Risk factors for undernutrition among children 0–59 months of age in Myanmar

The prevalence of childhood stunting in Myanmar is one of the highest among the countries of Southeast Asia. Cross‐sectional data from the Myanmar Demographic Health Survey 2015–2016 were used to examine risk factors for stunting, wasting, and underweight among children aged 0–59 months. The prevalence of stunting, wasting, and underweight was 29.0%, 7.3%, and 19.2%, respectively. Accounting for sampling design and weights, multivariable logistic regression was conducted with 35 household, maternal, and child characteristics. Current pregnancy and maternal height <145 cm, home delivery, child's small birth size recalled by mother, and older age (ref: 0–5 months) predicted both stunting and underweight. Larger than average birth size was protective for all stunting, wasting, and underweight. Maternal body mass index <18.5 kg m^?2 was a common risk factor for wasting and underweight. Lower wealth quintiles, maternal engagement in nonagricultural occupation, and male child predicted stunting only. Younger child age and not receiving vitamin A supplementation in the previous 6 months were risk factors for wasting only. Regional variation was also seen, with a higher odds of stunting in the West‐South Region, North‐East States, and West States, compared with the Central Regions. In Myanmar, socio‐economic and demographic factors, poor maternal nutritional status, and living in certain geographical locations are affecting children's undernutrition. It is recommended that interventions for growth faltering focus on the first 1,000 days of life; optimum maternal nutrition be ensured during and before pregnancy and at adolescence; societal support be provided for mothers in poverty or engaged in nonagriculture; and region‐specific undernutrition pathways be understood.     

Concurrent wasting and stunting among under‐five children in Niakhar,Senegal

The study describes the patterns of concurrent wasting and stunting (WaSt) among children age 6–59 months living in the 1980s in Niakhar, a rural area of Senegal under demographic surveillance. Wasting and stunting were defined by z scores lower than ?2 in weight for height and height for age. Both conditions were found to be highly prevalent, wasting more so before age 30 months, stunting more so after age 30 months. As a result, concurrent WaSt peaked around age 18 months and its prevalence (6.2%) was primarily the product of the two conditions, with an interaction term of 1.57 (p < 10^?6). The interaction was due to the correlation between both conditions (more stunting if wasted, more wasting if stunted). Before age 30 months, boys were more likely to be concurrently wasted and stunted than girls (RR = 1.61), but the sex difference disappeared after 30 months of age. The excess susceptibility of younger boys could not be explained by muscle mass or fat mass measured by arm or muscle circumference, triceps, or subscapular skinfold. Concurrent WaSt was a strong risk factor for child mortality, and its effect was the product of the independent effect of each component, with no significant interaction.