scholarly journals Maternal perception of malnutrition among infants using verbal and pictorial methods in Kenya

2014 ◽  
Vol 18 (5) ◽  
pp. 869-876 ◽  
Author(s):  
Martha K Mwangome ◽  
Gregory Fegan ◽  
Andrew M Prentice ◽  
James A Berkley

AbstractObjectiveTo compare mothers’ perceptions of their own infants’ nutritional status with anthropometric indicators of undernutrition.DesignA qualitative study and cross-sectional quantitative survey. The qualitative study involved developing tools to assess mother’s perception. Two methods of verbal description and a pictorial scale were developed. The quantitative survey involved measuring maternal perception and comparing it with the anthropometric measures of weight-for-age Z-score (WAZ) and mid-upper arm circumference-for-age Z-score (MUACZ).SettingA rural community setting in Kenya.SubjectsSeventy-four infants aged between 4 and 6 months, and their mothers, living in rural Kenya were enrolled.ResultsUsing verbal description, the positive and negative likelihood ratios were 3·57 (95 % CI 1·44, 9·98) and 0·69 (95 % CI 0·50, 0·96) respectively for MUACZ<−2; and 4·60 (95 % CI 1·60, 13·3) and 0·67 (95 % CI 0·49, 0·92) respectively for WAZ<−2. Using the pictorial scale, the positive and negative likelihood ratios were 8·30 (95 % CI 1·91, 36·3) and 0·69 (95 % CI 0·52, 0·93) respectively for MUACZ<−2; and 4·31 (95 % CI 1·22, 15·0) and 0·78 (95 % CI 0·61, 1·00) respectively for WAZ<−2.ConclusionsIn a rural community, mothers better identify undernutrition in their infants using a pictorial scale than verbal description. However, neither can replace formal anthropometric assessment. Objective anthropometric tools should be validated for identification of severe acute malnutrition among infants aged less than 6 months.

2020 ◽  
Vol 189 (12) ◽  
pp. 1623-1627
Author(s):  
Francisco M Barba ◽  
Lieven Huybregts ◽  
Jef L Leroy

Abstract Child acute malnutrition (AM) is an important cause of child mortality. Accurately estimating its burden requires cumulative incidence data from longitudinal studies, which are rarely available in low-income settings. In the absence of such data, the AM burden is approximated using prevalence estimates from cross-sectional surveys and the incidence correction factor $K$, obtained from the few available cohorts that measured AM. We estimated $K$ factors for severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) from AM incidence and prevalence using representative cross-sectional baseline and longitudinal data from 2 cluster-randomized controlled trials (Innovative Approaches for the Prevention of Childhood Malnutrition—PROMIS) conducted between 2014 and 2017 in Burkina Faso and Mali. We compared K estimates using complete (weight-for-length z score, mid-upper arm circumference (MUAC), and edema) and partial (MUAC, edema) definitions of SAM and MAM. $K$ estimates for SAM were 9.4 and 5.7 in Burkina Faso and in Mali, respectively; K estimates for MAM were 4.7 in Burkina Faso and 5.1 in Mali. The MUAC and edema–based definition of AM did not lead to different $K$ estimates. Our results suggest that $K$ can be reliably estimated when only MUAC and edema-based data are available. Additional studies, however, are required to confirm this finding in different settings.


2021 ◽  
Vol 16 ◽  
Author(s):  
Iribhogbe Osede Ignis ◽  
Sonila Tomini

Background: Vaccination of children has played a significant role in reducing early childhood morbidity and mortality from vaccine-preventable diseases; however, some factors act as deterrents in achieving adequate coverage in this susceptible population. Aims & Objectives: The study, therefore, aimed to identify vaccine-related determinants of childhood vaccination as well as determine the relationship between childhood vaccination status and body weight, height, and a child’s body mass index (BMI). Methods: The study was conducted using a cross-sectional design in which 608 caregiver-child pair was recruited sequentially by using a two-stage sampling technique. Structured questionnaires based on the SAGE vaccine hesitancy model were used to interview the participants. Elicited data was analyzed and categorical variables were presented in tables and charts as frequencies, while a chi-square test was used to test the association between the independent and dependent variables. Pearson’s correlation analysis was also done to determine the correlation between vaccination status and weight, height, and BMI of children. Result: The study showed that vaccination coverage was suboptimal (70.56%) in children and was below the expected target of 80%. Although a few (183, 30.10%) of the respondents claimed they would prevent the vaccination of their children due to the fear of needles, the majority (87.50%) will be willing to accept more vaccine doses for their children if there were no pain. While factors such as the experience of adverse reaction (X2 = 13.22, df = 2, p<0.001), crying from pain (X2 = 11.33, df = 2, p<0.001) and the scientific evidence of safety (X2 = 34.63, df = 2, p<0.001) were significantly associated with a complete vaccination status, vaccination status was positively correlated with the weight (r=0.160, p<0.001), height (r=0.081, p=0.023) and BMI (r=0.214, p<0.001) of children in the rural community. Conclusion: Vaccination uptake and coverage can be significantly improved in children by designing and implementing interventional programs that target pharmaceutical and vaccine-specific factors acting as barriers in these rural communities.


2016 ◽  
Vol 4 (1) ◽  
pp. 159
Author(s):  
Pranav G. Jawade ◽  
Neelam D. Sukhsohale ◽  
Gayatri G. Jawade ◽  
Binish Z. A. Khan ◽  
Pratik K. Kakani ◽  
...  

Background: Acute respiratory infections (ARI) and Malnutrition in children have tremendous burden on the health care sector of developing nations including India. The intensity with which these conditions are holding grip in the community is indeed a matter of concern and hence developing nations should develop an insight to assess the severity of it has become a necessity.Methods: A hospital based cross sectional study was carried out in children aged 0-14 years. Children were clinically assessed and diagnosis was made as URTI or LRTI Also anthropometry was performed and accordingly children were divided into categories of no malnutrition (NM), severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) in ‘under 5’ years age children according to WHO guidelines, whereas children aged ‘above 5’ years were categorized as per the IAP guidelines.Results: It was observed that most of the mothers of children were illiterate with inadequate or absent ventilation and use of biomass fuels (chulha) for cooking purpose in households of rural children. The proportion of malnutrition was found to be equal in Under 5 children. In ‘above 5 years’ age study subjects, 52.4% of urban study subjects were normal as compared to 16.7% of rural study subjects.Conclusions: Our study implies that ARI and Malnutrition definitely is more prevalent in the pediatric population. Prevalence of URTI was found to be on a higher side in the rural population and LRTI prevalence was found to be higher in the urban population. Similarly, the prevalence of malnutrition was almost similar in ‘Under 5’ aged children, whereas the prevalence of malnutrition in ‘Above 5’ aged children was higher in the rural population than urban population.


2021 ◽  
Author(s):  
Joana Apenkwa ◽  
Sam K Newton ◽  
Samuel Kofi Amponsah ◽  
Reuben Osei-Antwi ◽  
Emmanuel Nakua ◽  
...  

Abstract Background: Ghana for years has implemented the Community-based Management of Acute Malnutrition (CMAM) among children in order to reduce malnutrition prevalence. However, the prevalence of malnutrition remains high. This study aimed to determine CMAM coverage levels in the Ahafo Ano South (AAS), a rural district, and Kumasi Subin sub-metropolis (KSSM), an urban district. Methods: The study was a cross-sectional comparative study with a mixed-methods approach. In all, 497 mother/caregiver and child under-five pairs were surveyed using a quantitative approach while qualitative methods were used to study 25 service providers and 40 mother/ caregivers who did not participate in the quantitative survey. Four types of coverage indicators were assessed: point coverage (defined as the number of Severe Acute Malnutrition cases [SAM] in treatment divided by total number of Severe Acute Malnutrition cases in the study district), geographical coverage (defined as total number of health facilities delivering treatment for SAM divided by total number of healthcare facilities in the study district), and treatment coverage (defined as children with SAM receiving therapeutic care divided by total number of SAM children in the study district) and program coverage (defined as number of SAM cases in the CMAM programme ÷ Number of SAM cases that should be in the programme). The qualitative approach was used to support the assessment of the coverage indicators. Data were analyzed using STATA version 14, and Atlas.ti, version 7.5 for the quantitative and qualitative data respectivelyResults: Geographically, only 6% of the facilities in the urban communities were participating in the CMAM programme as against 29% of rural district facilities. The districts had point coverage of 41% and 10% for the urban and rural districts respectively. The urban setting recorded a SAM prevalence of 52% as against 36% in the rural setting. The proportion of SAM children enrolled in CMAM was higher in KSSM when compared with AAS; 41% and 33% respectively. In both districts, the most likely factors to attract mothers/caregivers to utilize the CMAM services were: ‘free services’ and ‘a cured child.’ The qualitative approach showed that coverage improvement in both districts is hampered by barriers such: distance, transportation cost, lack of trained personnel in the communities for community mobilization and home visits, and insufficient feeds. Conclusion: To improve CMAM coverage, there is the need to train health workers to embark on aggressive health education strategies to encourage mothers/caregivers of malnourished children to utilize CMAM while ensuring that services reach those who need them. Trial registration: This study is approved and registered with The Kwame Nkrumah University of Science and Technology Committee on Human Research, Ethics and Publications (CHRPE/AP/314/15)


2018 ◽  
Vol 5 (3) ◽  
pp. 1092 ◽  
Author(s):  
Rameshwar Ninama ◽  
Chakshu Chaudhry ◽  
Rameshwar Lal Suman ◽  
Suresh Goyal ◽  
Ramprakash Prakash Bairwa ◽  
...  

Background: Diarrhea is the major cause of death in children below five years of age. Hypoglycemia has been a potential fatal complication of infectious diarrhea in both well-nourished and poorly nourished children. But prevalence of hypoglycemia in diarrheal dehydration is not exactly known. This study was done to evaluate the glycemic status in children having acute diarrhea with dehydration and specifically associated with severe acute malnutrition (SAM).Methods: This descriptive cross-sectional study was conducted during July 2017 to December 2017 at Bal Chikitsalaya Udaipur, Rajasthan, India. Blood glucose levels were assessed in 150 children of acute diarrhea with dehydration, comprising of 100 SAM and 50 Non SAM children.Results: Average blood glucose of SAM children was 89 mg/dl and of non-SAM, it was 120 mg/dl. Average blood glucose was low in SAM as compared to non-SAM in both some dehydration (116.08±21.26) and severe dehydration (66.69±19.80) as well as with or without ORS intake. Overall 18 (12%) of children had hypoglycemia and all were in severe dehydration and not taking ORS. Blood glucose levels were statistically low in severe dehydration and those who were not taking ORS at the time of hospitalization (p = 0.001). In severe dehydration 25% of children had hypoglycemia means every fourth child had low blood glucose <54 mg/dl.Conclusions: Overall prevalence of hypoglycemia is 12% in diarrheal dehydration and 20% in SAM with dehydration. Twenty five percent of severe dehydration children had hypoglycemia, and all have not started ORS. None of the child started ORS developed hypoglycaemia.


2019 ◽  
Vol 8 (2) ◽  
pp. 219
Author(s):  
Abdu Oumer

<span>For appropriate management of severe acute malnutrition skilled, knowledgeable and concerned health professionals are critical for child survival. </span><span>Thus assessing the knowledge of nurses towards management protocol of severe acute malnutrition is crucial step for targeted interventions. </span><span>This study aimed to assess Knowledge towards Severe Acute Malnutrition Management Protocol and its Associated Factors among Nurses working in Hiwot Fana Specialized University Hospital, 2018. Cross-sectional study was conducted among eligible 132 nurses. Data were collected using self-administered questionnaire prepared from the national SAM management guideline of Ethiopia. SPSS version 20.0 software using frequency, tables, graphs, percentages and mean was used. Student t test and analysis of variance with F statistics and P value was computed. Overall, 65 (49.2%) of nurses had poor knowledge on SAM management. More than half, 100 (75.8%) of the nurses had experience in SAM management previously. Males were more likely to be knowledgeable (AOR=1.27) as compared to females. Nurses with the previous experience of managing malnourished child had 1.70) times more likely to be knowledgeable as compared to their counterparts. Having SAM training was associated with having higher knowledge score (AOR=1.56). Having SAM training was found to have significantly higher knowledge score (p=0.034). Knowledge level of nurses towards SAM management is not satisfactory. Those who ever involved in SAM management, having recent malnutrition training and gender were predictors of high knowledge score. There should be regular capacity building schemes for nurses especially for those who are involved in management of SAM at emergency or SAM unit.</span>


2020 ◽  
Author(s):  
Umesh Ghimire ◽  
Binod Kumar Aryal ◽  
Ankush Kumar Gupta ◽  
Suman Sapkota Sapkota

Abstract Background: Despite consistent efforts to enhance child nutrition, poor nutritional status of children continues to be a major public health problem in Nepal. This study identified the predictors of severe acute malnutrition (SAM) among children aged 6-59 months in the two districts of Nepal. Methods: We used data from a cross-sectional study conducted among 6 to 59 months children admitted to the Outpatient Therapeutic Care Centres (OTCC). The nutritional status of children was assessed using mid-upper arm circumference (MUAC) measurement. To determine which variables predict the occurrence of SAM, adjusted odds ratio was computed using multivariate logistic regression and p-value <0.05 was considered as significant. Results: Out of 398 children, 5.8 percent were severely malnourished and the higher percentage of female children were malnourished. Multivariate analysis showed that severe acute malnutrition was significantly associated with family size (five or more members) (Adjusted Odds Ratio [AOR]: 3.96; 95% Confidence Interval [CI]: 1.23 - 12.71). Children from severely food insecure households (AOR: 4.04; 95% CI: 1.88-10.53) were four times more likely to be severely malnourished. Higher odds of SAM were found among younger age-group (AOR: 12.10; 95% CI: 2.06 - 71.09) children (0 - 12 vs. 24 - 59 months). . Conclusions: The findings of this study indicated that household size, household food access, and the child’s age were the major predictors of severe acute malnutrition. Engaging poor families in kitchen gardening to ensure household food access and nutritious diet to the children, along with health education and promotion to the mothers of young children are therefore recommended to reduce child undernutrition.


2019 ◽  
Vol 6 (4) ◽  
pp. 1410
Author(s):  
Dhara Patel ◽  
Nisha Upadhyay

Background: It is very difficult to recognize the cases with mild-to-moderate malnutrition because clinical criteria for their diagnosis are imprecise and are difficult to interpret accurately. The objective of the study was daily weight gain in gram/kg/day in severely malnourished children.Methods: This was a hospital based cross sectional study in which total of 114 consecutive patients of SAM less than 5 years treated for complications of severe acute malnutrition using WHO protocol. The study design included 114 children from the NRC and then followed up the period of 6 months to assess the nutritional status during the period of initial stage and the entire follow up period using available record of anthropometry indicators of the admitted children recruited in the study at the NRC.Results: Mean weight at admission was 6.4 Kg, 6.5 Kg and 6.2 Kg of overall, boys and girls respectively. Mean weight at discharge was 6.8 Kg, 6.7 Kg and 6.6 Kg of overall, boys and girls respectively. Mean MUAC at admission was 10.7 cm, 10.9 cm and 10.6 cm of overall, boys and girls respectively. Mean MUAC at discharge was 10.9 cm, 10.9 cm and 10.8 cm of overall, boys and girls respectively.Conclusions: For treatment of severe acute malnutrition, systematic guidelines required, thus this study indicates that following WHO guidelines, it has become easier to manage SAM in hospital settings, with least possible stay at hospital. The objective of the study was to know the effect of nutritional intervention measures on selected anthropometric indicators of severe acute malnourished children.


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